Diabetes signs and symptoms as weight loss drug gets authorised
A diabetes drug has been authorised to help obese adults with weight loss and management, according to the Medicines and Healthcare products Regulatory Agency (MHRA).
Obese patients and people who are overweight with weight-related health problems like prediabetes (when your blood sugars are higher than usual, putting you at risk of developing type 2 diabetes), high blood pressure, high cholesterol or heart problems, could benefit from Tirzepatide if it receives further approval from the National Institute for Health and Care Excellence (Nice).
The drug – also known as Mounjaro – is to be used together with a reduced-calorie diet and increased physical activity.
It was first approved for NHS use in September by Nice as an option for patients with type 2 diabetes who don't have the condition under control. Semaglutide, or Wegovy, was also launched in the same month to help tackle obesity.
On Mounjaro's use for weight management (used as a pre-filled injection pen), health secretary Steve Barclay says, "Although further approvals are needed to use this in the NHS, Mounjaro has the potential to help thousands of people living with obesity and support those suffering from weight-related illnesses – if used alongside diet and physical activity.
“Tackling obesity could help cut waiting lists and save the NHS billions of pounds."
The drug works by making patients feel full and less hungry and reducing food cravings. The MHRA’s authorisation is based on the results of two clinical trials, which showed that patients who were treated with Tirzepatide "had a significant weight loss over time compared to patients who took a placebo".
The agency has warned it may affect how the contraceptive pill works in obese or overweight females, and lists potential side effects as nausea, diarrhoea, vomiting and constipation. The MHRA said it will keep the safety and effectiveness of Mounjaro under close review.
Other advancements in diabetes come from people opening up about their experiences and raising awareness. In July, James Norton revealed how "proud" he was to have overcome the challenge of managing diabetes while performing in his play, A Little Life.
The Happy Valley star, 38, said he had glucose shots and food hidden on stage to allow him to control his blood sugar levels during the three-and-a-half hour performances.
"Adrenaline affects sugar levels," the actor, who has type 1 diabetes, told BBC. "I can’t leave the stage apart from the interval for three and a hour hours, so I have to find ingenious ways of working out what my sugar levels are doing and then mitigating against going hypoglycaemic, which is a risky low, which would cause me to become disorientated and sweat, and eventually faint.
"If you’d asked me six months ago whether I'd be able to do a three-and-a-half-hour play as a diabetic, I’d have been really scared.
"I’m so proud that I’ve been able to prove to myself and other type 1 diabetics that I’m able to do that."
It's important that just because diabetes is a hidden condition, it doesn't get ignored. So, whether you suspect you might have the condition, have been recently diagnosed, are supporting someone else with it or just want to learn more, here's what you need to know.
What is diabetes?
Diabetes is a lifelong condition that causes a person's blood glucose levels (also called blood sugar) to become too high, according to the NHS. There are two main types, type 1 and type 2, though some can also get gestational diabetes.
Pre-diabetes is when people have blood glucose levels above the normal range, but are not high enough to be diagnosed with the condition itself. But it's important to keep in mind that if your levels are higher than most, your risk of developing full-scale diabetes is increased.
Getting diabetes diagnosed early on is key to prevent it getting progressively worse, which can happen if left untreated.
What is type 1 diabetes?
Type 1 diabetes is where the body's immune system attacks and destroys the cells that produce insulin. You need to take insulin every day to keep your blood glucose levels under control. Type 1 is not linked with age, being overweight or lifestyle factors, whereas type 2 is.
Type 1 symptoms
The NHS website says you should see a GP if you have symptoms of type 1, which include:
feeling very thirsty
peeing more than usual, particularly at night
feeling very tired
losing weight without trying
thrush that keeps coming back
blurred vision
cuts and grazes that are not healing
fruity-smelling breath
Type 1 signs and symptoms can come on quickly, particularly in children.
Type 1 diagnosis
To get tested, your GP will do a urine test and might also check your blood glucose level.
If you are diagnosed, then a specialist diabetes nurse will explain everything you need to know about the condition, including how to manage it, test your own blood glucose and how to inject insulin.
Finger-prick tests have long been used to manage diabetes, though you can now check your glucose levels at any time with a continuous glucose monitor (CGM) or flash monitor.
This involves using a sensor, a small device you attach to your arm or tummy that senses how much glucose is in the 'interstitial' fluid under your skin, and a reader or receiver, which shows the results (you can also read them on your smartphone). Some types have optional alarms to alert you if your levels go too low or high.
Although being diagnosed with and managing diabetes can be difficult at times, you can still do the things you enjoy. This useful NHS guide on being newly diagnosed provides information to help, including how to recognise and treat a hypo, useful websites, online courses and more.
What is type 2 diabetes?
Type 2 diabetes is where the body does not produce enough insulin, or the body's cells do not react to insulin. It is far more common than type 1, with around 90% of all adults in the UK with diabetes living with it.
It can be linked to being overweight or inactive, or having a family history of type 2 diabetes. You're also more at risk of this type of diabetes if you're over 40 (or 25 for people from a south Asian background), have a close relative with diabetes, are overweight or obese, are of Asian, African-Caribbean or Black African heritage.
Many people can have type 2 diabetes without realising, because symptoms don't always make you feel unwell.
Type 2 symptoms
The NHS website says you should see a GP if you have symptoms of type 2 (similar to type 1), which include:
peeing more than usual, particularly at night
feeling thirsty all the time
feeling very tired
losing weight without trying to
itching around your penis or vagina, or repeatedly getting thrush
cuts or wounds taking longer to heal
blurred vision
Type 2 diagnosis
You should also see a GP straight away if you're worried you may have a higher risk of getting type 2, who will ask you about your symptoms. You check your risk here.
Type 2 diabetes is usually diagnosed by blood or urine tests or something else, with results usually taking one to two days to come back.
If you have the condition, your GP will explain the results, what to expect next and the treatment they recommend. They'll typically talk to you about what the condition is, how high blood sugar can impact your health, if you need to take medicine, your diet and exercise, lifestyle factors like drinking and smoking.
For more information, visit the NHS' website on diabetes, or seek support from Diabetes UK on 0345123 2399.
Additional reporting PA.
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