WWYD? - GP response to Mounjaro

[wanttoimprovemyhealth]

I have type 2 diabetes, high blood pressure and am overweight. Life has been stressful over the past few years and i have let my health slide (all my fault- focusing on other things). I know I need to get a grip.

Since January I have been watching what I eat and am trying to sort out my medication. I am also interested in trying Mounjaro, paying privately (I can't afford to take time off work to attend lots of NHS appointments). As a diabetic I thought I should check with my GP first. Have been trying to get an appointment for weeks- finally got one today and she said she doesn't know anything about Mounjaro, the side effects and as such said I should not try it. She said she would normally advise me to speak to the pharmacist to find out about counter indications etc but they are on maternity leave.

I feel quite deflated my her response. I have read lots of reviews and it seems that it could potentially be very beneficial for someone in my circumstances. Unfortunately there are no other GPs available to speak to in the practice for another opinion and she also runs the other local NHS practice. Just not sure where to go from here. Wondered if anyone else had experienced anything similar with their GP and what they did? Thank you.

@ThePure how do you know that GPs are being bombarded with requests, both polite and rude, for weight loss injections? Is it from personal experience or have you seen a report about this?

I'm with Bolt pharmacy and they are very helpful. You could ask them for a phone call or describe your situation on the application form.

If I were you I would read Diabetes Code by Jason Fung, realise that type 2 is a reversible illness and reverse it. If you want a UK perspective look at David Unwin, a NHS GP, talking at the Public Health Collaboration.
YouTube talk "Dr David Unwin - Low carb diets: What predicts drug free T2D remission and how best to maintain it?"

Thank you very much for sharing OP as a a now ‘non diabetic’ I wonder in the long term what is going to happen - I recently tried along with my Mum to bring up about the long-termness of the injections and the answer from the diabetic nurse was to tell us we couldn’t get away from food could we and something about people being addicted to food and when working from home there is no self control - only afters I thought I should have said so are you trying to say you’d really give the injections to people with eating problems? wasn’t quick on the thinking there, not that I think our surgery are giving it out so readily.

I’ve definitely come to the conclusion we can’t get it in our area as people have started posting their discount codes on the town’s fbook page.

Fortunately I had a medicine review couple of days later (first time ever) where I repeated what type of injection I’m on and it has now ended up formally recorded. Not that anything should come as a shock as I’ve had two operations in an nhs hospital when I’ve been on the injections where I’ve also mentioned it. I’d be a fool not to. My conscience is very clear, I have no idea why people say it is just a case of asking the doctor nor the justification of people having lifelong entitlement on the nhs.

I understand the argument about if every diabetic got it, it would bankrupt the nhs but it does feel wrong.

I think I get the accu-chek test strips on prescription for the next 6 months at least, which is definitely something.

I suppose I just really wanted advice from my GP re how it may impact with my existing medications/health issues and if it did work I suppose they may need to reduce some of the medication I am currently on.

@wanttoimprovemyhealth any of the online pharmacies that prescribe will be able to answer these questions. Find one with a video consultation or telephone service.

I'm a Dr although not a GP. I have lots of friends who are GPs

I'm sorry that your GP friends are being bombarded with requests for WLI from patients @ThePure , and there's never any call for anyone to be rude to a HCP for any reason, clearly.

As you can see, most people here advise to deal with the pharmacies direct and not to waste a GP's time with an appointment when they can't and shouldn't be discussing a medication they don't know about and can't prescribe. I certainly wouldn't speak to my GP about it, and I haven't had any contact with a GP about anything for years now. Even my reviews for high BP medication are with a pharmacist, not the GP.

OP your mistake was asking your GP to prescribe it for weight loss which they can't do.

They can prescribe it for type 2 diabetes if you meet the criteria. This would be your best route as it would save you a fortune and not be time limited.

But it depends if you meet the prescribing criteria for diabetes. My diabetic friend didn't as she had made so many diet changes.

Think some confusion. GPs can already prescribe for diabetes, lots of folks in this forum getting it, they cannot prescribe for weight loss. The op is diabetic.

Your online pharmacy will ask about existing conditions and current medications and will check for contra indications.

Are you a bit wary of using an online pharmacy? Is that the case?

If so, maybe try one of the household names providing Mounjaro. Boots, ASDA?

Some GPs can prescribe it but in a lot of areas it can only be prescribed by diabetes specialists. Just because it is available on the NHS for people with diabetes doesn’t mean it’s GPs doing the prescribing.

