Input on new draft NICE Guideline on Diagnosis and Management of Type 1 Diabetes in Adults

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February 02, 2015 22:06
Peter DUAG Committee Member
University College London Hospitals (UCLH) 109 posts

I have another request from the DAFNE Executive for you input please.

NICE are in the process of updating their National Clinical Guideline on the treatment which should provided to all Type 1 Diabetics in the UK. This will be the first major update since 2004. The update will be published later this year (target in August) and will define the care we should be receiving in the next 10 years, and is therefore critical to all of us. The draft version has now been published for review. It covers a total of 183 recommendations in the following areas:

  • Diagnosis
  • Care process and support
  • Education programmes and self-care
  • Blood glucose control
  • Insulin therapy
  • Referral for islet or pancreas transplantation
  • Impaired awareness of hypoglycaemia
  • Ketone monitoring and management of diabetic ketoacidosis
  • Associated illness
  • Arterial risk control
  • Inpatient management
  • Management of complications

The revised recommendations range from the number of test strips which should be made available per day (at least 4 and up to 10 in some circumstances) to the preferred basal regime (twice-daily insulin detemir) and needle selection (choose needles with the lowest acquisition cost to use with pre-filled and reusable insulin pen injectors).

Within the Guideline encouragingly there are multiple mentions of DAFNE (e.g. Offer all adults with type 1 diabetes a structured education programme of proven benefit, for example the DAFNE programme). As a result the DAFNE Executive are stakeholders of the programme and are currently putting together a response to this draft and they have asked for input from graduates.

The whole Guideline runs to over 600 pages (excluding appendices)! There is also a summary available which covers all the recommendations, but excludes the scientific evidence justifying each. This is "only" 81 pages long. Both can be found here: Nice Type 1 Draft Guideline.

Any feedback you have can be submitted by responding to me directly at [email protected] or by replying to this topic. All suggestions will be passed to the DAFNE Executive for consideration in their response.

Finally, note your feedback is required urgently. Unfortunately the deadline I've been given for sending responses to the DAFNE Executive means that I need your comments within one week i.e. by the end of Monday 9th February. Sorry for the short notice with such lengthy documents.

Many thanks.