NICE guidance on type-2 diabetes

Draft NICE guidelines on type-2 diabetes have backed second-line use of DPP-4 inhibitors and glitazones in some patients.

The recommendations cover DPP-4 inhibitors (sitagliptin and vildagliptin), glitazones (pioglitazone and rosiglitazone) and exenatide, as well as when to start insulin therapy.

Metformin and a sulphonylurea remain preferred first- and second-line agents, but for patients not suitable for this treatment and who are uncontrolled on one of them, a DPP-4 inhibitor or a glitazone is recommended as an add-on therapy.

Exenatide can be added to metformin and a sulphonylurea for obese patients and those unsuitable for insulin therapy.

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