Thank you so much for all your replies. I really appreciate it.

I think I will approach one of the private companies suggested by pp for their opinion.

Just to confirm that I wasn't asking my GP to prescribe it (for diabetes or weight loss). I am happy to pay for it myself. I was just conscious that it might impact on the other conditions that she does prescribe for and thought I should mention it. I have never done anything like this before (bought medication online) , was a bit nervous and respect her opinion. I now appreciate that I shouldn't have done that.

Mounjaro is prescribed by a doctor who will know whether it’s safe with your existing medication far better than your GP will.

My husband is T2 and has been on Rhybelsus for a while now, prescribed by the doctor as oart of his diabetes regime. It’s been great for his blood sugar, when combined with his other meds, but he’s also lost about 3 stone and is almost at a healthy weight.

No, you did the right thing. Your gp,is the issue here, not you. This gp should know about mounjaro, it is their job to know, it is prescribed for diabetes and lots of patients will be taking it, it’s like saying I don’t know anything about alcohol, so I won’t treat you for alcoholism or being addicted to heroin. Or I’m celibate so can’t discuss the morning after pill. The gp was in the wrong.

snd they aren’t alone. Many gp’s do this, I suspect it’s because they are sick of being asked, and don’t want the additional work. But that’s no excuse for their behaviour, you are still their patient. They still have a responsibility to you and still have to treat your other issues, they have been told quite clearly to review patients on these drugs, and ensure it is appropriate. I personally watched, as did millions of others, when even starmer made that announcement.

gp’s don’t have the option of saying I don’t know so don’t take it. Their job is to know.

personally I’d complain to the practive manager. I’d point out firmly that gp;s have a responsibility, that their job is to know, and they have to review for suitability.

It seems very sensible to talk to your GP about this before taking the step. If being asked for advice makes GPs feel like they are being ’bombarded with requests’, that’s their often incredibly poor communication skills again.

They can but it is stage 3 treatment after following weight management. Oral semaglutude is prescribed first. It also has weight loss benefits. @wanttoimprovemyhealth doesn't seem to have done any of that.

Add to that not all health authories DO prescribe it for diabetes and many have a two year waiting list.

@wanttoimprovemyhealth if your practice doesn't even have a diabetic clinic they are highly unlikely to prescribe it. They also wouldn't be encouraging you to go private.

i get mine from my local independent pharmacy. I meet someone in person and they are qualified to prescribe and discuss your medical history and what other drugs you are on. They won’t prescribe if it’s not safe.

I’m fully aware it is tier 3 for weight loss. I was very clear I was talking about the nhs guidelines is they are able to prescribe for diabetes. As such doctors should know these drugs, but not just that, they are being told to review eligibility and pharmacies have to inform gp’s . If gp’s don’t know anything about the drug, how the heck can they say if someone isn’t suitable to a pharmacy?

@Queenofthejabs it doesn't mean Mounjaro can only be prescribed by a Tier 3 weightloss service. PP refers to prescribing for diabetes.

For type 2 diabetes it can only be prescribed if you are already on 3 therapies for you diabetes and still don't have adequate diabetes control, with a BMI>35 (less if you have complications of weight gain)

One of those drugs can then be switched to Mounjaro but if you don't have a significant weight loss AND improvement in HbA1C it will be stopped after 6 months.

Most type 2 diabetics aren't on triple therapy but some definitely are.

Well, I am a bit surprised that some GPs don't want to talk about it or haven't learned anything about it. My NHS GP was very happy to tell me what he thought, which was that I would probably do very well on it and he wished that he could just prescribe it for me instead of recommending I went private.

This, just order from a reputable pharmacy and be done with it if you want to take it

I’m on it for my diabetes - I spoke to the diabetes nurse and told her that metformin had debilitating side effects and I wanted to go on an injection so she put me on it. Once you have that conversation with them it’s really easy, I didn’t have appointments or waiting lists to contend with.

try the nhs again

You cannot just start Monjauro as you’re already on medication for you diabetes! Common sense should tell you that, it has the potential to mess your blood sugar levels up big time. I don’t know any diabetic that is solely managed by their GP. I suggest asking to be referred to a specialist diabetic service who will be able to support you if they think Mounjaro is a good option for you. But be prepared to be told it may not be, there are loads of contraindications to these medications!