Navigating the 2025 Diabetic Drug Landscape
For years, patients with type 2 diabetes have faced uncertainty regarding access to a key class of medications: glucagon-like peptide-1 (GLP-1) receptor agonists [1.3.1]. While the U.S. Food and Drug Administration (FDA) declared the widespread shortages of semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) to be resolved in early 2025, intermittent supply issues and ongoing shortages for other drugs in the same class persist [1.2.1, 1.3.1]. Patients may still encounter difficulties filling their prescriptions at local pharmacies due to lingering supply chain disruptions [1.7.1].
The primary medications that have been on the FDA's shortage list are GLP-1 and dual GIP/GLP-1 receptor agonists [1.3.1, 1.4.4]. As of September 2025, while the acute shortages for Ozempic and Mounjaro have ended, Trulicity (dulaglutide) and liraglutide remain listed as in shortage [1.2.1, 1.8.1]. Some insulin products, such as insulin glargine-yfgn, have also experienced shortages due to manufacturing issues and increased demand, with intermittent supply expected through the end of 2025 [1.2.3].
The Root Causes of the Medication Shortage
The scarcity of these drugs stems from a confluence of factors, chief among them a massive surge in demand [1.4.5]. This was fueled by several key developments:
- Off-Label Prescribing for Weight Loss: GLP-1 agonists proved to be highly effective for weight loss, leading to a dramatic increase in off-label prescriptions for this purpose [1.4.3, 1.4.5].
- Social Media and Advertising: Celebrity endorsements and social media trends amplified the popularity of drugs like Ozempic for cosmetic weight loss, further straining the supply intended for diabetic patients [1.4.4, 1.6.3]. Manufacturers also invested heavily in direct-to-consumer advertising, with Novo Nordisk reportedly spending $884 million on TV ads for Ozempic and Wegovy between 2018 and 2023 [1.3.1].
- Manufacturing and Supply Chain Constraints: The sudden explosion in demand outpaced manufacturers' production capacity [1.4.2]. The specialized single-use pens used for these injectable drugs also experienced shortages, creating a ripple effect that even impacted the supply of some insulin pens [1.4.3].
Impact on Patients with Type 2 Diabetes
The shortage has had significant consequences for patients who rely on these medications for glycemic control. Inconsistent access can lead to fluctuating blood sugar levels, which increases the risk of serious long-term complications, including cardiovascular disease, kidney damage, and nerve damage [1.3.1, 1.6.3]. Studies have shown that during these shortages, patients experienced worsened glycemic control, with one analysis noting a significant median increase in HbA1c levels [1.6.4].
Beyond the clinical impact, patients face financial and emotional burdens. They often spend considerable time and effort calling multiple pharmacies to locate their medication [1.6.2]. The situation has also created disparities, as patients with more financial resources and time are often more successful in navigating the shortages [1.4.3]. The disruption has forced many to switch to alternative medications, which may have different efficacy and side effect profiles [1.4.4].
During the peak of the shortages, some patients turned to compounding pharmacies, which were temporarily allowed by the FDA to produce versions of the scarce drugs [1.2.2]. However, the FDA has warned against this practice, as compounded drugs are not reviewed for safety, quality, or effectiveness, and has received reports of adverse events related to them [1.3.1]. With the shortages of semaglutide and tirzepatide officially resolved, the regular compounding of these specific drugs is no longer permitted as of March and May 2025, respectively [1.8.2, 1.7.3].
Alternatives and Patient Guidance
Patients affected by the ongoing shortages have several alternative treatment options. It is critical to consult with a healthcare provider before making any changes to a medication regimen [1.9.1].
Comparison of Affected GLP-1s and Alternatives
| Medication | Class | Administration | Approved For | Status (as of Sept 2025) |
|---|---|---|---|---|
| Trulicity (dulaglutide) | GLP-1 Agonist | Weekly Injection | Type 2 Diabetes, CV Risk Reduction [1.5.2] | In Shortage [1.2.1] |
| Ozempic (semaglutide) | GLP-1 Agonist | Weekly Injection | Type 2 Diabetes, CV Risk Reduction [1.5.5] | Shortage Resolved [1.2.1] |
| Mounjaro (tirzepatide) | Dual GIP/GLP-1 Agonist | Weekly Injection | Type 2 Diabetes [1.5.2] | Shortage Resolved [1.2.1] |
| Rybelsus (semaglutide) | GLP-1 Agonist | Daily Oral Tablet | Type 2 Diabetes [1.5.1] | Never in shortage [1.2.1] |
| Victoza (liraglutide) | GLP-1 Agonist | Daily Injection | Type 2 Diabetes [1.5.5] | In Shortage [1.8.1] |
| Metformin | Biguanide | Daily Oral Tablet/Liquid | Type 2 Diabetes [1.5.5] | Widely Available |
| Januvia (sitagliptin) | DPP-4 Inhibitor | Daily Oral Tablet | Type 2 Diabetes [1.5.2] | Widely Available |
| Jardiance (empagliflozin) | SGLT2 Inhibitor | Daily Oral Tablet | Type 2 Diabetes, Heart & Kidney Disease [1.5.5] | Widely Available |
For patients unable to access Trulicity or other GLP-1s, a healthcare provider might suggest:
- Switching to another GLP-1: Options like Ozempic (weekly injection) or Rybelsus (daily pill) might be viable since their acute shortages have been resolved [1.5.1].
- Different Drug Classes: Oral medications like Metformin, DPP-4 inhibitors (e.g., Januvia), or SGLT2 inhibitors (e.g., Jardiance) work through different mechanisms to control blood sugar [1.5.5].
What Patients Should Do:
- Consult Your Doctor: Do not ration or skip doses. Discuss the situation with your healthcare provider to find the best alternative medication for your specific needs [1.9.4].
- Contact Multiple Pharmacies: Supply can vary by location. Call different pharmacies, including independent and mail-order ones, to check for availability [1.9.3].
- Refill Early: Request refills several days before your current supply runs out to allow time to find the medication if it's not immediately in stock [1.9.3].
- Check with Your Insurance: When considering alternatives, verify your insurance coverage to avoid unexpected costs [1.9.3].
Conclusion
While the widespread, acute shortages of major diabetic medications like Ozempic and Mounjaro have been declared resolved in 2025, the landscape remains challenging for many patients [1.3.1]. Ongoing shortages of drugs like Trulicity and liraglutide, coupled with intermittent local supply issues for others, mean that patients and providers must remain vigilant [1.8.1]. The primary driver—unprecedented demand for weight loss—has fundamentally altered the market for these critical drugs [1.4.5]. Proactive communication with healthcare providers and pharmacists is the most effective strategy for patients to ensure continuity of care and manage their health effectively during this period of adjustment.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before making any decisions about your health or treatment.
Visit the FDA Drug Shortages Database for the most current information.
