5 changes in the new NICE guidance on Type 2 diabetes in adults that you might want to know:
- Drug treatment choice now incorporates cardiovascular and renal protection considerations – you may want to audit those diabetics who are highest cardiorenal metabolic risk
- SGLTs now considered suitable first line monotherapy if Metformin is contraindicated or not tolerated, and they have HF or high risk of developing Cardiovascular disease1 – you may want to audit those on SGLT2 monotherapy to ensure that Metformin has been tried before
- Repaglinide is no longer recommended for the treatment of Type 2 diabetes– you may want to review patients on this medicine at their next review especially owing to it’s long term stock issues!
- The phrase ‘threshold for intensification’ has been replaced by ‘threshold for intervention’ – this opens up the possibility of many different forms of intervention apart from pharmacological intensification – you may want to review what weight loss and lifestyle support services are also available to your patients
- Hypertension targets are now covered by the hypertension guidelines and no longer embedded in the Diabetes Guidelines in keeping with ESC Guidance
Want to know more? Why not join our forthcoming webinars on diabetes:
Diabetes Series: Management of Diabetes and Cardiovascular Risk including Hypertension, Hyperlipidaemia & Anticoagulation
21st March, East Midlands, East England, Greater London, South East – Book Now
15th July, Scotland, North East, North West, Yorkshire & Humberside, Northern Ireland – Book Now
3rd October, West Midlands, South Central, South West, Wales – Book Now
Diabetes Series: Guidance, Insulin types, GLPIs, Needle and Injection Technique, Shared Decision Making and Management of Injectable Therapies
30th September, East Midlands, East England, Greater London, South East – Book Now
Type 2 Diabetes in the Context of Cardiorenal Metabolic Syndrome
27th May, West Midlands, South Central, South West, Wales – Book Now
Diabetes Including Cardiovascular & Renal Aspects
26th April, North East, Manchester, Birmingham, Leicestershire – Book Now
Diabetes Series: Managing Complications in Diabetes including Hypoglycaemia, DKA, Foot and Eye Care
29th July, East Midlands, East England, Greater London, South East – Book Now
19th August – Scotland, North East, North West, Yorkshire & Humberside, Northern Ireland – Book Now
Aetiology, Symptoms, Treatment, Review and Monitoring of Diabetes in Primary Care
14th June, Babylon, Greater London – Book Now
Or if you are regularly reviewing Diabetes patients apply to be on the next cohort of our RCGP accredited Diabetes Academy: Apply Now
1Cardiovascular risk assessment should be completed for all patients, with high risk of developing cardiovascular is defined as adults with type 2 diabetes who have: QRISK2 more than 10% in adults aged 40 and over or an elevated lifetime risk of cardiovascular disease (defined as the presence of 1 or more cardiovascular risk factors in someone under 40)1. Cardiovascular disease risk factors are as follows: hypertension, dyslipidaemia, smoking, obesity, family history (in a first-degree relative) of premature cardiovascular disease.
