The medication change that could save 20,000 lives a year

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The once-daily tablet ‘works very well’ in a wide range of patients

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A new class of drug for type 2 diabetes could save thousands of lives each year, a study has found.

Researchers described the once-daily SGLT-2 inhibitor tablets as working “very well” for a wide range of patients.

This follows the National Institute for Health and Care Excellence (Nice) endorsing them as a first-line treatment, signalling a major change in diabetes care.

Drugs such as canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin reduce blood sugar by helping the kidneys remove glucose, which is then passed from the body through urine.

For the study, experts at UCL and the London School of Hygiene & Tropical Medicine (LSHTM) analysed data from 60,000 people in the UK.

They found that type 2 diabetes patients who were prescribed SGLT-2 inhibitors were 24 per cent less likely to die prematurely over an average of three years compared to those on other blood sugar-lowering medications.

Based on an estimate of three million people being treated for type 2 diabetes in the UK, researchers suggest about 20,000 deaths could be prevented each year.

Dr David Ryan, who specialises in clinical pharmacology and is also a PhD student based at the UCL Institute of Health Informatics, said: “Our study shows this drug works very well in a much wider range of people with type 2 diabetes than we previously had evidence for.

“Our findings support Nice’s draft guidance proposing its use as a first treatment for type 2 diabetes, in addition to metformin – which would be a major shift in diabetes care affecting millions.

“The typical person with type 2 diabetes may live longer with these tablets.”

There are around 4.6 million people in the UK living with diabetes, nine in 10 of whom have type 2.

It is estimated that a further 1.3 million people may have undiagnosed type 2 diabetes.

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In August, Nice announced the biggest shake-up of diabetes care in a decade, and said millions of people would have earlier access to newer treatments.

This included making SGLT-2 inhibitors a first-line treatment option.

Nice analysis of the records of 590,000 people and found the drugs inhibitors are under-prescribed, particularly to women, older people, and black patients.

Its new guidelines recommend patients who cannot tolerate metformin – the first-choice in type 2 diabetes medication – should start with an SGLT-2 inhibitor on its own.

Evidence suggests these drugs protect the heart and kidneys as well as controlling blood sugar.

Dr Patrick Bidulka, of LSHTM, said that the study, published in BMJ Open Diabetes Research & Care, “is a good example of how patient data can help inform patient care”.

“It shows how we can use electronic health records safely to complement evidence from randomised controlled trials to improve outcomes for patients,” he added.

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