Wednesday, Oct. 22, 2008; 3:27 PM

LONDON (Reuters) - New recommendations from experts at two international medical societies on treating people with type 2 diabetes no longer back the use of GlaxoSmithKline's drug Avandia.

A revision to a consensus statement first issued in 2006 by experts at the European Association for the Study of Diabetes and the American Diabetes Association states that Takeda's Actos may be considered, but a previous reference to Avandia has been dropped.

Sales of Avandia have plummeted in the past year after the drug was linked to risk of heart attack in a pooled analysis of past clinical studies.

The analysis was contested by Glaxo but the company's chief executive, Andrew Witty, acknowledged on Wednesday after announcing quarterly results that sales had not recovered and the outlook was negative for the drug, which remains on the market.

Both Avandia and Actos belong to same class of drugs, known as glitazones.

The latest treatment recommendations state that lifestyle changes and metformin should be the initial treatment to help people newly diagnosed with type 2 diabetes.

If patients fail to reach target blood sugar goals with this regimen, doctors should then consider adding insulin or a sulfonylurea drug.

"Alternatively, a less preferred and less validated choice includes the addition of pioglitazone (Actos) or a GLP-1 agonist to lifestyle changes and metformin," the expert panel added.