HUNDREDS of thousands more Brits could be offered weight loss jabs on the NHS in the biggest shake up of diabetes care in a decade – as the health service prepares to ease rules around prescriptions.
Under new proposed guidance, people with type 2 diabetes in England would be given Ozempic and new diabetes drugs sooner, rather than keeping them for later stages of treatment.
Diabetes patients could be offered GLP-1s earlier in their treatment[/caption]
Draft guidance from the National Institute for Health and Care Excellence (NICE) stated that the NHS should rethink its one-size-fits-all approach of starting everyone on the same medication.
Instead, it should offer patients more personalised care to prevent complications like heart failure and heart attacks.
Officials estimate the changes could save almost 22,000 lives.
Prof Jonathan Benger, the deputy chief executive and chief medical officer at NICE, said they would mean “more people will be offered medicines where it is right to do so”.
Under the guidance, doctors would be encouraged to prescribe GLP-1 receptor agonists such as liraglutide or semaglutide to diabetes patients who also have heart disease or obesity.
Semaglutide, sold under the brand name Ozempic, is licensed in the UK to treat type 2 diabetes, while its other brand – Wegovy – is used to help obese people lose weight.
Patients would be offered the drugs – which have also been shown to boost heart health – at diagnosis, rather than trying out other medications first.
Around 754,000 patients with cardiovascular disease (CVD) or early-onset diabetes could benefit from the proposed changes on weight loss drug prescriptions, NICE said.
The guidance says the jabs should be considered in diabetes patients who have also been diagnosed with heart disease, heart failure, or have early onset type 2, which means they were diagnosed before age 40.
People with both diabetes and obesity – a body mass index (BMI) over 35 – will also be able to get the jabs if they have not had success in bringing down their blood sugar levels within the first three months of using another drug.
NICE also called for making newer type 2 diabetes drugs, known as SGLT-2 inhibitors, a first-line treatment option for patients.
SGLT-2 inhibitors, which include canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin, are once-a-day tablets that reduce blood sugar levels by helping the kidneys remove glucose, which is passed from the body through urine.
However, analysis by NICE found these drugs are under-prescribed, particularly to women, older people, and black patients.
Prof Benger said: “The evidence from our analysis is clear. There are prescribing gaps that need to be addressed.
“The guideline update published today will help to increase equitable uptake of SGLT-2 inhibitors, which we know can prevent serious health complications.”
The new guidelines recommend patients who can’t tolerate metformin – the first-choice in type 2 diabetes medication – should start with an SGLT-2 inhibitor on its own.
The decision comes after evidence suggested these drugs protect the heart and kidneys as well as controlling blood sugar, NICE said.
Around 2.3 million people with type 2 diabetes are thought to be eligible for SGLT2’s.
Wegovy vs Ozempic – what’s the difference?
Ozempic is often used as a catch-all term for weight loss drugs, but the drug – whose active ingredient is semaglutide – is actually prescribed to treat type 2 diabetes and has the added benefit of making users lose weight.
Its manufacturer Novo Nordisk later released a higher dose of semaglutide under the brand name Wegovy to treat obesity.
Using Ozempic for weight loss would mean you’re using it ‘off label’ and not for its intended purpose.
Not only could that be dangerous to you, it could also mean you’re depriving diabetes patients from vital medication.
Wegovy and Ozempic are in a class of drugs called glucagon-like peptide-1 receptor agonists (GLP-1 RA).
They work by mimicking the GLP-1 hormone produced naturally by your gut when you eat food, which signals to the brain that you’re full and prevents you from overeating
Prof Benger added: “This guidance means more people will be offered medicines where it is right to do so to reduce their future risk of ill health.
“This represents a significant evolution in how we approach type 2 diabetes treatment.
“We’re moving beyond simply managing blood sugar to taking a holistic view of a person’s health, particularly their cardiovascular and kidney health.
“The evidence shows that certain medicines can provide important cardiovascular benefits, and by recommending them as part of initial treatment, we could help prevent heart attacks, strokes and other serious complications before they occur.
