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NICE recommend dapagliflozin (Forxiga) for treatment of type 1 diabetes

Forxiga, for Diabetes, Type 1 from AstraZeneca

The National Institute for Health and Care Excellence (NICE) have recommended AstraZeneca's type 1 diabetes treatment, dapagliflozin, (brand name Forxiga) with insulin as an option for treating type 1 diabetes.

The treatment is recommended for adults with a body mass index (BMI) of at least 27 kg/m2, when insulin alone does not provide adequate glycaemic control despite optimal insulin therapy, only if:
  • they are on insulin doses of more than 0.5 units/kg of body weight/day and
  • they have completed a structured education programme that is evidence based, quality assured, delivered by trained educators and includes information about diabetic ketoacidosis, such as:
  • how to recognise its risk factors, signs and symptoms
  • how and when to monitor blood ketone levels
  • what actions to take for elevated blood ketones, and
  • treatment is started and supervised by a consultant physician specialising in endocrinology and diabetes

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About Forxiga (source EMA)
Forxiga is a diabetes medicine used for adults whose condition is not controlled well enough.

In type 2 diabetes, it is used with appropriate diet and exercise in patients who cannot take metformin (another diabetes medicine). It can also be used as ‘add-on’ treatment to other diabetes medicines.

In type 1 diabetes, Forxiga is used with insulin in overweight patients (body mass index of at least 27 kg/m2) when insulin on its own does not control blood sugar well enough.

Diabetes can occur when the body does not make enough insulin to control the amount of glucose (sugar) in the blood or when the body cannot use insulin effectively. This leads to high levels of glucose in the blood.

The active substance in Forxiga, dapagliflozin, blocks the action of a protein in the kidneys called sodium-glucose co-transporter 2 (SGLT2). As blood is filtered by the kidneys, SGLT2 stops glucose in the bloodstream from being passed out into the urine. By blocking the action of SGLT2, dapagliflozin causes the kidney to pass out more glucose in the urine, thereby reducing the levels of glucose in the blood.

Forxiga was first made available in the EU in 2012. It is manufactured by AstraZeneca.

European Medicines Agency website page for Forxiga
Accessed 13/09/19
Links available in External Resources

© NICE [2019]

Dapagliflozin with insulin for treating type 1 diabetes. Technology appraisal guidance [TA597]. Published date: 28 August 2019
Available from: See Link below. All rights reserved. Subject to Notice of rights
NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication.

The information provided by NICE was accurate at the time this article was issued.

NICE information about Forxiga (TA597)

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