Are Patients With Type 2 Diabetes Responsible For The Semaglutide Shortage?

Shortages in supply of semaglutide, approved in various countries (including the US, Canada, UK, and the European Union) for the treatment of type 2 diabetes and obesity, have led to calls to restrict its use to patients with type 2 diabetes (T2DM). 

Indeed, there has been much ado about people using (and misusing) semaglutide “simply” for weight loss, apparently depriving people living with T2DM of this “essential” medication. 

While it makes no sense to pit one disease against another, one could well argue that it is the people living with T2DM who are in fact depriving the folks living with obesity of this “essential” medication. 

For one, there are plenty of treatments available for managing T2DM. Although semaglutide may well be a safe and effective medication for T2DM, there are plenty of other GLP-1 analogues around, not to mention the many other classes of medications approved for T2DM. Thus, were semaglutide to disappear from the market, most people living with T2DM would do just fine with the many alternatives that already exist.. 

This, however, is not the case for obesity! People living with obesity requiring obesity treatment have no alternative that is even remotely as effective as semaglutide, which, for a significant proportion of patients, can result in weight loss comparable only to what can be achieved with bariatric surgery. 

Thus, while there is no discernable unmet need for people with T2DM, the unmet need for those living with obesity is indisputable. Reserving the limited supplies of semaglutide for them should be a priority. 

Obviously, most people living with T2DM are also living with obesity (which highlights the absurdity of pitting one disease against the other), but emphasising the need for people with T2DM while ignoring the much greater need for those living with obesity, to me, reeks of weight bias and discrimination. 

Hopefully, the supply of semaglutide will eventually increase to meet the demand, but perhaps in the meantime those living with T2DM who are not in desperate need of losing weight should help conserve the limited supplies of semaglutide in favour of those living with obesity, who do not have the luxury of switching to an alternative but equally effective treatment. 

Berlin, D

Disclaimer: I have received honoraria as an independent medical, research and/or educational consultant from various companies including Aidhere, Allurion, Boehringer Ingelheim, Currax, Eli-Lilly, Johnson & Johnson, Medscape, MDBriefcase, Novo Nordisk, Oviva and Xenobiosciences.