NICE issues guidance on diabetes treatments

doi:10.1136/bmj.327.7414.520-d

BMJ 2003;327:520 (6 September), doi:10.1136/bmj.327.7414.520-d

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NICE issues guidance on diabetes treatments

BMJ Andrew Iles

The use of thiazolidinediones (glitazones) for type 2 diabetes is to be restricted, after the release of new guidelines by the National Institute for Clinical Excellence (NICE).

NICE recommends that the treatment should be offered only to patients who cannot tolerate the combination treatment of metformin and a sulphonylurea. It no longer recommends glitazones to reduce blood glucose concentrations when treatment with metformin and a sulphonylurea has failed.

Glitazones directly target insulin resistance and preserve the ( cells in the pancreas. Currently doctors in the United Kingdom prescribe glitazones in addition to combination treatment, as a monotherapy, or in combination with insulin treatment. None of these additional indications is licensed at present.

Professor David Barnett, chairman of the Independent Appraisal Committee, which advises NICE, said: "The use of combination therapy with a glitazone and either metformin or a sulphonylurea is not likely to be cost effective when . . . [Full text of this article]

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