Who should be considered for treatment with exenatide, according to NICE guidelines?

Patients who are unable to control glycaemic control despite maximal doses of metformin and/or sulphonylureas-2. patients who have a bmi >35kg/m^2-quoted from nice guidelines cg66 update:exenatide: glp-1 mimeticsr44 exenatide is not recommended for routine use in type 2 diabetes.r45 consider exenatide as an option only if all the following apply for the individual: a body mass index over 35.0 kg/m2 in those of european descent, with appropriate adjustment in tailoring this advice for other ethnic groups specific problems of a psychological, biochemical or physical nature arising from high body weight inadequate blood glucose control (hba1c 7.5 %) with conventional oral agents after a trial of metformin and sulfonylurea other high-cost medication, such as a thiazolidinedione or insulin injection therapy, would otherwise be started.r46 continue exenatide therapy only if a beneficial metabolic response (at least 1.0 % hba1c reduction in 6 months and a weight loss of at least 5% at 1 year) occurs and is maintained.note: use with thiazolidinediones is not yet recommended in the uk but the fda has approved it in the usa