NICE has unveiled draft guidelines that promise to overhaul type 2 diabetes treatment across the UK, marking the biggest shake-up in a decade. Under the new proposal, millions of people could gain earlier access to innovative medicines, such as SGLT-2 inhibitors, as the NHS moves away from a “one-size-fits-all” approach towards a more personalised plan of attack.
Designed to reduce heart attacks, kidney damage and other serious complications, NICE is recommending for the first time that treatment starts with SGLT-2 inhibitors alongside metformin, rather than holding them back as a second‑line option. In addition, some patients will be offered GLP‑1 therapies much earlier in their treatment plan.
“This represents a significant evolution in how we approach type 2 diabetes treatment,” said Professor Jonathan Benger, Chief Medical Officer, NICE. “We’re moving beyond simply managing blood sugar to taking a holistic view of a person’s health, particularly their cardiovascular and kidney health.”
This shift could have substantial ramifications for the pharmaceutical sector. With demand for these newer, more advanced therapies likely to rise as clinicians update their prescriptions for the UK’s 4.6 million diagnosed, and over a million undiagnosed, people with diabetes, drugmakers may experience increased demand for their SGLT-2 inhibitor and GLP-1 products.
Encourgingly, NICE’s modelling suggests that expanding access to SGLT-2 inhibitors in particular could prevent up to 22,000 deaths, provided uptake reaches 90% of eligible patients.
As Dr Waqaar Shah, chair of the guideline committee, remarked: “These recommendations could help reduce health inequalities while providing better outcomes for everyone.” Having reviewed the cases of 590,000 people, the report highlights that SGLT-2 inhibitors are currently under-prescribed – especially among minority communities.
The draft guideline is open for public consultation until October. Once finalised, it is expected to shape NHS prescribing practices, with far-reaching implications for access to care, patient outcomes, and the future of the diabetes medicines market.
