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Diabetes (type 2) - liraglutide - NICE TAG TA203

1 Guidance

Units for reporting HbA1c have changed from % to mmol/mol since this guidance was published. The NICE Pathway ondiabetes has been changed to reflect this. The guidance is being updated and the new recommendations (to be published in 2015) will use mmol/mol.

1.1 Liraglutide 1.2 mg daily in triple therapy regimens (in combination with metformin and a sulphonylurea, or metformin and a thiazolidinedione) is recommended as an option for the treatment of people with type 2 diabetes, only if used as described for exenatide in 'Type 2 diabetes: the management of type 2 diabetes' (NICE clinical guideline 87); that is, when control of blood glucose remains or becomes inadequate (HbA1c ≥ 7.5%, or other higher level agreed with the individual), and the person has:

  • a body mass index (BMI) ≥ 35 kg/m2 in those of European descent (with appropriate adjustment for other ethnic groups) and specific psychological or medical problems associated with high body weight, or

  • a BMI < 35 kg/m2, and therapy with insulin would have significant occupational implications or weight loss would benefit other significant obesity-related comorbidities.

1.2 Treatment with liraglutide 1.2 mg daily in a triple therapy regimen should only be continued as described for exenatide in 'Type 2 diabetes: the management of type 2 diabetes' (NICE clinical guideline 87); that is, if a beneficial metabolic response has been shown (defined as a reduction of at least 1 percentage point in HbA1c and a weight loss of at least 3% of initial body weight at 6 months).

1.3 Liraglutide 1.2 mg daily in dual therapy regimens (in combination with metformin or a sulphonylurea) is recommended as an option for the treatment of people with type 2 diabetes, only if:

  • the person is intolerant of either metformin or a sulphonylurea, or treatment with metformin or a sulphonylurea is contraindicated, and

  • the person is intolerant of thiazolidinediones and dipeptidyl peptidase-4 (DPP-4) inhibitors, or treatment with thiazolidinediones and DPP-4 inhibitors is contraindicated.

1.4 Treatment with liraglutide 1.2 mg daily in a dual therapy regimen should only be continued if a beneficial metabolic response has been shown (defined as a reduction of at least 1 percentage point in HbA1c at 6 months).

1.5 Liraglutide 1.8 mg daily is not recommended for the treatment of people with type 2 diabetes.

1.6 People with type 2 diabetes currently receiving liraglutide who do not meet the criteria specified in section 1.1 or 1.3, or who are receiving liraglutide 1.8 mg, should have the option to continue their current treatment until they and their clinicians consider it appropriate to stop

https://www.nice.org.uk/guidance/ta203 

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