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Published: 22 January, 2021


New national type 2 diabetes management guidance published

The New Zealand Society for the Study of Diabetes and the Ministry of Health have published new guidance on the management of type 2 diabetes in adults. This guidance provides information on screening and diagnosis, glycaemic monitoring and targets, non-pharmacological and pharmacological treatments (including the place of the newly funded diabetes medicines), management of diabetes complications, hypoglycaemia, diabetes in pregnancy and pre-diabetes.

bpacnz will be publishing an updated article on diabetes management, highlighting the main changes in practice, including use of SGLT-2 inhibitors and GLP-1 agonists.

Pre-COVID-19 Special Authority criteria to be reinstated from 1 February, 2021

PHARMAC has advised that temporary changes made to Special Authority funding criteria in response to the COVID-19 pandemic will no longer apply from 1 February, 2021 and original funding criteria will be reinstated. This will only affect new Special Authority applications. Any active Special Authority approvals will continue; people with current approvals will only be affected if or when Special Authority renewal is required.

N.B. Prior to this announcement, a small number of temporary funding changes were made permanent and therefore will continue for these medicines; click here for more information.

Supply update for oral contraceptives Norimin and Brevinor 1/28

Norimin (ethinyloestradiol 35 micrograms with norethisterone 500 micrograms) is now back in stock with the supplier and is being released to wholesalers. Norimin will be available once the stock of Necon, an alternative brand listed to cover the out-of-stock period, has been used.

Brevinor-1 28 (ethinylestradiol 35 micrograms + norethisterone 1 mg) is also now back in stock with the supplier and being released to wholesalers. No equivalent alternative brand was available to replace Brevinor-1 28, therefore people who were taking it were switched to a different contraceptive. Patients switching back to Brevinor-1 28 will need to follow the seven-day rule to maintain effective contraception due to possible bioequivalence differences, i.e. use an additional contraception method until seven consecutive hormone pills have been taken.

Moclobemide (Aurorix) 300 mg tablets: stocks are running low

A manufacturing issue has affected supplies of moclobemide (Aurorix) 300 mg tablets; 150 mg tablets are unaffected. It is expected that supply will be restored by the end of April, 2021. Pharmacists can dispense two 150 mg tablets instead of one 300 mg tablet, and PHARMAC is confident that there is enough stock to cover the increased demand for 150 mg tablets.

NZF updates in January release

New sections added to the NZF in January, 2021, include:

  • Urinary tract infection - includes guidance on antibiotic choice for cystitis, recurrent cystitis, pyelonephritis and acute and chronic prostatitis
  • COVID-19 vaccines - includes links to relevant organisations involved in preparing the COVID-19 immunisation programme

Other updates include:

  • New indications added for several antibiotics, e.g. if antibiotics are required for diverticulitis, additional options are now indicated; contraindications, dosing in renal impairment and pregnancy advice updated for nitrofurantoin
  • New indication added for dexamethasone – treatment of coronavirus disease 2019 (COVID-19) in patients who require supplemental oxygen therapy
  • Caution added for progesterone – Utrogestan capsules are contraindicated for people with hypersensitivity to peanut or soya as they contain soya lecithin as an excipient

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Paper of the week: Are low carbohydrate diets effective and safe for type 2 diabetes remission?

People with type 2 diabetes who are overweight can achieve a non-diabetic state if they are able to lose enough body weight. A new analysis published in the BMJ assesses the effectiveness and safety of low carbohydrate diets (<130 g/day or <26% of a 2000 kcal/day diet) and very low carbohydrate diets (<10% calories from carbohydrates) undertaken for at least 12 weeks in adults with type 2 diabetes. Measured outcomes included type 2 diabetes remission, weight loss, HbA1c, fasting glucose and adverse events. Low carbohydrate diets were associated with a 32% increase in diabetes remission at six months compared with control (mostly low fat) diets. However, in the long term, low carbohydrate diets are associated with increased all-cause mortality, therefore the study authors recommend that clinicians consider short-term low carbohydrate diets for the management of patients with type 2 diabetes.

Read the full paper here

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