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NICE changes insulin advice in diabetes guidelines

Published on 12/12/14 at 08:00am
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NICE has changed its recommendations on type 1 diabetes in adults and children, and type 2 diabetes in children, to reflect ‘major recent major advances’ in the management of diabetes.

The regulator last published guidance on type 1 diabetes ten years ago – and the number of people with diabetes has risen sharply since.

The Health Survey for England, published this week, found the prevalence of diabetes increased from 2.4% to 6.2% between 1994 and 2013. Last year there were 24,000 children with type 1, and 450 with type 2 – which is linked to lifestyle and usually develops slowly and in people over the age of 40. There are over 370,000 adults with type 1 diabetes in the UK.

The guidance on diabetes in children and young people recommends those with type 1 should be prescribed multiple daily insulin injections, or insulin pumps to control their blood sugar levels. The guidance for type 1 in adults recommends multiple daily injection basal bolus insulin, rather than twice-daily mixed insulin regimens, as first-choice insulin injections.

Both draft guidelines are now open for consultation until March next year. Professor Mark Baker, director of clinical practice at NICE says: “In the past decade there have been major changes in how we routinely manage both adults and children with diabetes and it is now possible for many to achieve much stricter targets for their blood sugar levels.

“We now want to hear from all those involved in the care of adults and children with diabetes to inform our recommendations and shape the final guideline.”

NICE will also release draft updated guidance on type 2 diabetes in adults in January. The update is expected to include its recommendations on Janssen’s Invokana (canagliflozin), Bristol-Myers Squibb and AstraZeneca’s Forxiga (dapagliflozin), Lilly’s Bydureon (exenatide prolonged-release) and Novo Nordisk’s Victoza (liraglutide), which have all been appraised since NICE published the last version of its type 2 guidance back in May 2009.

Lilian Anekwe

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