“This is particularly important given that cardiovascular disease is the leading cause of death in people with type 2 diabetes.”
Around 4.6 million people in the UK are living with diabetes, with nine in 10 of those having type 2.
However, it is estimated that a further 1.3 million people may have undiagnosed type 2 diabetes.
The proposed changes won’t be instituted just yet, as a public consultation on the NICE guidelines is open until October 2.
Douglas Twenefour, head of clinical at Diabetes UK, said: “This long-awaited announcement propels type 2 diabetes treatment into the 21st century.
“Boosting access to newer treatments will be transformative for people with type 2 diabetes, while ensuring the UK keeps pace with the global momentum in treating the condition.
The 7 fat jab mistakes stopping you losing weight
WHILE weight loss jabs have been hailed as a breakthrough in helping tackle Britain’s obesity crisis, some users say they’re missing out on their waist-shrinking powers – and it could be down to some simple mistakes…
POOR PENMANSHIP
Many people don’t correctly use the injection pen, according to Ana Carolina Goncalves, a pharmacist at Pharmica in Holborn, London.
Make sure to prime your weight loss pen correctly, as per the instructions. If nothing comes out, try again, and if it still doesn’t work, switch the needle or ask a pharmacist for help.
It’s also recommended to rotate injection sites between the abdomen, thigh and upper arm to avoid small lumps of fat under the skin.
TIME IS OF THE ESSENCE
Make sure you’re using the jabs on the most effective day of your schedule.
For example, taking the jab right before a takeaway or party won’t stop you from indulging, says Jason Murphy, head of pharmacy and weight loss expert at Chemist4U.
Weight loss injections need time to build up in your system, so if you’re planning for a heavier weekend, inject your dose mid-week.
MAKING A MEAL OF IT
You may not feel the urge to overeat at mealtimes due to the jabs. But skipping meals altogether can backfire, says Dr David Huang, director of clinical innovation at weight loss service Voy.
If a person is extremely malnourished, their body goes into emergency conservation mode, where their metabolism slows down.
FOOD FOR THOUGHT
A key mistake using weight loss jabs is not eating the right foods.
As well as cutting out sugary drinks and alcohol, Dr Vishal Aggarwal, Healthium Clinics recommends focusing on your protein intake.
DE-HYDRATION STATIONS
Dehydration is a common side effect of weight loss injections. But it’s important to say hydrated in order for your body to function properly.
Dr Crystal Wyllie, GP at Asda Online Doctor, says hydration supports metabolism, digestion, and can reduce side effects like headaches, nausea and constipation.
MOVE IT, MOVE IT
It can be easy to see the jabs as a quick fix, but stopping exercising altogether is a mistake, says Mital Thakrar, a pharmacist from Well Pharmacy.
Exercise helps maintain muscle mass and help shape the body as you lose weight, which may be crucial if you’re experiencing excess skin.
QUIT IT
While there’s the tendency to ditch the jabs as soon as you reach your desired weight, stopping them too soon can cause rapid regain.
Mr Thakrar recommends building habits like healthier eating during treatment for sustaining results.
“The majority of people with type 2 diabetes are not currently taking the most effective medication for them, putting them at risk of devastating diabetes-related complications.
“Diabetes is a leading cause of cardiovascular disease, and tailoring treatment based on individual risk could protect thousands against heart attacks and kidney disease.
“These guidelines could go a long way to easing the burden of living with this relentless condition, as well as helping to address inequities in type 2 diabetes treatments and outcomes.”
Earlier this month, drug maker Eli Lilly would hike up the price of its weight loss jab Mounjaro from September 1, meaning the price of the drug in UK private clinics will almost double.
Patients have been scrambling to get their hands on the jabs before the price rise comes into force, while others are considering switching to the competitor Wegovy – after its maker Novo Nordisk said it wouldn’t be raising prices.
Meanwhile, it was revealed that some patients taking Mounjaro privately may be able to get NHS prescriptions for it, as long as they meet key criteria.