29 July 2015 - NICE has re-drafted new guidelines for type 2 diabetes treatments after a major backlash from doctors – but critics say the second attempt is still badly flawed.

The UK's National Institute for Health and Care Excellence (NICE) first issued new guidelines for type 2 diabetes in January, but these were heavily criticised for being out of step with international opinion on the best treatment options.

Diabetologists say the recommendations remain often inconsistent with evidence, illogical, and don't even reflect NICE's own recommendations of newer drugs.

The first draft of the guideline recommended the infrequently used repaglinide as a first line therapy for patients who cannot tolerate metformin. This decision was widely attacked as lacking an evidence base, the drug having a difficult three-times-a-day dosing and carrying a known risk of hypoglycaemia.

The strength of opposition has led NICE to re-draft the guidelines – a very rare occurrence - but stakeholders say major problems remain in the updated version.

The amended draft restores some choice for doctors prescribing drug treatments – but doctors still say repaglinide should not play a prominent role, and that newer drugs have been sidelined without good reason.

For more details, go to: http://www.pharmaphorum.com/news/nice-diabetes-guidelines-still-dont-add-up-say-doctors-and-pharma-company