Diabetes

Nice | Type 2 diabetes in adults

This is an update of the last Nice guideline on type 2 diabetes in adults, which was published in 2009. I am just summarising things that have changed since the last update. If you don't want to read anything else, just be aware that Nice has produced an excellent single A4 summary of what drugs to…
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Nice | Type 2 diabetes in children and young people

This is the other half of the guideline on diabetes in children and young people, recently published by NICE.  I would suggest reading my blog on type 1 diabetes in children first. Again, I haven't covered everything, just the bits that are particularly useful for us, or things that I wasn't aware of, or thought were…
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Nice | Type 1 diabetes in adults

This is an updated guideline from NICE on Type 1 diabetes in adults. It is a huge guideline. Most patients will be managed in secondary care, so I've tried to pull out the bits that are most relevant to us or that seemed new to me. If you do a lot with these patients, the…
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Diabetic foot problems

This is a new guideline from NICE on assessing and managing people with diabetic foot problems. Foot problems are very common in people with diabetes and come with huge morbidity. The following are some surprising statistics: 10% of people with diabetes will get a foot ulcer at some point in their lives. 1 in 3…
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RCOG | Polycystic ovarian syndrome

RCOG's new guideline looks at the long term health problems with polycystic ovarian syndrome PCOS. There isn't very much that's new, but I think that generally we aren't very good at following these women up, so I'm doing a general summary. The biggest risk is with diabetes, both gestational and type 2 if you don't want…
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Nice | Canagliflozin in Type 2 diabetes

This new guideline from NICE outlines when canagliflozin can be used. This is an SGLT2 inhibitor (selective sodium-glucose cotransporter-2). It blocks reabsorption of glucose in the kidneys, so increases secretion. It's trade name is Invokana. Another one of these drugs (Dapagliflozin) was approved last year. When can it be used?  As a second drug added on to metformin…
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Nice | Dapagliflozin for Type 2 Diabetes

This guideline advises that Dapagliflozin can be used in Type 2 Diabetes as add-on therapy: • With metformin if: - glycaemic control is not adequate - a sulphonylurea can not be used - its addition gives a 0.5% or more drop in HbA1c at 6 months • In combination with insulin, with or without other…
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Preventing Type 2 diabetes

This is one of those guidelines that you look at, makes you want to cry, then wouldn’t normally bother to read. But it is actually packed full of really useful information and advice to give patients about diet and exercise. I will try to summarise the most useful bits, but it’s a long document… I…
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Exenetide prolonged release

The new NICE guideline advises that Exenetide Prolonged Release can be used instead of normal Exenetide and is given just once weekly rather than twice daily. It causes fewer side-effects (on the GI / hypo front). It is more cost-effective than normal Exenetide. Allthough it is a little more expensive, it gives a better drop…
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