Type 2 diabetes in adults: management

Reviewing medicines

NICE's guideline on type 2 diabetes in adults recommends reassessing the person's needs and circumstances at each review and thinking about whether to stop any medicines that are not effective. Before changing treatments, current treatment should be optimised, taking into account adherence, adverse effects, dosage, formulations and non-pharmacological aspects of care. Decisions about any changes to treatment should be made in collaboration with the person.

If the person has reached their individualised glycaemic target and weight target, continuing any medicines that have contributed to this should be considered. In addition, it may be appropriate to continue SGLT-2 inhibitors for their cardiovascular or renal benefits, even if they do not help the person reach their individualised glycaemic targets. GLP-1 receptor agonists or tirzepatide should be stopped if they do not help the person reach their individualised glycaemic targets and are not being taken for their cardiovascular benefits. They should also be stopped if the person becomes underweight (BMI under 18.5 kg/m²).