The obesity It is a disorder that affects a large part of the Spanish population. According to the Spanish Agency for Food Safety and Nutrition and the Carlos III Health Institute, in 2020, 37.1% of the Spanish population was overweight, and 18.7% fell within the weight ranges that are considered obesity. Given these worrying figures, a series of medications promise to facilitate weight loss by “tricking” the body by activating the system that calms hunger.
However, people who suffer from diabetes also depend on these medications, and they have had supply problems in their pharmacies. To make up for this shortage, the Spanish Agency for Medicines and Health Products (AEMPS) has recently included in the catalog wegovy, another drug with the same active ingredient, which began to be marketed on May 1 for weight loss. In this way, they hope to cover all demand.
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According to the Spanish diabetes society, Spain is the second country with the highest prevalence of diabetes in Europe. Of the more than 5 million people who suffer from diabetes, 90% correspond to type II diabetes and the remaining 10% to other variants (type I, gestational, MODY, LADA or others). Until one third of people with diabetes could not be diagnosedwhich increases the risk of more serious illnesses in the future.
Anti-diabetes medications
There are different types of medications to treat diabetes. Depending on the case, availability and the balance between risks/benefits, the use of one will be advised. according to its mechanism of action. Currently, diabetes can be combated (among other ways) by limiting glucose absorption through the intestine, promoting glucose secretion by the kidneys, or directly by injecting insulin so that circulating sugars accumulate in the body in the form of fat.
Recently, a class of medications called glucagon-like peptide 1 (GLP1RA) receptor agonists have received a great deal of media and public attention. This type of medication, indicated for type II diabetes, mimics incretins, proteins produced during digestion naturally by the intestine. These proteins stimulate the production of insulin and decrease the production of glucagon, the two hormones that control blood sugar levels. In addition, GLP1 receptors can be found in other organs of the body, such as the heart, stomach or nervous system and has been related to the feeling of satiety after eating food.
Therefore, one of the side effects of anti-diabetes drugs based on arGLP1 is loss of appetite, a chance for people with severe obesity problems. Now, the increase in demand for these medications posed a serious problem in supply by pharmaceutical companies. In 2022, both the pharmaceutical company Lilly and Novo Nordisk Pharma announced that they could not meet the needs of the population with their products (Trulicity and Ozempic, respectively) and AstraZeneca announced that it would stop marketing Bydureon.
Wegoby arrives
This circumstance posed serious problems for health, whose representatives were exploring the different possibilities for more than a year before giving a response. And this response came on April 24, when the AEMPS announced that would allow the marketing of Wegovy (also from Novo Nordisk Pharma) to make up for the lack of other medications.
The drug has become the goose that lays the golden eggs for the Danish pharmaceutical company, which expects growth of almost between 18 and 26% during 2024. However, with skyrocketing demand, some experts They do not believe that Novo Nordisk can meet the orders. Its finance director, Karsten Munk Knudsen, assures that they will be able to guarantee supplies in the short term, and that they are in the process of building new Wegovy production plants.
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Certain analysts compare the success of this medicine with what it had at the beginning of the century Viagra. Sildenafil, its active compound, was originally intended for the treatment of angina pectoris. Now, after carrying out the relevant tests, the results of the clinical trials were not as expected and, like so many other compounds being tested, it was going to be discarded. However, a side effect of the drug (it caused erections and decreased pain in the volunteers) caught the attention of the researchers and led to its reuse as Erectile disfunction treatment.
What if there isn’t enough?
However, there is a key difference between sildenafil and Ozempic and Trulicity’s compound, semaglutide. In the case of sildenafil, it did not treat angina, but semaglutide is capable of keeping type II diabetes at bay. In fact, according to their technical information, these medications in Spain are only authorized to improve blood glucose control in people with type II diabetes who cannot control it with diet and exercise. Therefore, the shortage of these medications is presumably due to inappropriate prescriptions and sales without a prescription, practices that could have consequences after the relevant investigations.
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With the arrival of Wegovy, indicated specifically for weight loss, the AEMPS hopes to alleviate the burden on the other two medications, and urges medical professionals to only prescribe this treatment in very specific cases: people with a body mass index greater than 30, or greater than 27 who have problems associated with their weight, such as type II diabetes or hypertension.
Now, other countries in the European Union, the United States, or Japan, where their sale is also allowed, a large number of Patients request this medication despite not having any decrease in quality of life due to being overweight.. Generally, people who go to get a prescription do so influenced by social networks, where certain people announce the results they have observed after obtaining these medications. Furthermore, some of these people, unable to obtain it through legal means, turn to the black market, where it cannot be guaranteed that the manipulation of the treatments has been correct.
Therefore, strict regulation will ensure supply to those people who need it. As professionals remember, this treatment does not act by magic, but rather serves as complement to be able to carry a low calorie diet and exercise routine. The purpose of these medications is improve global health and minimize the complications caused by obesity in the long term, not just lose weight.