HERTFORDSHIRE MEDICINES MANAGEMENT COMMITTEE (HMMC) SEMAGLUTIDE (OZEMPIC®) FOR ADULTS WITH TYPE 2 DIABETES RECOMMENDED FOR RESTRICTED USE IN PRIMARY, COMMUNITY AND SECONDARY CARE

Abstract

NICE guidance recommends:  Where TRIPLE therapy (metformin and 2 other oral antidiabetics) is not effective, not tolerated, or contraindicated, consider combination therapy with metformin, a sulfonylurea and a GLP-1 mimetic for adults with T2DM who: o have a BMI of 35 kg/m or higher (adjust accordingly for people from black, Asian and other minority ethnic groups) and specific psychological or other medical problems associated with obesity or o have a BMI lower than 35 kg/m and for whom insulin therapy would have significant occupational implications or weight loss would benefit other significant obesity-related comorbidities Only continue GLP-1 mimetic therapy if the person with type 2 diabetes has had a beneficial metabolic response (a reduction of at least 11 mmol/mol [1.0%] in HbA1c and a weight loss of at least 3% of initial body weight in 6 months).  In adults with type 2 diabetes, only offer a GLP-1 mimetic in combination with insulin with specialist care advice and ongoing support from a consultant-led multidisciplinary team