Overview

• Draft guidance shifts from a uniform pathway to personalised treatment, making SGLT‑2 inhibitors a first‑line option for people who cannot tolerate metformin.
• NICE proposes earlier use of GLP‑1 receptor agonists for defined high‑risk groups, including triple therapy for adults with cardiovascular disease and tailored approaches for chronic kidney disease.
• Analysis of 590,000 patient records found SGLT‑2 drugs are under‑prescribed, particularly for women, older people and Black patients.
• Modeling by NICE suggests the changes could save nearly 22,000 lives once uptake reaches about 90% of people with type 2 diabetes.
• The recommendations remain in draft form and will be finalized after the consultation, which follows evidence that 4.6 million people in the UK live with diabetes and many more may be undiagnosed.