There has been a shortage of Ozempic (semaglutide) in pharmacies for the past few months, as manufacturer Novo Nordisk has been struggling to meet the increasing demand. This injectable drug was initially developed to help control blood sugar in people with type 2 diabetes (T2D), but it has become too popular due to one of its side effects: weight loss.

The shortage, which was expected to end in October 2023, will continue at least until April 2024. This is causing a lot of stress and complications for people using Ozempic, including certain people with type 1 diabetes (T1D). According to the BETTER registry, close to 5% of people with T1D report using Ozempic as part of their treatment.

Other drugs in the same family that could temporarily replace Ozempic are also more difficult to find. Shortages are expected for Trucility (dulaglutide), Victoza (liraglutide) and Mounjaro (tirzepatide), which are increasingly popular for treating diabetes and obesity.

Ozempic and T1D

Just like Trucility, Victoza and Mounjaro, Ozempic is not currently indicated for treating T1D, but some studies support the use of these drugs in addition to insulin, in particular to improve blood sugar management and to support weight control in certain people.

This class of medications – called GLP-1 (glucagon-like peptide-1) receptor agonists – improves glycemic balance in different ways. First, it stimulates insulin secretion.However, this mechanism is ineffective in people with T1D, whose pancreas can no longer produce insulin. However, recent studies hint at the potential of semaglutide (the active ingredient in Ozempic) to delay the start of insulin treatment following diagnosis.

These medications also help to reduce levels of glucagon (the hormone naturally produced by the body to increase blood sugar), slow down stomach emptying (which can contribute to limiting blood sugar peaks after meals) and decrease the feeling of hunger. People who use this type of treatment feel full more quickly, which can also help to control post-prandial blood sugar. These effects explain in large part the weight loss that is associated with these treatments.

Strategies to use until the shortage is resolved

If you’re currently using Ozempic, talk to your pharmacist or healthcare team about the best strategy for you.

For example, if you use the 1 mg Ozempic pen, your doctor could replace it with a 0.5 mg pen that you will use twice daily to get a 1 mg dose. Note that access to these lower-dose pens is also becoming more difficult due to supply problems.

Depending on their inventory, your pharmacist could also suggest that you replace Ozempic with Trucility or Mounjaro (once-weekly injection) or Victoza (once-daily injection).

In some cases, and depending on availability in your area, your doctor or pharmacist could recommend that you lower or space out your doses of Ozempic, use an alternative treatment, or even suspend the treatment temporarily.

Regardless of the strategy that will be suggested to you, it will be important to monitor your blood sugar closely. An interruption in this type of treatment can lead to an increase in your blood sugar and appetite. You may need to consider adjusting your insulin doses. Don’t hesitate to ask your healthcare team for help to deal with this situation.

     

References :

Diabète Québec. (2023). Shortage of GLP-1 receptor agonists and related drugs (Ozempic, Trucility, Victoza, Mounjaro). Press release from the Conseil professionnel de Diabète Québec, consulted on November 30th, 2023 . https://www.diabete.qc.ca/actualites/avis-penurie-dozempic/

Gouvernment of Canada. The supply and use of Ozempic. Page consulted on November 21st, 2023. https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-shortages/information-consumers/supply-notices/ozempic.html

Canadian Pharmacists Association. Ozempic and other GLP-1 agonists supply. Page consulted on November 21st, 2023. https://www.pharmacists.ca/advocacy/issues/drug-shortages/ozempic-supply/?lang=en. 

Eli Lilly. Trucility, dulaglutide injectable. Page consulted on November 21st, 2023. [in French] https://pi.lilly.com/ca/fr/trulicity-ca-pmi-fr.pdf

Novo Nordisk. Victoza, liraglutide injectable. Page consulted on Novembre 21st, 2023. [in French] https://caf.novonordisk.ca/content/dam/nncorp/ca/fr/products/victoza-consumer-information.pdf


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Written by: Nathalie Kinnard, scientific writer and research assistant

Reviewed by:

  • Sarah Haag, RN. BSc.
  • Rémi Rabasa-Lhoret, M. D., Ph. D.