Type 2 Diabetes: Availability of Drugs

I beg to move,

That this House has considered the availability of drugs to treat type 2 diabetes.

It is a pleasure to serve under your chairmanship, Mr Pritchard.

I am grateful for the opportunity to speak about what is a vital and, I think, under-recognised issue. I wish I did not have to, and that all the necessary medicines were available for all of the serious, life-changing conditions we face, but the reality at the moment is that they are not. Specifically, I would like to talk about type 2 diabetes, which is more common than type 1 and can go undiagnosed for years.

To be clear about what we are talking about, if someone’s body does not make enough insulin or what it makes does not work properly, the result is high blood sugar levels—type 2 diabetes. If untreated, that increases the risks of serious problems with their eyes, feet, heart and nervous system. High blood sugar levels can cause serious complications, potentially at great cost to individuals, but also to the national health service. The reality is that any of us can develop type 2 diabetes, but it mostly affects people over 25, and often those who have a family history of it.

What about treatment and medication? We know there is currently no cure, but we also know that type 2 diabetes can be put into remission by losing weight. We all know that eating well and exercising are the key to a healthy lifestyle, and that is never truer than with preventing and reversing the onset of type 2 diabetes.

I commend the hon. Lady for bringing the debate forward. I am a type 2 diabetic—I declare an interest as such—and when I was diagnosed some 13 or 14 years ago, I went on a weight loss course right away. The doctor told me, “You lose weight!” I lost about 4 stone, and I have kept it off, but that did not stop the diabetes in its entirety. I still have it, and I still have to be very careful about what I eat.

The point I want to make is that there are recent indications that certain diabetes treatments can also be successful for weight loss, but weight loss is really important at least for the first stage of diabetes, and priority for such treatments must be given to those with type 2 diabetes before, with respect, those who are finding success with them for weight loss. How can the Minister and our Government encourage such guidelines to be firmly set in place?

I thank the hon. Member for that intervention, because that point is at the heart of the matter. We have to ensure that the supply of drugs, which is short at the moment, is prioritised for those who need them for important health reasons.

A healthy weight, as the hon. Member said, and keeping active make it easier for someone’s body to manage their blood sugar levels and help prevent insulin resistance, which can lead to type 2 diabetes. Research has shown that, for some people, a combination of lifestyle changes can reduce the risk of type 2 diabetes by about 50%, but sufferers may also need to take diabetes medication such as metformin and insulin, as well as making changes to their lifestyle.

In the UK, 4.6 million people have type 2 diabetes and around 13.6 million are at risk of developing it. People often need help, such as intervention and medicines. Last year, I called on the UK Government to take action on the shortage of medicines for type 2 diabetes patients, after a constituent came to me concerned that her treatment and her health would be impacted by a shortage of the diabetes drugs she needed. They are known as GLP-1 RAs—glucagon-like peptide-1 receptor agonists—and include one of the most common drugs, semaglutide.

As for many other manufactured drugs, there is currently a supply problem with semaglutide. In this case, the problem has been made worse, as the hon. Member for Strangford (Jim Shannon) said, by the fact that the same drugs are effective for weight loss. The very thing that semaglutide does to help diabetes patients is making it difficult for them to access it.

I wrote to the Scottish Government, who told me they did not expect the supply to return to normal until mid-way through this year. I appreciate that that is not the most helpful response, but in some ways it is understandable, because medicine supply and licensing is a reserved matter. That is why I am raising it with the UK Government. We have seen issues with drug shortages beyond diabetes, and that is why I am so concerned at the slow response to the lack of medication.

Does the hon. Lady recognise that this is not just about access to drugs for type 2 diabetics, but about access to medical equipment, such as the LibreView glucose monitoring sensors that have changed people’s lives? Does she agree that, because the incidence of type 2 diabetes is closely related to areas of social deprivation, where the finance is not available, the NHS should look to give those sensors to as many people living with type 2 diabetes as possible? That would save a fortune in the future, and it would reduce harm to lots of people who are currently suffering greatly because of diabetes.

