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Doctor wants to stop my mounjaro - what are the official guidelines?

C

ch.83

Member
Messages
8
Type of diabetes
Type 2
Treatment type
Non-insulin injectable medication (incretin mimetics)
I have been on mounjaro for diabetes since April 2024.

I am not on any other medication.

My hba1c was 68 when I started. It is now 38.

Everything is going great.

Last night I received a call from my doctors surgery to say they are going to stop my mounjaro because my hba1c is normal.

My hba1c is only normal because of the mounjaro. Why can’t they see this?

What are the official UK guidelines for stopping mounjaro for this reason?

They wouldn’t take you off metformin, or off statins or blood pressure tablets, so I am very shocked they want to stop my mounjaro.

Thank you.
 
Hi,

Welcome to the forum.

With regards to other meds & NHS policy.
My father was pulled off metfomin when his A1c came down.
& last year my mum had her statin tabs stopped assumedly due to cholesterol reduction?

Well done on your A1c reduction..
 
My metformin was stopped when my HbA1c was below 48 and metformin is a very cheap drug.

I guess mounjaro is for diabetics and with an HbA1c of 38 you are no longer diabetic. Well done on achieving this.
 
Did your blood sugar not go up?
 

Overview | Tirzepatide for managing overweight and obesity | Guidance | NICE

www.nice.org.uk

This is a link to the NICE guidelines for tirzepatide/mounjaro. It is approved as a weight management drug, rather than blood glucose reduction.

Tirzepatide (Mounjaro, Eli Lilly) is indicated for 'weight management, including weight loss and weight maintenance, as an adjunct to a reduced-calorie diet and increased physical activity in adults with an initial Body Mass Index (BMI) of:

  • ≥30 kg/m2 (obesity) or
  • ≥27 kg/m2 to <30 kg/m2 (overweight) in the presence of at least one weight-related comorbid condition (e.g., hypertension, dyslipidaemia, obstructive sleep apnoea, cardiovascular disease, prediabetes, or type 2 diabetes mellitus)'.

 
There are also NICE guidelines for T2 diabetes treatment too.
 
ch.83 said:
There are also NICE guidelines for T2 diabetes treatment too.
Click to expand...
There are.

Recommendations | Type 2 diabetes in adults: management | Guidance | NICE

www.nice.org.uk

You would want to look at 1.7.21 specifically for mention of GLP-1s. There are also a set of draft guidelines currently out for consultation. There's threads on these already. -

Thread 'Draft NICE Guidelines on management of Type 2 Diabetes in Adults'

NICE has today published its revised draft T2 guidelines for consultation. You may have read about this already - most of the media seems to be obsessed with "weight-loss jabs".

If you want to read the document itself, you can find it here:


Details of how to respond to the consultation can be found on the NICE website.

I've not read this yet myself....
 
I take Rybelsus (oral semaglutide) another GLP 1 med. At my review in May I was asked if I wanted to come off it and like you my attitude is why when it helps me maintain non diabetic HbA1cs and a healthy weight. I said I wanted to stay on it and was allowed. I’m sorry your GP isn’t so willing to do the same for you. I wonder if your GP has heard about the shortages of Mounjaro and it has swayed his opinion?

Patients struggle to get weight loss drug ahead of price rise

The drug's US manufacturer has asked UK distributors to stop taking orders from pharmacies until next month's price increase.
www.bbc.co.uk
 
I’ve run into something similar with my GP, and it seems to come down to the NHS rules around these newer meds being pretty rigid. A lot of practices will only prescribe Mounjaro if your HbA1c is above a set level, and once you’re in range they feel obliged to stop it, even though, like in your case, the numbers are only normal "because" of the treatment. When I queried it, my doctor explained they were following local prescribing guidance rather than making a personal judgment. It might be worth asking them directly if it’s NICE guidance or just a local funding rule, and if there’s scope to be referred to an endocrinologist. I agree it feels different from something like metformin or statins, where nobody would suggest coming off just because your readings are good.
 
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Hey - can I ask what your outcome on this has been? I've found myself in a very similar position and I'm worried that my HbA1c will simply go back up again. It seems so short-sighted.
 
I have lodged a complaint and it’s been escalated to a diabetic specialist. I hope you have some success too.
 
ch.83 said:
I have lodged a complaint and it’s been escalated to a diabetic specialist. I hope you have some success too.
Click to expand...
So I just had a text from my GP saying they are reducing it down to 5mg while I wait for a referral to a consultant diabetologist.
 
Ahh I’ve heard people are being put on a maintenance dose of 5mg which controls sugars apparently. I’d be more than happy with that rather than coming off completely.
 
I’m on GLP1’s although privately and got chucked off Metformin 6 months ago when I also got 38 mmol. It has now been 38 twice (despite ending up in hospital close to sepsis) and it is like banging my head against a brick wall that all I’ve done is swap wegovy/Mounjaro for metformin.

I’m due to see the diabetic nurse Tuesday and will definitely be bringing it up.
 
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