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New treatments provide alternatives to metformin

Three new treatments for type 2 diabetes have been recommended by NICE, for patients who cannot use metformin, sulfonylurea or pioglitazone

Three new treatments for type 2 diabetes have been recommended by NICE, for patients who cannot use metformin, sulfonylurea or pioglitazone.

The treatments are also suitable for patients who are not controlling their blood glucose levels with diet and exercise alone, to manage their condition.

Read more: Metformin use and B12 deficiency: What nurses need to know

'We know that different people with type 2 diabetes may respond favourably to different medications,’ said Simon O’Neill, director of health intelligence and professional liaison at Diabetes UK. ‘So this guidance offers more choice for clinicians to individualise the care they provide, which can have a significant impact on the quality of life of some people with Type 2 diabetes.’

Read more: Ten things you should know about type 2 diabetes

As many as 31,000 people with the condition may be eligible for the new drugs, canagliflozin, dapagliflozin, and empagliflozin. The drugs are designed to help patients who cannot take more commonly prescribed treatments control their blood sugar. ‘[The new drugs] give people with type 2 diabetes and their healthcare team more options when metformin is not appropriate,’ added Mr O’Neil.

Read more: Interventions that prevent pre-diabetes from becoming type 2

Many people with type 2 may not suit treatment with drugs such as metformin, which can cause side effects such as nausea and diarrhoea. Those with kidney damage are also unable to take such drugs.

‘For many people whose blood glucose levels aren’t controlled by diet and exercise, metformin is the first drug treatment that they’ll be offered,’ said Professor Carole Longson, director of the NICE Centre for Health Technology Evaluation. ‘For people who can’t take a sulfonylurea or pioglitazone, then the three drugs recommended in this guidance can be considered. This is as an alternative to the separate group of drugs called dipeptidyl peptidase-4 (DPP-4) inhibitors.’

According to NICE, in the UK, almost 3.5 million people have been diagnosed with diabetes. Of these, it is estimated that roughly 90% of adults have type 2 diabetes.