The hon. Gentleman makes an excellent point, and I completely agree.

Type 2 diabetes is a problem in itself, with the lack of medication, but it is also an illustration of a major problem that our health services are facing with growing costs. We should be looking at how we prevent the problem in the first place, both in areas of social deprivation and in society generally. We should be looking at how we help people to avoid the problems that come with conditions such as type 2 diabetes. If we fail in that, people will fall into the situation where they are living with diabetes—a condition that requires 24/7 self-management to stay healthy. I invite Members to imagine living with a condition that they have to manage every day—a condition that has the power to affect them at any moment, disrupting what they are doing and altering their day to day life—when they have done all they can to stop that happening. Now consider how the lack of a medication that we have organisations and administrations responsible for providing makes that situation worse.

A couple of years ago, as part of a campaign by Diabetes UK, I tried to live life as if I had diabetes, and I have to say that I failed dismally. I realised just how difficult it is, and I realised that people living with diabetes —type 1 or type 2—deserve much better than they are getting at the moment. To be turned away at the GP surgery or pharmacy through no fault of the practitioner and to be told, “You might have to wait 18 months for what has been helping you get on top of the condition”, is simply unacceptable.

I know some people who have been left waiting since 2023. Shortages have been linked to those without diabetes using the drugs, as the hon. Member for Strangford mentioned, simply for weight-loss purposes. Drugs such as Ozempic are being sold online for nearly £200—a 1,765% increase on the cost of what they would be on an NHS prescription.

It is a pleasure to see you in the Chair, Mr Pritchard. I thank the hon. Member for Edinburgh West (Christine Jardine) for raising such an important issue. I want to begin by emphasising that I understand that medicine supply issues are a significant cause of frustration for many of our constituents across the United Kingdom. I also recognise that there have been particular challenges recently with certain medicines. Without diminishing those challenges, it is important that we set them in context.

There are around 1,400 medicines licensed in the UK, most of which are in good supply.[Official Report, 1 February 2024, Vol. 744, c. 14MC.] The Department is regularly notified of supply issues; thankfully, the vast majority of those can be managed with minimal impact on patients. The medicine supply chain is highly regulated, complex and global, meaning that there can sometimes be supply issues that affect the UK, along with other countries around the world.

There are a number of reasons why a limited number of medicines might be subject to a disruption in supply, such as manufacturing difficulties, regulatory non-compliance, access to raw materials or distribution problems. We cannot always prevent supply issues occurring, but where they do the Department has a range of well-established processes to manage them and help mitigate the risk to patients.

Where there are concerns about supply, they largely, although not exclusively, concern medication to treat the most common conditions. That is exactly the case with what we are talking about today—diabetes—a condition experienced by more than 4.9 million people across the UK. Action on diabetes will be included in the major conditions strategy, as it is an important risk factor for cardiovascular disease. If someone has diabetes, they are twice as likely to have heart disease or a stroke than someone who does not have diabetes, which goes to the heart of what the hon. Member for Edinburgh West said about the importance of ensuring diabetics get their medication.

I thank the Minister for his comprehensive and helpful response. Some years ago, when I first came to Parliament there was a diabetes strategy for the whole of the United Kingdom of Great Britain and Northern Ireland. If the Minister could look at it, I think a renewal of that particular strategy would help. It was agreed here at Westminster, but took in all the regions of Scotland, Wales and Northern Ireland. It was a marvellous objective to address diabetes and it seemed to work. I would like to see it happen again.

The hon. Member makes an important and powerful point, as usual. As he knows, I am a proud Unionist and am keen for us to do as much as we can in collaboration. I recognise that health is a largely devolved matter. However, since I joined the Department of Health and Social Care in October, I have visited Northern Ireland, Scotland and Wales, I have talked about how we can collaborate more closely on things such as research and innovation, and I am sure that we can do more together where the devolved Governments agree. Last night we had encouraging news. Hopefully we will have power-sharing arrangements back in place in Northern Ireland so that we can work together collaboratively to deliver those benefits for patients.

