Type 2 diabetes – canagliflozin, dapaglifozin and empaglifozin as monotherapies

This is new guidance from NICE advising that canagliflozin, dapagliflozin and empagliflozin can all be used as monotherapies in treating Type 2 Diabetes. Previously they have only been advised as add-on therapies.

For a reminder of other drug treatments, see the helpful pdf produced by NICE.

Just a reminder - these are selective sodium-glucose cotransporter 2 (SGLT-2) inhibitors, which block the kidneys reabsorbing glucose. This increases glucose excretion through the kidneys.

They can be used as monotherapies when:

  • Metformin can not be used and
  • Diet an exercise alone has not been adequate and
  • A DDP-4 inhibitor (gliptin) would otherwise be prescribed and
  • A sulfonylurea or pioglitazone is not appropriate

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