Type 2 Diabetes - newer agents (partial update of CG66) (CG87)
Fast, easy summary view of NICE guidance on 'diabetes'
Specific, concise statements that act as markers of high-quality, cost-effective patient care
This guidance partially updates and replaces NICE clincal guideline 66 (published in May 2009).
The advice in the NICE guideline covers:
- the monitoring of glucose, lipid (blood cholesterol and fat) and blood pressure levels
- diabetes education programmes
- dietary advice
- the use of medications to:
- control blood glucose
- prevent vascular (blood vessel) disease
- reduce blood pressure
- improve lipid levels
- the detection and ongoing management (with referral to a specialist if necessary) of:
- eye disease
- kidney disease
- nerve damage and nerve pain
It does not specifically look at:
- the prevention and management of foot problems related to diabetes (there is already guidance in this area – see CG10 Type 2 diabetes - footcare for more information)
- preventing type 2 diabetes or screening for it
- how specialists should manage problems caused by diabetes
- the management of diabetes during pregnancy (there is already guidance in this area – see CG63 Diabetes in pregnancy for more information).
The MHRA has issued new advice on risk of bladder cancer with the anti-diabetic drug pioglitazone.
The European Medicines Agency (EMA) and rosiglitazone
In September 2010 the EMA, the European Union (EU) body responsible for monitoring the safety of medicines, recommended the suspension of the marketing authorisation for rosiglitazone (Avandia, Avandamet and Avaglim) from GlaxoSmithKline. The EMA has concluded that the benefits of rosiglitazone no longer outweigh its risks and the marketing authorisation should be suspended across the EU.
The EMA has advised that patients who are currently taking rosiglitazone-containing medicines should make an appointment with their doctor at a convenient time to discuss suitable alternative treatments. Patients are advised not to stop their treatment without speaking to their doctor. NICE does not recommend the use of drugs without marketing authorisation. Therefore, as a result of the EMA's decision, NICE has temporarily withdrawn its recommendations on the use of rosiglitazone in this guideline.
Recommendations 188.8.131.52, 184.108.40.206, 220.127.116.11 and 18.104.22.168 in this guidelinehave been updated and replaced by Neuropathic pain: the pharmacological management of neuropathic pain in adults in non-specialist settings? (NICE clinical guideline 96).
NICE clinical guideline 87 partially updates NICE clinical guideline 66 and replaces it. Most of the recommendations were developed for NICE clinical guideline 66 by the National Collaborating Centre for Chronic Conditions. Details of the methods and evidence used to develop these recommendations are in CG66 Type 2 diabetes: full guideline. The recommendations on DPP-4 inhibitors (sitagliptin, vildagliptin), thiazolidinediones (pioglitazone, rosiglitazone), exenatide and insulin were developed by the Centre for Clinical Practice at NICE following the process for short clinical guidelines. Details of the methods and evidence used to develop these recommendations are in CG87 Type 2 diabetes - newer agents: short guideline.
This guidance has been incorporated into the following NICE Pathways, along with other related guidance and products.
Visit the NICE Pathway: diabetes
- None found
This page was last updated: 06 March 2014
- Web format
- Quick reference guide (PDF)
- NICE Guideline (PDF)
- Full Guideline
- CG87 Diabetes math 2: deall canllawiau NICE (fformat MS Word)
Information for the public
Consultation on review proposal with stakeholders: 01 June 2011 - 14 June 2011
Review decision date: August 2011
Following the recent review recommendation, an update of this guideline is in progress
Implementation tools and resources
See this guidance in practice
The summary of the key recommendations in the guidance written for patients, carers and those with little medical knowledge and may be used in local patient information leaflets.
Quick Reference Guide
The quick reference guide presents recommendations for health professionals
The published NICE clinical guideline, contains the recommendations for health professionals and NHS bodies.
The published full clinical guideline for specialists with background, evidence, recommendations and methods used.