A new updated “Oral Anti-Diabetic Therapy Guidelines for Type 2 Diabetes Mellitus” prescribing algorithm has been developed. This is very similar to the algorithm published in 2021.
1. Prescribing of SGLT-2 inhibitors is simplified with Dapagliflozin replacing Empagliflozin/Canagliflozin.
2. There is an increased focus on cardiorenal protection. In essence, for people with cardiac and/or renal disease, we are recommending that Dapagliflozin is commenced automatically after Metformin therapy is established, irrespective of HbA1c. In the old guideline, an SGLT2 inhibitor was recommended as 2nd line therapy only if HbA1c was above target.
The Lothian Diabetes MCN prescribing algorithm was previously introduced as a simplified version of the ADA/EASD guidelines in April 2021 to support primary care prescribing of oral anti-diabetic therapies in adults.
Further advice is available from the three diabetes centres in Lothian, through their advice email services and at the following links:
SJH Clinadvdiab@nhslothian.scot.nhs.uk
WGH WGH.DiabeticAdvice@nhslothian.scot.nhs.uk
RIE RIE.DiabetecAdvice@nhslothian.scot.nhs.uk
For MCN updates regarding GLP-1 shortages please visit Prescribing Information – Diabetes Managed Clinical Network (nhslothian.scot)
