Why are they changing type 2 diabetes treatment?

The National Institute for Health and Care Excellence (NICE) has announced the biggest update to diabete di tipo 2 care in more than a decade. New guidance will see the current one-size-fits-all approach be replaced by personalised treatment plans.

As well as diabetes, your new treatment plan should help your overall health - especially that of your heart and kidneys.

Professor Jonathan Benger, deputy chief executive and chief medical officer at NICE says: “We're moving beyond simply managing blood sugar to taking a holistic view of a person's health, particularly their cardiovascular and kidney health.”

If you have type 2 diabetes you are likely to be using the medicine metformin. The new draft guidelines from NICE recommend also prescribing new medicines earlier on in your treatment - which are better suited to your specific needs.

As well as metformina you may also be prescribed:

• SGLT-2 inhibitors – such as canagliflozin, dapagliflozin, and empagliflozin.

• GLP-1s - such as semaglutide and liraglutide,

If you cannot take metformin, you may be offered an SGLT-2 inhibitor straight away.

As well as helping to manage your blood sugar levels - these medicines also protect your heart and kidneys and could help prevent serious complications such as attacchi di cuore e ictus.

Benger says: “By recommending certain medicines as part of initial treatment, we could help prevent heart attacks, strokes and other serious complications before they occur.”

He says that this is particularly important as heart disease is the leading cause of death in people with type 2 diabetes.

NICE estimates that these changes could eventually save up to 22,000 lives.

The update is part of a wider NHS 10 Year Plan to focus more on prevention - helping people stay well rather than waiting until someone develops a condition. It will also help support care in the community and through digital tools such as continuous glucose monitoring.

The draft guideline is open for public consultation until Thursday 2nd October. NICE’s guideline committee will consider all feedback received before publishing the final recommendations. The consultation document and details of how to respond are available at www.nice.org.uk.