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Primary care experts are urging NICE to overhaul draft guidelines on type 2 diabetes, claiming recommendations to use the drug repaglinide are ‘bonkers’ and risk setting care back a decade, Pulse has learned.
The experts said the recommended treatment algorithm for glycaemic control was ‘nonsensical’, drawing particular attention to the promotion of the insulin secretagogue repaglinide – which primary care has ‘little understanding of’ because it is rarely prescribed.
The draft guidelines still recommend metformin as first-line initial therapy, but have demoted sulfonylureas from their position as a second-line or alternative option to metformin over concerns about their associated risks of hypoglycaemia.
They now propose repaglinide as an alternative first-line therapy in people who cannot tolerate metformin. But Professor Roger Gadsby, GPSI in diabetes and principle teaching fellow at the University of Warwick, told Pulse the treatment algorithm was considered ‘bonkers’ by diabetes experts.
Professor Gadsby said: ‘Many experts in diabetes have labelled part of this draft guidance as “bonkers”… A particular area of concern is the recommendation that in the 15% or so who cannot tolerate metformin as initial monotherapy for glycaemic control the drug repaglinide should be used.’
More on this new Pulse story here http://www.pulsetoday.co.uk/20009139.article#.VNoOJNUgiiw
The experts said the recommended treatment algorithm for glycaemic control was ‘nonsensical’, drawing particular attention to the promotion of the insulin secretagogue repaglinide – which primary care has ‘little understanding of’ because it is rarely prescribed.
The draft guidelines still recommend metformin as first-line initial therapy, but have demoted sulfonylureas from their position as a second-line or alternative option to metformin over concerns about their associated risks of hypoglycaemia.
They now propose repaglinide as an alternative first-line therapy in people who cannot tolerate metformin. But Professor Roger Gadsby, GPSI in diabetes and principle teaching fellow at the University of Warwick, told Pulse the treatment algorithm was considered ‘bonkers’ by diabetes experts.
Professor Gadsby said: ‘Many experts in diabetes have labelled part of this draft guidance as “bonkers”… A particular area of concern is the recommendation that in the 15% or so who cannot tolerate metformin as initial monotherapy for glycaemic control the drug repaglinide should be used.’
More on this new Pulse story here http://www.pulsetoday.co.uk/20009139.article#.VNoOJNUgiiw
