Type 2 diabetes is a chronic condition in which the pancreas does not produce enough insulin or the body does not properly use insulin — the hormone which controls the level glucose (sugar) in blood — causing a rise in blood glucose levels. Type 2 diabetes affects many major organs, including the heart, nerves, blood vessels, kidneys and eyes. Therefore, getting the right treatment to control diabetes is necessary to help prevent these complications.
The National Institute for Health and Care Excellence (NICE) has recently recommended three new drugs for the treatment of type 2 diabetes in adults in the UK: canagliflozin (Invokana), dapagliflozin (Forxiga), and empagliflozin (Jardiance).Nearly three million people in the UK have type 2 diabetes. An estimated 31, 000 people may be qualified for treatment with these three drugs.
Canagliflozin, dapagliflozin, and empagliflozin are all selective sodium-glucose cotransporter 2 (SGLT-2) inhibitors that work by blocking the re-absorption of glucose in the kidneys and enhancing the removal of excess glucose from the body in the urine. Through this mechanism, these drugs may help control glucose level in the blood independently of insulin pathways.
The three drugs could be used as monotherapy for people with type 2 diabetes in England and Wales for people who can’t take metformin (which is usually the first drug treatment offered to patients with type 2 diabetes) due to side effects or contradictions, or if diet and exercise alone do not provide sufficient control of blood glucose. For people who can’t take sulfonylurea or pioglitazone, then the three drugs recommended in this guidance can be considered. These three drugs may also be used as add-on combination therapy with other drugs that lower glucose, including insulin, when these other drugs, together with diet and exercise, do not provide sufficient control of blood glucose.
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