The Scottish Medicines Consortium has issued guidance that will allow NHS boards to give physicians the go-ahead to prescribe Forxiga (dapagliflozin) to adults in Scotland with type 2 diabetes. It is for restricted use as dual therapy in combination with metformin, when metformin alone with diet and exercise does not provide adequate glycaemic control and a sulphonylurea is inappropriate. Around 200,000 people in Scotland are currently living with type 2 diabetes, which is almost 4% of the entire population, and cases of type 2 diabetes are continuing to rise. Professor Naveed Sattar, Professor of Metabolic Medicine, University of Glasgow, said: “Effective blood glucose control is essential in managing type 2 diabetes and lowering the risk of developing complications, in particular those that effect eyesight or kidney function but also heart disease and stroke. However, weight management is also important and weight reduction is recommended as a first step for managing the condition. Physicians are therefore interested to see how new therapies, such as dapagliflozin, can help patients achieve blood glucose targets with the secondary benefit of weight loss.” Dapagliflozin is the first in a new class of treatments called sodium-glucose cotransporter 2 (SGLT2) inhibitors. It works by reducing the amount of glucose reabsorbed in the kidney. As a result, in people with type 2 diabetes, an increased amount of glucose is passed out of the body via the urine each day, along with the associated calories. Unlike many other diabetes medications, dapagliflozin works in a novel way that is independent of insulin action.