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.
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