I will finish the point I was making about the major conditions strategy. That strategy aims primarily to improve care and health outcomes for those living with multiple conditions, and it will be centred on prevention. We have heard from a wide range of stakeholders, whose views are informing the development of the strategy. I will meet Diabetes UK this week to continue that engagement.

With regards to the availability of drugs to treat type 2 diabetes, as the hon. Member for Edinburgh West set out, there has been a significant global supply issue affecting glucagon-like peptide-1 receptor agonists—GLP-1RAs—with the shortages driven by an increase in demand for such products for licensed and off-label indications, meaning that the medicine is being used for a different use from that stated on its licence.

I will set out the steps we have taken to manage those issues. We have continued to work with suppliers to take action to resolve the issues as quickly as possible, including expediting deliveries and boosting supplies. In July last year, we issued guidance for healthcare professionals, which took the form of a national patient safety alert on how to manage patients during the supply disruption. Clinicians and prescribers were directed not to initiate new patients on these medicines, which were to be used only to treat their licensed indication, protecting supplies for diabetic patients. Guidance was supported and echoed in a statement issued by the professional regulators.

I think the hon. Members for Edinburgh West (Christine Jardine) and for Wansbeck (Ian Lavery) and I would be interested know about the other option—if I caught you right, Minister—that you mentioned, which is in the form of an injection but is not insulin. Just so we know, is it a different system?

Sorry, was the hon. Gentleman asking about the approval of the new drug, Mounjaro, which I just mentioned?

Yes, I am trying to understand, because I am not aware of it, and neither are the hon. Lady or the hon. Gentleman. It is not insulin for type 2, is it? The Minister mentioned an injection system.

It is an injectable medicine for adults with type 2 diabetes. It was recently approved by the MHRA. To put a little bit of extra information out there, the National Institute for Health and Care Excellence recommended Mounjaro, the same drug, for the treatment of patients with type 2 diabetes who meet specific criteria. The NHS in England is therefore now legally required, in line with NICE recommendations, to fund its use for eligible patients. The availability of that new medicine in Scotland is, however, a matter for the devolved Administration. The Scottish Medicines Consortium, which makes decisions on the use of medicines in Scotland, has not yet published guidance on Mounjaro. It will be a matter for the SMC as to whether that becomes an option in Scotland.

As I was saying, Mr Pritchard, unfortunately we expect supply chain issues to continue for the rest of the year. Throughout the management of this issue, our guidance has been supported by additional advice issued in Scotland, Wales and Northern Ireland, which has, critically, reinforced the messaging provided by the national patient safety alerts.

Does the Minister understand and recognise the benefits of glucose monitoring centres? It is not a supply chain issue, but an access issue. They can and do change people’s lives, but they are not widely accessible. People are very much unaware that they actually exist. If they did and understood that the centres were available from the NHS, it would save the NHS millions if not billions of pounds. It would change the lives of many people, mainly in deprived areas. Can the Minister give a commitment to look at that and see how we can allow more people to access glucose monitoring systems?

I hear what the hon. Gentleman says and I am more than happy to look at the issue. However, I believe—I may be mistaken—that he is suggesting something that we would routinely advise for type 1 diabetics to be provided to type 2 diabetics. As far as I am aware, the clinical advice does not suggest that we do that, but I am more than happy to look at the issue, because I want to ensure that we support people living with diabetes as much as we can.

Finally, I emphasise that our guidance remains clear that medicines licensed for the treatment of type 2 diabetes should be used only for that purpose. All prescribers, whether employed privately or by the NHS, are expected to take into account the appropriate national guidance. Unfortunately, the supply disruption is a common issue for the UK and other countries around the world, which is both frustrating and distressing for patients. We cannot always prevent supply issues from occurring, but where they do arise, the Department has a range of well-established processes and tools to manage them and to help mitigate the risk to patients. Addressing issues with GLP-1 RAs continues to be a priority for the Department. We will continue to work hard with industry to resolve the issues as quickly as possible. Once again, I am grateful to the hon. Member for Edinburgh West for raising such an important issue.