Type 2 Diabetes: Availability of Drugs

Christine Jardine Excerpts

Tuesday 30th January 2024 Westminster Hall

[Christine Jardine (Edinburgh West) (LD)]

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.

[Jim Shannon (Strangford) (DUP)]

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?

[Christine Jardine]

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.

Patients find themselves stuck between the proverbial rock and a hard place. In Scotland, they have the Scottish Government unable to act, and they perceive the UK Government to be very slow to act. It seems that neither Government have realised how potentially serious this situation could be for patients who use these drugs daily. For a patient to be in a position where they do not know whether they can get what they need to help them get well and keep them healthy is simply not acceptable. I have heard from people in my constituency and beyond about the impact that the situation is having on their lives.

[Ian Lavery (Wansbeck) (Lab)]

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.

[Christine Jardine]

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.

The Association of Independent Multiple Pharmacies has talked of the shortage of medication to treat the likes of epilepsy and attention deficit hyperactivity disorder as well as diabetes, all of them potentially life-changing and life-ending conditions. That is true also of some cancer drugs and hormone replacement therapy. The consequences do not lie just at the door of patients but, as we have heard, at that of the NHS and community pharmacy teams, which are under increased strain.

A national patient safety alert has been issued by NHS England and the Department of Health and Social Care to address supply, but I ask those with the power to consider standing in the shoes of those going through this. People who should have been started on GLP-1s are facing delay or are being put on to less effective options. Let us imagine being told that we had to take less effective medicine for a life-changing condition. If the supply is interrupted, a person potentially has to go through the side effects again and again when being restarted. People have been contacting Diabetes UK regularly since the start of the shortage in early 2023. This is not just about equality or ease of access. For all those affected, it is about quality of life.