Millions with type 2 diabetes should get personalised care and new medicines, says review

Millions of people with type 2 diabetes should receive personalised treatment and greater access to newer medicines, including weight-loss drugs, the healthcare assessment body for England, Wales and Northern Ireland has recommended.

The move is being described as the biggest shake-up in type 2 diabetes care in a decade.

Offering more people these drugs could prevent complications such as heart disease, strokes and kidney damage, reduce NHS costs and potentially save lives, according to the National Institute for Health and Care Excellence (Nice).

Nice, which issues guidance for the NHS on patient care, is calling for a move away from a “one size fits all” approach towards more personalised treatment.

It recommends SGLT-2 inhibitors, which lower blood sugar while protecting the heart and kidneys, should become the first-choice treatment for all people with diabetes.

Around 2.3m patients would be eligible.

Nice estimates that 22,000 lives could be saved if 90 per cent of diabetes patients were prescribed these medicines, but access is unequal across the UK. Evidence shows women, older people and black people are less likely to receive them.

Dr Waqaar Shah, chair of the guideline committee, said: “There is some urgency to find ways to increase the uptake of SGLT-2 inhibitors because if we were to achieve perfect uptake, the nation would be significantly healthier.”

Currently, only one in five people with type 2 diabetes and cardiovascular disease are prescribed the drugs.

Prescribing them to more people would particularly benefit those living in poorer areas and ethnic minority groups, Nice said.

Under the guidance, which is still in draft form and open to consultation, around 750,000 more people with type 2 diabetes will be offered GLP-1 agonists such as semaglutide and liraglutide – drugs widely used in weight-loss jabs.

Adults with cardiovascular disease and those diagnosed with type 2 before the age of 40 are among the groups recommended for these medicines, which lower blood sugar and support weight loss.

Prof Jonathan Benger, deputy chief executive and chief medical officer at Nice, said the updated guidance represented “a significant evolution” in type 2 diabetes treatment which could help prevent heart attacks, strokes and other serious complications.

“This guidance means more people will be offered medicines, where it is right to do so, to reduce their future risk of ill health,” he said.

The guidance is part of a long-term NHS plan in England to reduce health inequalities and focus on preventing ill health.

Diabetes UK described the announcement as propelling type 2 diabetes treatment “into the 21st century”.

Douglas Twenefour, head of clinical at the charity, said: “These guidelines could go a long way to easing the burden of living with this relentless condition, as well as helping to address inequities in type 2 diabetes treatments and outcomes.”