NICE updates type 2 diabetes guidance
Changes have been made to the guidance of type 2 diabetes management by the National Institute of Care and Excellence (NICE).
The organisation has added text on sodium–glucose cotransporter 2 (SGLT-2) inhibitors to the section on initial drug treatment. 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.
New information on SGLT-2 inhibitors has also been added to the box on action to take if metformin is contraindicated or not tolerated.
NICE said the reason the advice had been updated was because since the publication of the 2009 guideline, “availability of new evidence and several key developments have prompted an update in the following areas: managing blood glucose levels, antiplatelet therapy and erectile dysfunction”.
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”.
Now, because there evidence and safety issues relating to the “off‑label use of antiplatelet therapy (aspirin and clopidogrel) in the primary prevention of cardiovascular disease” has been found this “motivated an update of this review”.
The newly updated guidelines updates and replaces NICE guideline CG87, NICE guideline CG66, NICE technology appraisal guidance 248 and NICE technology appraisal guidance 203.