The German independent Institute for Quality and Economic Efficiency in Health Care has come under fire from doctors, patients, politicians, and the drugs industry for questioning the use of short acting insulin analogues for late onset (type 2) diabetes. The institute is Germany's equivalent of the National Institute for Health and Clinical Excellence (NICE) in England.

Following the institute's report, a federal committee has announced that it intends to forbid health insurance companies from paying for costly short acting insulin analogues rather than insulin.

No other institution in Europe has published recommendations on the use of these drugs, but NICE published recommendations on long acting insulin in December 2002 (www.nice.org.uk/page.aspx?o=43424).

The …