Tammie Rachell Largent-Phillips, 52, has Type 2 diabetes. For the past two years, she's managed the condition using a drug called Ozempic, which helps people with diabetes keep blood sugar levels in check.
But in November, she was forced to switch to another medication, insulin. The Ozempic she needed was no longer available at her pharmacy.
In recent months, demand for the drug has soared, colliding with global supply issues. Together, it's led to a shortage of Ozempic.
But the popularity of Ozempic, or semaglutide, isn't because of rising rates of diabetes. Instead, it's because of its weight loss benefits, doctors say. At a higher dose, semaglutide is used for weight loss. Ozempic manufacturer Novo Nordisk sells that higher dose under a different brand name: Wegovy.
Shortages of Wegovy, also highly popular, were widespread last year. As a result, some people who had been taking Wegovy were instead prescribed Ozempic off-label for weight loss. That's causing problems for people like Largent-Phillips, who need the drug to manage their chronic illness.
"It's been very frustrating," Largent-Phillips, of Florida, said of the shortage, adding that her blood sugar levels have been fluctuating as she's had to change medications.
In people with Type 2 diabetes, the body doesn't use insulin properly. Insulin is a hormone that tells cells in the body to absorb glucose, or sugar, from the blood. If the body doesn't use it well, that sugar stays in the blood, resulting in high blood sugar levels.
Ozempic works by mimicking a hormone in the body that regulates insulin levels. It's a type of drug called a GLP-1 agonist. The medication is self-administered weekly as an injection.
Without medication, people with Type 2 diabetes risk blood sugar spikes that can potentially lead to serious health problems, including heart disease, kidney disease, hearing loss and stroke.
"Even in the short run, people can feel poorly from high blood glucose levels," said Dr. Robert Gabbay, chief scientist for the American Diabetes Association.
The supply shortages of Ozempic have meant that some patients have had to go to several pharmacies before they could find the medication, said Dr. Marcio Griebeler, an endocrinologist at the Cleveland Clinic in Ohio. In other cases, he said, patients have been forced to take a lower dose because it's all that was available.
That's not "ideal," Griebeler said, because patients may not respond the same way as they did on the higher dose.
For those who cannot find the drug at all, the only option is to switch to another medication, which may not be as effective, said Dr. Susan Spratt, an endocrinologist and senior medical director for the Population Health Management Office at Duke Health in North Carolina.
That's what Shane Anthony, 57, of Seattle, has had to do. He has Type 2 diabetes and hasn’t been able to get Ozempic since October.
Anthony was prescribed a different medication, but he said it’s not as effective. His wife, Gerilynn, who is a nurse, said his blood sugar levels have gone back up since being off Ozempic.
“It really makes me mad; it infuriates me,” Anthony said. “We need it to stay alive and keep functioning on an everyday basis.”
Switching to another drug also complicates matters when Ozempic becomes available again.
Going back on Ozempic isn't always a simple adjustment, Spratt said; because it can come with side effects, such as nausea or vomiting, patients are often first prescribed a lower dose that is gradually increased over several weeks.
“In order to get back on the drug, you have to start all over again,” she said, “and that’s really burdensome.”
Dr. Disha Narang, an endocrinologist at Northwestern Medicine Lake Forest Hospital in Illinois, said she sees patients "every day" who were taking Ozempic and then later found out their pharmacy no longer carried the medication.
Some patients have found luck finding samples in doctors' offices, she said.
But others stopped taking medication altogether, she said, leading their blood sugar levels to rise.
The shortage has been tough on both patients and physicians, she added.
"We don't necessarily have control over the supply chain," she said, adding that physicians act as a sort of middleman between patients and the medications they need.
Novo Nordisk, the company that makes both Ozempic and Wegovy, told NBC News that the availability of Ozempic has improved, but supply issues still remain.
Allison Schneider, a spokesperson for the company, said in a statement that Ozempic is available in certain dosages for Type 2 diabetes; however, the company is still experiencing supply issues that will last through the month and patients in some regions of the U.S. will experience delays in getting their medication.
“Anyone concerned with continuity of treatment, should contact their healthcare provider,” she said.
Largent-Phillips, of Florida — who has been documenting her experience on TikTok — said that for now, she has to be vigilant about monitoring her blood sugar levels.
She said she doesn't blame the people who are using it for weight loss for the shortage, but the manufacturer and supply chain.
She noted that there are a lot of people besides her who need this medication to manage their illnesses.
"This is awful," she said.