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Updated UK diabetes guideline stresses individualized care
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The United Kingdom’s National Institute for Health and Care Excellence recently updated its diabetes guideline to include focus on tailoring advice and treatments to individual circumstances.
“This updated guideline focuses on the importance of putting each person’s needs and preferences at the heart of joint discussions and decision making,” Andrew Dillon, chief executive of the United Kingdom’s National Institute for Health and Care Excellence (NICE), said in a press release. “Following these evidence-based recommendations will enable health professionals to create individual packages of care to prevent serious illnesses linked to diabetes. And to ensure the guideline keeps pace with new developments in diabetes care, NICE has plans in place to establish a standing subcommittee on diabetes within its guideline updates program.”
The importance of structured education for adults with type 2 diabetes as well as their family members or care providers is outlined in the guideline to help them develop knowledge and skills for diabetes self-management.
“The guideline encourages all patients to eat well and be physically active,” Amanda Adler, MD, PhD, FRCP, a developer of the guideline, said in the release. “For the many adults with type 2 diabetes who do require drugs to help manage their diabetes, the guideline details treatments and includes an algorithm which summarizes the range of treatment options.”
The guideline also includes a newly developed algorithm to help health care providers determine appropriate drug therapies for their patients.
Other key elements of the guideline include the following:
monitoring blood pressure every 1 to 2 months until BP is consistently less than 140/80 mm Hg. Antihypertensive therapy should be intensified to achieve the goal if the patient is currently taking it;
including dietary advice with the personalized management plan;
offering standard metformin as the initial drug;
reinforcing advice about diet, lifestyle, adherence to drug treatment and intensifying drug treatment to achieve target HbA1c levels; and
measuring HbA1c at 3 to 6 month intervals in adults with type 2 diabetes until glucose levels are stable.
“The guideline highlights that putting people with type 2 diabetes at the center of their care package is essential,” Ian Lewin, MD, FRCP, a developer of the guidelines, said in the release. “For example, the guideline recommends that adults with type 2 diabetes should be involved in decisions about their individual HbA1c target. ... Health professionals are also advised to individualize recommendations for carbohydrate intake and alcohol intake, and meal patterns. All of these steps should result in improved outcomes for adults with type 2 diabetes — reduced complications and better health.”
Reference:
National Institute for Health and Care Excellence. Type 2 diabetes in adults: management. Available at: http://www.nice.org.uk/guidance/ng28.