GLP-1 agonists are a type of medication you might need to take if you have type 2 diabetes. They are also known as GLP-1 analogues, GLP-1 RAs and incretin mimetics.
These drugs can be prescribed to lower blood sugar levels in people living with type 2 diabetes. They can also be prescribed to support some people with weight loss.
The NHS had been facing supply issues with GLP-1 agonists, meaning that thousands of people could not access them. But stocks were resupplied at the end of December 2024 and this issue has now been reported as resolved.
If you are still having issues getting your GLP-1 medications as prescribed, please contact your healthcare team. Give our helpline a call if you have questions or concerns – call 0345 123 2399.
This medication works by increasing the levels of incretins – hormones – which help the body produce more insulin when needed and lowers blood sugar levels.
Some people lose weight when they take a GLP-1 agonist as part of their type 2 diabetes treatment. This is because these drugs slow down how quickly food is digested and can reduce your appetite, so you eat less.
There are many GLP-1 agonists that can be prescribed as a treatment for type 2 diabetes in the UK, which have a variety of brand names:
Ozempic and Rybelsus are brand names for the drug semaglutide.
Although some GLP-1 medications are given via injection, they are different medications to insulin.
There are also some GLP-1 agonists that can be prescribed to help with weight loss:
Adults over the age of 18 with type 2 diabetes can take GLP-1 agonists.
Children over the age of 10 with type 2 diabetes can take Bydureon.
Guidelines from NICE recommend that GLP-1 agonists can be prescribed to adults with type 2 diabetes when:
GLP-1 agonists are only prescribed when someone has a Body Mass Index, or BMI, of 35kg/m2 or higher, and has additional psychological or other medical conditions that are related to obesity.
However, someone with type 2 diabetes can be prescribed a GLP-1 agonist if they have a BMI below 35kg/m2 and:
NICE recommends – due to their risk from obesity-related health problems at a lower BMI – that people from Black African, African-Caribbean, Asian, South Asian, Chinese, and Middle Eastern backgrounds take a GLP-1 agonist at a lower BMI.
Adults over 18 years might be prescribed a GLP-1 agonist for managing overweight and obesity alongside a reduced-calorie diet and physical activity.
There are two GLP-1 agonists that can be used for managing overweight and obesity. One is called Wegovy and the other is called Saxenda.
Adults with prediabetes or type 2 diabetes can only be prescribed Wegovy and Saxenda within specialist weight management services.
You should only be given a prescription for a GLP-1 agonist following an assessment by your healthcare team to make sure that you meet the criteria and that you’ll benefit from it.
This should be an individual assessment that includes how this medication will fit into your current treatment plan and considers any diet or activity programme that you are following, as well as the risk of side effects, the dose you’ll need, and your personal choices.
It is important that the healthcare professional prescribing your medication is aware of your full medical history, including type of diabetes, and accurate body weight.
Guidance has been produced for pharmacists providing private prescriptions.
Some medications might not be suitable for some people, which might be because of medical conditions or other reasons:
When you start a new medication always check with your healthcare team that it’s suitable for you to take.
Your healthcare team should explain your prescription to you but it's important to make sure you ask if you don't feel you know enough.
And make sure you talk to your GP or your diabetes team if you struggle to take your medication. They might be able to help by giving you a different dose.
In England, if you need to take any medication to manage your diabetes, your prescriptions will be free. Ask your healthcare team about a prescription exemption certificate if you don't have one, to make sure you don't get charged for your medication. Prescriptions are already free for everybody in the rest of the UK, so you shouldn't pay for medication.
Common side effects can include:
This medication does not usually cause blood sugar levels to become too low, also known as hypoglycaemia, or hypos, when taken on their own. But hypos can happen when you take GLP-1 agonists with other diabetes medications such as insulin or a sulphonylurea.
Your healthcare team may advise reducing the dose of your sulphonylurea or insulin medicine when you start taking a GLP-1 to reduce the risk of hypos.
If you have diabetic eye disease, known as diabetic retinopathy, and you’re using insulin, then your retinopathy could get worse when you start using semaglutide, and this might need treatment.
Tell your doctor if you have diabetic eye disease or if you experience eye problems during treatment with semaglutide.
If you take a GLP-1 agonist with insulin and your insulin dose is reduced too quickly it can cause high blood sugar levels, this is also called hyperglycaemia, and there is an increased risk of DKA. Your health care team should discuss with you the signs and symptoms of DKA.
And you should have a plan for when you are unwell, which is also known as sick day rules.
Acute pancreatitis is a condition where the pancreas becomes inflamed (swollen) over a short period of time.
Although uncommon, there have been reports of acute pancreatitis in people taking GLP-1 medications. While it is infrequent, it can be serious. The main symptom is severe pain your stomach that radiates to your back. Other possible symptoms include:
If you experience any of these symptoms, it is very important to get urgent medical help. You should also report side effects via the Medicines and Healthcare products Regulatory Agency (MHRA) Yellow Card Scheme, which is the government system used for recording side effects with medicines in the UK.
The MHRA are now asking for people to report their experiences of taking GLP-1s and being hospitalised with acute pancreatitis, this is so we can learn more about who might be more at risk
You may have heard in the news about a possible increased risk of suicidal thoughts and thoughts of self-harm when taking some GLP-1 agonists.
The European Medicines Agency (EMA) and the American Food and Drugs Administration (FDA) have been investigating this. Their initial investigations have found that there was no evidence that taking these medicines cause suicidal thoughts or actions.
Thoughts and actions can be affected by many things in life so the findings were that the information in these reported events did not demonstrate a clear relationship with the use of GLP-1 agonists. But because of the small number of these events in people using GLP-1 agonists they can’t completely rule out that a small risk may exist so they are continuing to monitor the issue.
If you are taking a GLP-1, you should pay attention to any sudden changes in your mood, behaviours, thoughts and feelings and contact your healthcare team straight away if you are concerned about your mental health, especially if you have any new or worsening symptoms.
If you think these mood changes are a result of taking GLP-1, you should report this to the Yellow Card Scheme. You can report other side effects to the Yellow Card Scheme as well.
These are not all the side effects.
