Type 2 diabetes: national clinical guideline for management in primary and secondary care

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Developed by the National Collaborating Centre for Chronic Conditions at the Royal College of Physicians

This guideline was partially updated in 2009 and can be downloaded from the NICE website.

Type 2 diabetes can cause severe complications, affecting the eye, the nervous system and the kidney. The overall risk of cardiovascular disease is more than doubled, and the life expectancy is reduced by an average seven years. In 2002, the National Institute for Health and Clinical Excellence (NICE) published a suite of five guidelines dealing with different aspects of the care of type 2 diabetes. The rising prevalence of the disease, and the range of complications which can arise, reinforce the importance of up-to-date guidance and accordingly NICE have asked the NCC-CC to produce this guideline, amalgamating and updating the previously published work.

Topics of particular relevance to life expectancy, such as control of cholesterol and lipid levels, and management of hypertension, are covered in the guideline. It deals with major complications such as renal disease. There are also key recommendations in areas of great importance to patients such as structured education and the monitoring of glucose levels. Naturally, there are also sections dealing with control of blood glucose levels and the use of the various drugs available for this purchase.

The guideline is an invaluable resource for general physicians, diabetologists, dieticians, general practitioners, nurses and healthcare professionals who are involved in the management and care of people with type 2 diabetes.

The challenge now is to implement its recommendations and to make a genuine difference to the well-being and health of those with type 2 diabetes.

Contents

  • The development
  • Introduction
  • Methodology
  • Key messages of the guideline
  • The guideline
  • Education
  • Lifestyle management/non-pharmacological management
  • Glucose control levels
  • Self-monitoring of plasma glucose
  • Oral glucose control therapies
  • Glucose control: insulin therapy
  • Blood pressure therapy
  • Cardiovascular risk estimation
  • Management of blood lipid levels
  • Anti-thrombotic therapy
  • Kidney damage
  • Eye damage
  • Nerve damage
  • Areas for future research

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