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General principles for managing Type 2 Diabetes Mellitus • The goal of treatment is remission in eligible or appropriate patients • Adopt an individualised approach to diabetes care that is tailored to the needs and circumstances of adults with type 2 diabetes, considering their personal
Once type 2 diabetes is established it is recommended that blood glucose lowering agents are used by all international guidelines. The aim of treatment is to reduce HbA1c to agreed target levels to reduce long term complications from diabetes. The current NICE guidelines, NG28, which was updated in 2022 includes an algorithm for incremental ...
This guideline offers guidance on the prescribing for adults with type 2 diabetes in primary care (except insulin prescribing), and brief advice on the wider management of type 2 diabetes. It does not cover lifestyle advice, the management of type 2 diabetes with insulin,
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This guideline includes recommendations on: 1. individualised care 2. managing blood glucose levels, including HbA1c measurement and targets 3. first-line drug treatment 4. reviewing drug treatments 5. treatment options if further interventions are needed 6. antiplatelet therapy 7. managing complications For recommendations on hypertension in peopl...
Healthcare professionalsCommissioners and providersAdults with type 2 diabetes, and their families and carersUpdates in progres: Drug therapy (excluding insulin-based treatments): see the December 2024 guideline update page. Portfolio review in May 2023: We have reviewed our guidelines portfolio to identify topics that we think will add the most value to the health and care system and have agreed the update on insulin therapy recommended in this surveilla...
How we develop NICE guidelines This guideline updates and replaces: 1. NICE guidelines CG66 (published May 2008) and CG87 (published May 2009) 2. NICE technology appraisal guidance 203 and 248 3. NICE evidence summaries ESNM20, ESNM26 and ESNM59.
Algorithm for the Management of Type 2 Diabetes. STEP 1 – Initial Drug Treatment – Monotherapy: Target HbA1c 48 mmol/mol. Lifestyle advice + Referral to Good2Go Metformin (consider 3 months lifestyle change first) Consider trial of modified-release metformin in patients who experience gastrointestinal side effects with standard release metformin.
Fig. 1 Protocol for control of blood glucose in type 2 diabetes*. TEST ADULTS who have symptoms of diabetes with fasting or random plasma glucose (FPG or RPG) TEST ASYMPTOMATIC ADULTS who are 40+ years old and BMI ≥25 (FPG) FPG ≥7 mmol/L and <18 mmol/L or RPG ≥11.1 mmol/L. IF ASYMPTOMATIC repeat test on subsequent day.
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Simplified summary. HbA1c targets. Usual targets – NICE. 48 mmol/mol if treated with lifestyle alone, or a single drug. 53 mmol/mol if on a single drug associated with hypoglycaemia (insulin or SU). If on a single drug, the threshold for adding a second drug is HbA1c ≥58 mmol/mol. 53 mmol/mol on two or more drugs or insulin.
