6.3.1.4 Glucagon-like peptide-1 receptor agonists

SUPPLY ISSUE: There are currently very limited, intermittent supplies of all glucagon-like peptide-1 receptor agonists (GLP-1 RAs). This is likely to be until at least mid-2024. Please see here (free SPS subscription required) for further information, actions and advice on alternatives.

Do not initiate new patients on GLP-1 RAs until full supplies become available.

Please prescribe for licensed indications only, prescribe by brand, and check quantity prescribed (do not prescribe in quantities greater than one month).

Kent and Medway ICB Position Statement on Wegovy and GLP-1 RAs

Wegovy (Semaglutide) for managing overweight and obesity is only available via Tier 3 services within Kent and Medway. Only commissioned obesity services are able to undertake the appropriate level of service.

TA875

GLP1 mimetics should be initiated by clinicians who have received appropriate training (eg PITSTOP training). Adequate training on the use of the injectables and follow up reviews should be provided to patients initiated on GLP-1 mimetics. GLP-1 mimetics across Kent and Medway have a green status so can be initiated in primary, community or secondary care. Where MDT support is also possible (not for all of Kent and Medway) this can be utilised. In primary care Arden’s templates are available in EMIS to support the initiation of GLP-1 mimetics and are encouraged to be used.

Oral Semaglutide has been approved as an option for insufficiently controlled type 2 diabetes, especially where an injectable GLP-1 mimetic may not be preferrable. GLP-1 mimetic would be considered as part of this pathway. Oral semaglutide is not a replacement for injectable GLP-1 mimetics and should still be initiated by a clinician with PITSTOP or equivalent training. It can be prescribed alongside other diabetes medications (apart from DPP-4 inhibitors and other GLP-1 mimetics).

K&M type 2 diabetes guidelines in Adults