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 use when.
HbA1C targets for Type 2 diabetes
Nice advise that these targets can be tailored to the patient. They also advise that the targets can be relaxed if the side-effects from medications, or if the effort to reach that target impairs their quality of life.
- 48 mmol/mol (6.5%) = target for people just managed with lifestyle or on a single drug which doesn’t cause hypoglycaemia.
- 53 mm0l/mol (7%) = target for people on drugs which cause hypoglycaemia.
- 58 mmol/mol (7.5%) or above:
- Offer encouragement
- Lifestyle advice
- Intensify drug treatment
BM testing
This is largely the same and the differences are subtle. Nice no longer advising doing BMs routinely twice a week. They also no longer advise monitoring with illness, though they do acknowledge that you need to be aware of the risk of hyperglycaemia with illness. Previously they advised monitoring if on oral medication that could cause hypos, but now they only advise testing if they are also driving or operating machinery.
