NICE have recommended three new alternative treatments for people with type 2 diabetes as an alternative to metformin.

The three new treatments, canagliflozin, dapagliflozin and empagliflozin are recommended as stand-alone treatments for people with type 2 diabetes who do not tolerate metformin and when diet and exercise do not provide the necessary control of blood sugar levels.

Recently published guidelines by National Institute for Health and Care Excellence (NICE) recommend the treatments for people when a dipeptidyl peptidase‑4 (DPP‑4) inhibitor, or gliptin, would otherwise be prescribed and a sulfonylurea or pioglitazone is not appropriate.


NICE have recommended three treatments that could help treat type 2 diabetes

The report added: “Adults whose treatment with canagliflozin, dapagliflozin or empagliflozin as monotherapy is not recommended in this NICE guidance, but was started within the NHS before this guidance was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.”

The three treatments block glucose (sugar) from being reabsorbed in the kidneys and encourage extra blood glucose to be passed in urine. Through this mechanism these drugs may help control glycaemia without the need for insulin.

They all have UK marketing authorisations for treating type 2 diabetes to improve glycaemic control in adults.

In addition to being used as a stand-alone treatment, or monotherapy, the report also recommends that the treatments could be used as an add‑on treatment in combination with other glucose–lowering medicinal products including insulin, when these, together with diet and exercise, do not provide adequate glycaemic control.

To find out more, read the NICE guidelines
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