The updated 2015 guidelines on type 2 diabetes in adults – released on Wednesday – are the first since 2009, prompting experts to criticise 'long delays' since the last update.
Recommendations new to the updated guideline say GPs should ‘intensify drug treatment’ in patients whose HbA1c levels are not adequately controlled by a single drug and rise to 58mmol/mol or higher.
Although metformin is specified as the initial drug treatment option for adults with type 2 diabetes, it also emphasises ‘an individual approach’ to treating patients with type 2 diabetes, and features an algorithm to help clinicians make decisions on the best drug options.
NICE diabetes guidelines
The changes come as Diabetes UK hit out at NICE for ‘putting unnecessary obstacles in the way’ of type 2 diabetes patients getting the best available care, after ‘long delays’ in the road to the guideline’s publication.
The current changes mark the first for type 2 diabetes since the last update six years ago, in 2009.
Although ‘broadly supportive’ of the guideline, the charity said that NICE still needed to make further changes to bring the guidance more in line with other international guidelines – and to prevent it from being slow to adapt from future progressions in diabetes medicine.
This ‘out-of-date’ nature of the guidelines therefore could lead many clinicians to be unaware of the latest treatments, thereby denying patients the option of the best treatments, it warned.
Chris Askew, chief executive of Diabetes UK, said: ‘Diabetes treatment is an ever-changing field so it is important for recommendations to be updated regularly to reflect new evidence.
Informed patient decision
‘We urge NICE to go ahead and set up the proposed standing committee to enable a far more rapid update of reputable diabetes guidance. Up-to-date guidelines will enable generalist practitioners to support people with diabetes to manage their condition far better, so they can reduce their risk of developing devastating complications.’
Sir Andrew Dillon, NICE chief executive, confirmed the institute has plans in place to establish a ‘standing subcommittee on diabetes’ within its guideline updates programme.
He added: ‘This updated guideline focuses on the importance of putting each person’s needs and preferences at the heart of joint discussions and decision-making. Following these evidence-based recommendations will enable health professionals to create individual packages of care to prevent serious illnesses linked to diabetes.’
The guideline also features new recommendations for antiplatelet therapy and treating erectile dysfunction related to diabetes.