Type 2 Diabetes: National Clinical Guideline for Management in Primary and Secondary Care (Update)

Excerpt

Over 90% of people with diabetes have Type 2 diabetes. This is still perceived as the milder form, and while this may be true in some respects, such as the risk of ketoacidosis, the causation of Type 2 diabetes is more complex and the management is not necessarily easier. 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 life expectancy is reduced by an average 7 years. In 2002, 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 National Collaborating Centre for Chronic Conditions (NCC-CC) to produce this guideline, amalgamating and updating the previously published work.

This is an update of the following NICE (inherited) clinical guidelines on Type 2 diabetes which were published in 2002: E – retinopathy; F – renal disease; G – blood glucose; H – management of blood pressure and blood lipids

The recommendations in this guideline on thiazolidinediones (R40 to R43, chapter 10), GLP-1 mimetic (exenatide) (R44 to R46, chapter 10) and insulin therapy (R49 to R55), chapter 11) have been updated and replaced by NICE short clinical guideline 87 ‘Type 2 diabetes: newer agents for blood glucose control in type 2 diabetes’ (available at www.nice.org.uk/CG87shortguideline). This short guideline contains details of the methods and evidence used to develop the updated recommendations. Chapter 10 and 11 should be read in conjunction with the short clinical guideline 87.