Type 2 Diabetes: Newer Agents for Blood Glucose Control in Type 2 Diabetes

Excerpt

This guideline covers newer agents for blood glucose control in adults with type 2 diabetes; it does not address care for pregnant women with diabetes. It is a partial update of ‘Type 2 diabetes’, NICE clinical guideline 66 (CG 66), published in 2008, which updated NICE clinical guidelines E, F, G and H (2002) and updated and replaced the recommendations on type 2 diabetes in NICE technology appraisal guidance 53 (2002), 60 and 63 (2003).

Specifically, this guideline updates and replaces recommendations in sections 1.6, 1.7.1.3, 1.7.2 and 1.7.3 of CG66. The new recommendations from this short guideline use the same levels of HbA_1c for the addition of extra glucose-lowering drugs as defined in CG 66 (that is, a value of 6.5% for people on one glucose-lowering drug and 7.5% for people on two or more oral glucose-lowering drugs or people needing insulin). The use of these different levels takes into account the increasing risk of hypoglycaemia with insulin and the clinical and cost-effectiveness of the newer agents. Otherwise, CG 66 stands.

This short guideline addresses the licensed indications of drugs as of September 2008. The recommendations do not apply to drugs not yet available in the UK and exclude liraglutide which did not receive UK marketing authorisation for type 2 diabetes during the development of this guideline. Recommendations are consistent with safety information from the European Medicines Agency and the Medicines and Healthcare products Regulatory Agency.