New NICE Guidance for Diabetes
NICE have issued two draft guidelines on diabetes care. Of the two documents, one focuses on adults with type 1 diabetes and the other concentrates on children and young adults, with either type 1 or type 2.
Sparking this call for updated guidance, the last was issued in 2004, is the worrying evidence that rates of diabetes diagnosis are swelling profusely throughout the country. Research shows that there are over 370,000 type 1 diabetes sufferers across the country, and 450 children with type 2.
The guidance for adults focuses on greater personalisation of care, and encourages a structured education program for diabetes sufferers to improve understanding. It also specifies achievable individualised targets for HbA1c levels and plasma glucose. The guidance supports testing at least 4 times a day on a routine basis for blood glucose and up to ten times if the patient fulfils any further conditions e.g. before and after sport, if they aren’t achieving HbA1c targets, during illness, pregnancy (more here).
For children, there have been major changes to the routine management of type 1 diabetes since 2004 when the last guidance was issued. The guidance outlines what these are - including technology advances, and it is the first guidance to recommend attempting to achieve an HbA1c level in the normal range and near normoglycaemia . Increasing information and education for children and their families is recommended, as well as ongoing access to mental health professionals.
The guideline development group (GDG) believes that by implementing the strict blood glucose control recommended in this guideline, improvements can be made to diabetes care that reduce the impact of the condition on the future health of children and young people.
Importantly the guideline development group have said that ‘Preparations should also be made for the child or young person’s transition to adult services, which have a somewhat different model of care and evidence base’. This has previously been an issue for development, and BIVDA are pleased to see that this has been picked up.
BIVDA will be responding to this guidance on behalf of the IVD industry. Please contact Rebecca to input into this response.