NICE plans to recommend extra ‘triple therapy’ type 2 diabetes drug

7 October 2016  •  Author: Niamh Louise Marriott, Digital Content Producer

The National Institute for Health and Care Excellence (NICE) has published final draft guidance recommending dapagliflozin for treating type 2 diabetes in triple therapy, meaning that if someone is already taking two drugs for type 2 diabetes but it’s not controlling their blood sugar, then dapagliflozin can be added as a third drug. 


A person with type 2 diabetes has too much glucose (sugar) in their blood, a condition which approximately 3 million people in the UK suffer from.

Blood glucose levels might not be controlled by diet and exercise alone, so people in this position are offered metformin (or an alternative drug if they can’t take metformin) as their first single drug treatment. If blood glucose levels still don’t decrease, then a second drug can be added, or if needed they can also have a third drug – triple therapy.

Combination therapy

Once final guidance is published, dapagliflozin will join two other similar drugs, empagliflozin and canagliflozin, as options for triple therapy. All three drugs are already recommended for use on their own if a person can’t use metformin or other specific drugs, or in combination with metformin as dual therapy.

This final draft guidance is now with consultees, who have the opportunity to appeal against it. Until NICE issues final guidance, NHS bodies should make decisions locally on the funding of specific treatments.

Once NICE recommends a treatment ‘as an option’, unless otherwise specified the NHS must make sure it is available within three months of its publication date.

Professor Carole Longson, director of the NICE centre for health technology evaluation, said, “Tailoring treatments for type 2 diabetes to each person’s individual needs is essential and having a range of drug options makes this easier. This guidance plans to recommend dapagliflozin in triple therapy – only in combination with metformin and a sulfonylurea – which will widen the choice available.”

“We’ve been able to speed up this appraisal, going straight to final draft stage because we plan to recommend dapagliflozin. This should help final guidance to be published sooner, and so benefit people more quickly.  Diabetes is a serious, long-term condition but the right treatment and support helps manage the impact on people who live with it.”

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