NICE updates type 2 diabetes guideline
NICE have recently updated the guidance in a number of sections of the type 2 diabetes guidelines (NG28). New information on sodium–glucose cotransporter 2 (SGLT-2) inhibitors has been added to the section on initial drug treatment. The guideline now says that “Treatment with sodium–glucose cotransporter 2 (SGLT-2) inhibitors may be appropriate for some adults with type 2 diabetes if metformin is contraindicated or not tolerated”.
The algorithm for blood glucose lowering therapy in adults with type 2 diabetes has also been revised to allow for a footnote with links to relevant NICE guidance on SGLT-2 inhibitors.
The updated guideline also includes new recommendations on individualised care, managing blood glucose levels, antiplatelet therapy and managing complications as new information on these areas have become available since the publication of the 2009 guideline.
The organisation said the reasons “included safety concerns surrounding some blood glucose lowering medicines, new evidence on new dipeptidyl peptidase‑4 (DPP‑4) inhibitors and glucagon‑like peptide‑1 (GLP‑1) receptor agonists, new indications and licensed combinations for licensed class members and the potential impact of drugs coming off patent on health‑economic issues”. There have been also new evidence and safety issues relating to the off‑label use of antiplatelet therapy in the primary prevention of cardiovascular disease.
The newly updated guidelines updates and replaces NICE guideline CG87, NICE guideline CG66, NICE technology appraisal guidance 248 and NICE technology appraisal guidance 203.