T2DM: Type 2 diabetes Nice update (March 2022)

7th July 2022 by Dr Louise Hudman

T2DM: Type 2 diabetes Nice update (March 2022)

Nice has released an update to its guidance on its Type 2 diabetes mellitus in adults. This was published in Mar 2022. The last big update was in 2015.

In June 22, NICE released an update on this guideline. We should be advising all patients with T2DM that they are at higher risk of periodontitis. If they get periodontitis, managing it can help their blood glucose control and reduce the risks of hyperglycaemia. We should be advising patients to have regular dental checkups.

To support this update, Nice has published a handy visual guide to the drugs used in the management of T2DM. It is definitely one for the wall…

What is new in this update?

  • Bariatric surgery. This isn’t new guidance, but I have added a section on it in this summary.
  • Hypertension. People with T2DM should be managed as per the Nice hypertension guidelines. The BP targets are now the same as for people without diabetes.
  • Cardiovascular disease (CVD) and chronic heart failure. All patients with T2DM should be assessed for their cardiovascular risk. If patients have established chronic heart failure or ischaemic CVD then an SGLT2 inhibitor should be offered once the patient is established on metformin. If patients are at high risk of CVD the SGLT2 inhibitors should be considered.
  • GLP-1 mimetics. These can now be considered alongside a broader range of other medications.
  • Continuous glucose monitoring. This can now be offered to some patients with T2DM. I have put further information about who will be eligible in the summary below.

HbA1C targets for Type 2 diabetes

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