Nearly three in ten adults in England are living with obesity, while around 5.8 million people in the UK are estimated to have diabetes, including approximately 1.3 million who remain undiagnosed. Obesity is one of the strongest risk factors for developing type 2 diabetes and cardiovascular disease, placing increasing pressure on the NHS and creating a growing need for accessible, preventative healthcare services delivered within the community.[9,10]
July 2026's launch of the UK's first oral GLP-1 medicine for weight management – Wegovy® tablets (oral semaglutide) represents another significant milestone in obesity treatment in the UK. The convenience of a once-daily tablet is expected to make GLP-1 therapy accessible to even more people and further increase demand for pharmacy-led weight management services.[6,7]
Community pharmacy has rapidly become a trusted provider of weight management services, combining prescribing, lifestyle advice and ongoing patient support. However, the greatest opportunity may not simply be in supplying medication, but in demonstrating measurable improvements in a patient's overall metabolic health.
Forward-thinking pharmacies can differentiate themselves by offering a complete metabolic monitoring clinic, enabling patients to see improvements not only in weight, but also in blood glucose and cardiovascular risk factors throughout their treatment journey.
Weight loss is only part of the story
Successful weight management is about far more than losing kilograms.
Obesity is closely associated with:
- Type 2 diabetes
- Prediabetes
- Dyslipidaemia
- Hypertension
- Cardiovascular disease
- Metabolic syndrome
Many patients beginning treatment with Wegovy®, Mounjaro® or other GLP-1 medicines will already have one or more of these conditions, often without realising it. NICE recommends that semaglutide is used as part of a specialist weight management programme alongside dietary, physical activity and behavioural support.[8]
Monitoring only body weight means valuable opportunities to assess and demonstrate improvements in overall health may be missed.
The Complete Pharmacy Metabolic Monitoring Clinic
A structured pharmacy monitoring programme can provide patients with objective evidence of improvements in their metabolic health by measuring:
- Weight
- Body Mass Index (BMI)
- Waist circumference
- Blood pressure
- HbA1c
- Lipid profile
Together, these markers allow pharmacists to have richer clinical conversations, support behaviour change and demonstrate the broader health benefits associated with successful weight loss.
Rather than asking, "How much weight have you lost?", pharmacists can begin asking, "How much healthier have you become?"
Why HbA1c should be measured
HbA1c remains one of the most valuable biomarkers available to pharmacists.
Unlike a single blood glucose reading, HbA1c reflects average blood glucose levels over the previous 8–12 weeks and is recognised internationally as the gold standard marker for assessing longer-term glycaemic control.[10]
A baseline HbA1c measurement can help pharmacies:
- Identify previously undiagnosed prediabetes
- Identify previously undiagnosed type 2 diabetes
- Establish a clinical baseline before treatment
- Monitor improvements over time
- Support appropriate referral where required
- Motivate patients through objective evidence of progress
This is particularly important because obesity and abnormal glucose metabolism frequently coexist.
The evidence supporting HbA1c monitoring
The clinical evidence supporting GLP-1 therapies continues to grow.
Across the STEP clinical programme, semaglutide demonstrated significant improvements in:
- HbA1c
- Fasting plasma glucose
- Insulin resistance
- Regression from prediabetes to normoglycaemia compared with placebo.[1,4]
The OASIS 1 study demonstrated that oral semaglutide also produces clinically meaningful weight loss in adults with overweight or obesity, further supporting the expanding role of oral GLP-1 therapy.[5]
The SELECT trial demonstrated that semaglutide significantly reduced progression to type 2 diabetes while increasing regression to normoglycaemia among participants with overweight or obesity.[2]
Collectively, these studies suggest that improvements in glycaemic health represent an important additional clinical benefit of GLP-1 therapy that pharmacies are ideally placed to monitor.
Why baseline HbA1c testing matters
Many people accessing pharmacy weight management services may be living with undiagnosed prediabetes or type 2 diabetes. Establishing a baseline HbA1c before starting GLP-1 therapy provides an objective measure of glycaemic health, helping pharmacists identify those who may require further assessment or referral.
Repeat HbA1c testing at appropriate intervals allows pharmacies to demonstrate improvements alongside weight loss, reinforcing patient engagement and providing tangible evidence of the wider health benefits of treatment. It also supports informed conversations with patients about long-term metabolic health and diabetes prevention.[1,2]
Don't overlook cardiovascular health
Cardiovascular disease remains one of the leading causes of morbidity among people living with obesity.
Many patients entering pharmacy weight management programmes will also have elevated cholesterol or other cardiovascular risk factors.
Monitoring lipid profiles alongside HbA1c enables pharmacists to provide a much more comprehensive assessment of metabolic health while demonstrating improvements that extend beyond weight loss alone.
The landmark SELECT cardiovascular outcomes trial demonstrated significant reductions in major adverse cardiovascular events among people living with overweight or obesity receiving semaglutide, reinforcing the wider health benefits associated with successful treatment.[3]
This holistic approach aligns closely with the preventative healthcare role increasingly being delivered by community pharmacy.
A1cNow+ Professional – immediate HbA1c results during the consultation
For pharmacies wishing to introduce HbA1c testing, A1cNow+ Professional provides a convenient point-of-care solution that fits easily into a pharmacy consultation.
