Major Shake-Up in Type 2 Diabetes Care Brings Hope for Kidney Health

“Millions of people are set to benefit from earlier access to newer type 2 diabetes treatments – the biggest shake-up in care for a decade – as part of NICE’s commitment to re-evaluate priority clinical pathways described in the 10-Year Health Plan for the NHS” (National Institute for Health and Care Excellence (NICE), 20 August 2025)

This announcement from the National Institute for Health and Care Excellence (NICE) marks a major shake-up in type 2 diabetes care, and it brings real hope for kidney health as well as for preventing heart attacks and strokes.

For our African and Caribbean communities, this is important news. We know that people of African and Caribbean heritage are up to five times more likely to develop kidney disease than other groups, with type 2 diabetes being one of the leading causes. So, while this guidance is a big step forward, it is vital to ask: who will actually benefit from these life-saving medicines?

Why were Black people under-prescribed in the first place?

NICE’s own analysis highlights that SGLT-2 inhibitors were under-prescribed to Black patients, women, and older people. This is not a small oversight. Black people in the United Kingdom are five times more likely to develop kidney disease than other groups, and one of the leading causes is type 2 diabetes. Given this risk, why has there been a delay in ensuring fair access to treatments that can prevent kidney failure?

How many Black people are represented in the data?

NICE reviewed 590,000 patient records to reach these conclusions. But how many of those records represented Black patients? We would like to know this, because without knowing, how can we be confident that the data reflects the true scale of inequality in prescribing practices?

Access: who will actually get these medicines?

The new guidance suggests that people should discuss their options with their GP. But what if patients do not see this announcement, or if they are not aware that they can ask for a review? Access cannot rely solely on individuals knowing the system, or seeing a press release. NICE and the NHS need to work directly with Black-led community organisations, faith groups, and patient education networks to ensure the message is heard and acted on. Otherwise, the risk is that the same communities who were under-prescribed in the past will continue to be left behind.

Other questions we should be asking

• Who is NICE partnering with to ensure equitable access for under-represented groups, particularly Black communities?

• Will there be a national campaign to raise awareness among patients about these new treatment options?

• How will GPs be supported (and held accountable) to ensure that prescribing inequalities do not continue?

• How will NICE measure success – will they publish data showing changes in prescribing patterns by ethnicity?

• What role can Black-led health organisations and patient voices play in shaping how this guidance is rolled out?

Moving from policy to real change

This guidance could save thousands of lives and prevent many cases of kidney disease. But unless the system actively addresses the barriers to access that Black people face – from lack of awareness to systemic biases in prescribing – the benefits will not be felt equally.

Here at the African Caribbean Kidney Education Enterprise, we welcome this major shake up in type 2 diabetes care, as hopefully it will translate into better kidney health, meaning fewer cases of kidney disease and ultimately kidney failure. But we also call on NICE, the NHS, and all partners to work with our communities to ensure that everyone who could benefit from these life saving treatments actually receives them.

Because good news is only good if it reaches those who need it most.