New NICE Guidelines for Type 1 diabetes in adults: diagnosis and management

On August 28th NICE published the updates guidelines for the diagnosis and management of Type 1 in Adults. The key priorities are identified as:

Education and information

Offer all adults with type 1 diabetes a structured education programme of proven benefit, for example the DAFNE (dose-adjustment for normal eating) programme. Offer this programme 6–12 months after diagnosis. [new 2015]

Blood glucose management

Support adults with type 1 diabetes to aim for a target HbA1c level of 48 mmol/mol (6.5%) or lower, to minimise the risk of long‑term vascular complications. [new 2015]

Agree an individualised HbA1c target with each adult with type 1 diabetes, taking into account factors such as the person's daily activities, aspirations, likelihood of complications, comorbidities, occupation and history of hypoglycaemia. [new 2015]

Support adults with type 1 diabetes to test at least 4 times a day, and up to 10 times a day if any of the following apply:

the desired target for blood glucose control, measured by HbA1c level (see recommendation 1.6.6), is not achieved
the frequency of hypoglycaemic episodes increases
there is a legal requirement to do so (such as before driving, in line with the Driver and Vehicle Licensing Agency [DVLA] At a glance guide to the current medical standards of fitness to drive)
during periods of illness
before, during and after sport
when planning pregnancy, during pregnancy and while breastfeeding (see the NICE guideline on diabetes in pregnancy)
if there is a need to know blood glucose levels more than 4 times a day for other reasons (for example, impaired awareness of hypoglycaemia, high‑risk activities). [new 2015]

a fasting plasma glucose level of 5–7 mmol/litre on waking and
a plasma glucose level of 4–7 mmol/litre before meals at other times of the day. [new 2015]

Thks for the information!