NICE recommends dapagliflozin as type 1 diabetes treatment

A drug used to treat type 2 diabetes has been recommended by health watchdog NICE to treat people with type 1 diabetes. Dapagliflozin (marketed as Forxiga) is an SGLT2 inhibitor which helps the kidneys remove glucose from the blood and pass it out through urine. It was first approved by the EU for treating type 2 diabetes in November 2012 and has since become the first licenced oral add-on therapy to insulin in type 1 diabetes. Although, it does present an increased risk of diabetic ketoacidosis (DKA) in type 1 diabetes. NICE says that dapagliflozin is not a replacement for insulin in type 1 diabetes but could be used alongside as insulin if certain criteria are met. It is estimated that around 90,000 people could be eligible. Last week, NICE leant its support to the drug, calling it an "innovative treatment" for adults with type 1 diabetes who have a body mass index (BMI) of 27 kg/m2 or more and are struggling to control their blood glucose levels. NICE has prepared draft guidance with criteria for when dapagliflozin would be appropriate for adults with type 1 diabetes, and if no appeals are lodged it will release the final guidance in August. Previously, a NICE appraisal committee had previously not recommended dapagliflozin, with more information requested. Explaining this latest decision, NICE said: "At present, dapagliflozin with insulin is considered to have only modest benefits based on the evidence from clinical trials. These showed small improvements in blood glucose levels and weight loss, and very small improvements in quality of life. NICE's independent appraisal committee however highlighted an unmet need for interventions that help people to reach good glycemic control without complications."

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