Grey, Red, Green - after consultant/specialist initiation
Decision Date:
July 2016


Type 2 diabetes
  • Type 2 Diabetes without CKD: GREY by exceptionality defined as intolerance to the preferred 1st line choice or restricted its licensing. Indicated for use as per NICE TA288, NICE TA390 and NICE TA418 for type 2 diabetes: in combination (triple therapy) with other glucose-lowering agents and for use as monotherapy. See local type 2 diabetes guidance. 
  • Type 2 Diabetes with CKD: GREEN consultant/specialist initiation - as per NICE NG203, for adults with CKD and type 2 diabetes, in additions to an ACEI or ARB at an optimised dose, if the ACR >30mg/mmol and meets the criteria in the marketing authorisation.  (Decision date - Sep 2021)
Chronic Heart failure:
  •  GREEN after specialist/consultant initiation and stabilisation: NICE TA679 - Dapagliflozin for treating chronic heart failure with reduced ejection fraction. Dapagliflozin to be initiated and stabilised by specislist/consultant before transfering the patient to primary care. See local heart failure guidance for further details. (Decision date - April 2021)
Type 1 diabetes: 
  • RED:  Dapagliflozin with insulin for treating type 1 diabetes (unlicenced).
  • NICE have withdrawn guidance for this indication, because dapagliflozin with insulin is no longer licenced for treating type 1 diabetes. (November 2021).  

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Derby and Derbyshire CCG

Derby and Derbyshire CCG

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