Key features
- HbA1c result in approximately 5 minutes
- Requires just a 5 μL fingerstick blood sample
- Easy-to-use point-of-care system
- Portable and suitable for consultation rooms
- Room temperature storage
- Immediate discussion of results during the consultation
Receiving results while the patient is still in the consultation allows pharmacists to educate patients, explain progress and tailor lifestyle advice immediately, without waiting for laboratory results.
Introducing HbA1c testing into pharmacy weight management services enables pharmacists to deliver an even more clinically focused consultation while demonstrating measurable improvements in metabolic health.
CardioChek® PA – supporting comprehensive cardiovascular monitoring
HbA1c tells only part of the metabolic story.
The CardioChek® PA Professional Lipid Analyser enables pharmacies to assess cardiovascular risk from a simple fingerstick blood sample by measuring:
- Total cholesterol
- HDL cholesterol
- Triglycerides
- Calculated LDL cholesterol
- Total cholesterol/HDL ratio
Together, A1cNow+ Professional and CardioChek® PA provide pharmacies with two complementary point-of-care solutions capable of supporting a truly comprehensive metabolic monitoring service.
By combining glucose and lipid monitoring with routine measurements such as weight, BMI and blood pressure, pharmacies can deliver a holistic service that supports both weight management and long-term cardiovascular health.
Supporting patients between appointments
Many patients appreciate the reassurance of monitoring their own progress between pharmacy reviews.
For these patients, pharmacies can also offer A1cNow® Self Check, allowing HbA1c to be measured conveniently from home.
A1cNow Self Check benefits
- HbA1c result in approximately 5 minutes
- Designed specifically for home use
- Simple fingerstick test
- Enables patients to monitor long-term glucose control between consultations
- Supports continued engagement with healthy lifestyle changes
Offering A1cNow Self Check gives pharmacies the opportunity to extend patient support beyond the consultation room while encouraging ongoing engagement with their weight management programme.
A new opportunity for community pharmacy
The arrival of oral Wegovy is likely to accelerate demand for pharmacy weight management services across the UK.[6,7]
However, the pharmacies that stand out will be those that deliver more than prescribing alone.
By incorporating structured metabolic monitoring—including HbA1c and lipid testing—community pharmacies can:
- Provide more personalised patient care
- Identify patients requiring further investigation or referral
- Demonstrate measurable improvements in metabolic health
- Strengthen patient engagement and retention
- Reinforce their position as trusted providers of preventative healthcare
Weight loss is the beginning of the journey. Measuring improvements in metabolic health allows pharmacies to demonstrate the wider clinical value of the services they provide and further differentiates pharmacy-led weight management services in an increasingly competitive market.
As pharmacy continues to expand its clinical role, embracing comprehensive metabolic monitoring presents an opportunity to improve patient outcomes, strengthen professional services and showcase the value that community pharmacy brings to the prevention and management of long-term conditions.
References
1. Perreault L, Davies M, Frias JP, et al. Changes in Glucose Metabolism and Glycaemic Status With Once-Weekly Subcutaneous Semaglutide 2.4 mg Among Participants With Prediabetes in the STEP Programme. Diabetes Care. 2022;45(10):2396-2405.
https://diabetesjournals.org/care/article/45/10/2396/147113/Changes-in-Glucose-Metabolism-and-Glycemic-Status
2. Ryan DH, Lingvay I, Rubino DM, et al. Effect of Semaglutide on Regression and Progression of Glycaemia in People With Overweight or Obesity: A Prespecified Analysis of the SELECT Trial. Diabetes Care. 2024;47(8):1350-1358.
https://diabetesjournals.org/care/article/47/8/1350/156833/Effect-of-Semaglutide-on-Regression-and
3. Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. New England Journal of Medicine. 2023;389:2221-2232.
https://www.nejm.org/doi/full/10.1056/NEJMoa2307563
4. Wilding JPH, Batterham RL, Calanna S, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine. 2021;384:989-1002.
https://www.nejm.org/doi/full/10.1056/NEJMoa2032183
5. O'Neil PM, Birkenfeld AL, McGowan B, et al. Oral Semaglutide 50 mg Once Daily in Adults with Overweight or Obesity (OASIS 1): A Randomised, Double-Blind, Placebo-Controlled, Phase 3 Trial. The Lancet. 2023;402(10403):705-719.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01185-6/fulltext
6. Medicines and Healthcare products Regulatory Agency (MHRA). First GLP-1 tablet for weight loss approved in the UK. Published June 2026.
https://www.gov.uk/government/news/first-glp-1-tablet-for-weight-loss-approved-in-the-uk
7. National Institute for Health and Care Excellence (NICE). Semaglutide for Managing Overweight and Obesity (Technology Appraisal TA875).
https://www.nice.org.uk/guidance/ta875
8. NHS England. Health Survey for England 2024 – Adults' Overweight and Obesity. National Statistics. Published January 2026.
https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/2024/adults-overweight-and-obesity
9. National Institute for Health and Care Excellence (NICE). Type 2 Diabetes in Adults: Management (NG28). Updated February 2026.
https://www.nice.org.uk/guidance/ng28
10. Office for Health Improvement and Disparities (OHID). Diabetes Profile – Statistical Commentary. Updated March 2025.
https://www.gov.uk/government/statistics/diabetes-profile-update-march-2025/diabetes-profile-statistical-commentary-march-2025
