The National Institute for Health and Care Excellence (NICE) yesterday (August 20) revealed that “millions of people are set to benefit from earlier access to type 2 diabetes treatments”, such as GLP-1 RAs, in “the biggest shake-up in care for a decade”.
Draft guidelines propose that the NHS “moves away from a one-size-fits-all approach” and shifts from “automatically starting everyone on one medicine to personalised treatment plans that aim to prevent heart failure, heart attacks and other serious medical problems”.
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As part of this, NICE set out that “some groups of patients [will] stand to benefit from...GLP-1 RAs, such as liraglutide or semaglutide, rather than keeping them for later stages of treatment”.
The draft guidelines introduce “different treatment approaches based on patient characteristics and other health conditions”, the organisation said.
And they align with the government 10-year health plan’s shift from treatment to prevention by aiming “to prevent the future complications of diabetes”, it added.
“Significant evolution” in treatment
The proposed treatment approaches include offering:
- Adults with cardiovascular disease (CVD) “triple therapy including a GLP-1 RA”
- People living with obesity “specific treatment combinations”
- Adults with early onset type 2 diabetes (diagnosed before age 40) “dual therapy before a GLP-1 RA is considered”
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NICE advised that those with type 2 diabetes “speak with their GP or diabetes team at their next annual review meeting to discuss what treatment option is right for them”.
The draft guidance is “open for public consultation” until October 2 and NICE’s guideline committee will then “consider all feedback received before publishing the final recommendations”, it said.
NICE deputy chief executive and chief medical officer Professor Jonathan Benger said that “this represents a significant evolution in how we approach type 2 diabetes treatment”.
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“We’re moving beyond simply managing blood sugar to taking a holistic view of a person’s health, particularly their cardiovascular and kidney health,” he added.
Benger explained that “the evidence shows that certain medicines can provide important cardiovascular benefits”, arguing that “by recommending them as part of initial treatment, [NICE] could help prevent heart attacks, strokes and other serious complications before they occur”.
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It comes after NICE published updated guidance earlier this month calling for healthcare services to provide “tailored action plans” for patients for “at least a year” after stopping weight loss medication – such as GLP-1 RAs - to prevent weight regain.
And last week, Mounjaro manufacturer Eli Lilly revealed that it will hike the UK price of the drug from September to align it with the cost to other countries – although it has now invited pharmacies to participate in a “Mounjaro rebate scheme”.
