As reported by the National Health Executive, thousands of lives could be saved under updated treatment guidance for type 2 diabetes, as the National Institute for Health and Care Excellence (NICE) introduces significant changes to prescribing in England
The revised recommendations move SGLT2 inhibitors – commonly known as “flozins” – much earlier in the treatment pathway. NICE modelling suggests that earlier use of these medicines, alongside GLP-1 receptor agonists and tirzepatide for certain patients, could prevent around 17,000 deaths across the UK within three years.
Beyond lowering blood glucose, the medicines are shown to protect heart and kidney function and reduce the risk of heart attacks, strokes and kidney disease.
Under the new approach, treatment will be more personalised. Clinicians are advised to tailor prescriptions according to individual circumstances, with most patients now recommended to begin therapy with a combination of metformin and an SGLT2 inhibitor. The guidance also encourages the use of a slow-release form of metformin to minimise gastrointestinal side effects.
Previously, the majority of patients were started on metformin alone.
The changes are also expected to expand access to newer injectable treatments, with up to 810,000 additional people potentially becoming eligible for GLP-1 receptor agonists and tirzepatide.
Financially, the NHS is projected to save £560 million across 2025/26 and 2026/27, largely due to the availability of generic dapagliflozin, a widely prescribed SGLT2 inhibitor. Health leaders say these savings could be reinvested into diabetes education, community-based support services and wider NHS care.
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