NICE 2002/063
Issued: 6th December 2002


PRESS RELEASE

NICE provides the NHS and people with diabetes with guidance on long-acting insulin

 

The National Institute for Clinical Excellence has today issued guidance to the NHS in England and Wales on the use of long-acting insulin analogues - insulin glargine - for the treatment of people with type 1 and type 2 diabetes.
In summary, the guidance recommends that:

  • Insulin glargine is used as a treatment option for people with type 1 diabetes

  • Insulin glargine is not recommended for routine use for people with type 2 diabetes who require insulin therapy - it should only be considered for people with type 2 diabetes who either need assistance to administer their insulin injections; or whose lifestyle is significantly restricted by recurring episodes of low blood glucose that are symptomatic; or who would otherwise need twice-daily injections of insulin in combination with oral anti-diabetic drugs


Diabetes is a common condition with over 1 million people diagnosed in England and Wales. People with diabetes fall into 2 main groups: those who can't make insulin, and need daily injections of insulin to survive - they are referred to as having type 1 diabetes and often diagnosed early in life. The second group are referred to as having type 2 diabetes, or non-insulin dependent diabetes. Their system still makes insulin but either not enough for their body's needs or their cells have become resistant to its effects. This type of diabetes traditionally develops later in life and was referred to as 'maturity onset diabetes', although recent evidence has shown that changes in diet and exercise patterns have resulted in some younger people being diagnosed with type 2 diabetes. One of the main drawbacks of current insulin regimens and one which is recognised as having a negative effect on quality of life, is the difficulty individuals can have in consistently achieving blood glucose control and the balance between the risk of hypoglycaemia (too low a level of blood glucose) and hyperglycaemia (too high a level of blood glucose) - both of which can be potentially life-threatening. An example of a typical insulin regimen is four or five-times daily injections of short-acting insulin before meals and one or two injections of basal insulin.

Insulin glargine is a long-acting insulin analogue that can provide a more consistent level of insulin release during the day. Its allows for once-daily dosing, which can be supplemented by injections of a short-acting insulin if required.

Anne-Toni Rodgers, Corporate Affairs Director and executive lead for the appraisal said: "The committee that advises NICE saw clinical data and evidence presented by people with diabetes who require insulin, those who represent them and clinical experts showing that the quality of life of people with diabetes is affected by the problems inherent in controlling their blood glucose levels and that Insulin glargine can add value for certain groups. As a result of this guidance around 137,000 people with diabetes in England and Wales will be able to enjoy an enhanced flexibility and quality of life through being able to control their insulin levels with a single daily injection ".

Ends

Notes to Editors

About NICE

1. NICE is part of the NHS. It is the independent organisation responsible for providing national guidance on treatments and care for those using the NHS in England and Wales. Its guidance is for healthcare professionals and patients and their carers to help them make decisions about treatment and healthcare. For further information about NICE you can visit www.nice.org.uk.
   
2.

NICE produces guidance in three areas of health:

  • the use of new and existing medicines and treatments within the NHS in England and Wales - technology appraisals
  • the appropriate treatment and care of patients with specific diseases and conditions within the NHS in England and Wales - clinical guidelines.
  • whether interventional procedures used for diagnosis or treatment are safe enough and work well enough for routine use- interventional procedures.
3.

NICE also funds four enquiries that undertake research into the way patients are treated to identify ways of improving the quality of care (the investigations are known as confidential enquiries).

   
4. NICE guidance and recommendations are prepared by independent groups that include professionals working in the NHS and people who are familiar with the issues affecting patients and carers.
   
About technology appraisals
   
5.

Technology appraisals are recommendations on the use of new and existing medicines and treatments within the NHS in England and Wales, such as:

  • medicines (for example, drugs)
  • medical devices (for example, hearing aids or inhalers)
  • diagnostic techniques (tests used to identify diseases)
  • surgical procedures (for example, repairing hernias)
  • health promotion activities (for example, patient education models for diabetes).
6. Our technology appraisal recommendations are prepared by an independent Committee, who include healthcare professionals working in the NHS and people who are familiar with the issues affecting patients and carers. The Committee considers the evidence on the clinical and cost effectiveness of the technology - this includes hearing the views of, and evidence from, clinical health professionals, experts and patients.
   
7. NHS organisations in England and Wales have to make the resources and facilities available to enable NICE guidance to be implemented. In January 2002 the Government announced a legal obligation for the NHS to provide funding for treatments and drugs recommended by NICE as a part of its technology appraisals work.
   
8. For details of NICE technology appraisals currently in development, log on to the NICE website at http://www.nice.org.uk/catta2.asp?c=17935
   
About the long-acting insulin analogues guidance
   
9. A briefing sheet on the guidance will be available on the NICE website at launch http://www.nice.org.uk/Docref.asp?d=43438. This sheet contains information on diabetes, more details on the guidance and details of related NICE guidance.