NICE updates type 2 diabetes guidance
Guidelines to help healthcare professionals to identify adults at high risk of type 2 diabetes have been updated.
The National Institute for Health and Care Excellence (NICE) has issued the newly updated document, saying it aims to “remind practitioners that age is no barrier to being at high risk of, or developing, the condition”.
It is also hoped the guideline will help healthcare professionals provide those at high risk with an “effective and appropriate intensive lifestyle-change programme” in a bid to prevent or delay the onset of type 2 diabetes.
The updates state that when commissioning local or national services to deliver intensive lifestyle-change programmes is being considered, if availability of places is limited, people with a fasting plasma glucose of 6.5–6.9 mmol/l or HbA1c of 44–47 mmol/mol [6.2–6.4 per cent] should be prioritised.
It also states that intensive lifestyle-change programmes are designed to “help as many people as possible to access and take part in them”.
Changes to metformin recommendations have also been made. NICE suggests: “Clinical judgement on whether (and when) to offer metformin to support lifestyle change for people whose HbA1c or fasting plasma glucose blood test results have deteriorated if this has happened despite their participation in intensive lifestyle-change programmes or if hey are unable to participate in an intensive lifestyle-change programme, particularly if they have a BMI greater than 35.”
The recommendations in the guideline can be used alongside the NHS Health Check programme. A guideline on population and community-level interventions for preventing type 2 diabetes has also been produced, which recommends how to tailor services for people in ethnic communities and other groups who are particularly at risk of type 2 diabetes.
The guidance, which was originally called Preventing Type 2 Diabetes: Risk Identification and Interventions for Individuals at High Risk, is set to be reviewed again in February 2018.