Type 2 diabetes in adults – management. NICE NG28, 2015 (Updated 2017)

This guideline from 2015 deals with the management of blood glucose levels and provides recommendations for initial drug treatment and subsequent intensification to achieve and maintain agreed HbA1c targets. The guideline was updated in 2017 to include advice on SGLT2i’s, which can be considered as an option for initial therapy for adults for whom metformin is not tolerated or contraindicated.

Pharmacological management of glycaemic control in people with type 2 diabetes. SIGN, 2017

This guideline provides evidence-based recommendations and best practice guidance on optimal targets for glucose control for the prevention of micro- and macrovascular complications. It also covers the risks and benefits of the main therapeutic classes of glucose-lowering agents and insulins currently available for those who require measures beyond diet and exercise to achieve glucose targets.

Stepping away from inertia in diabetes care

Beverley Bostock-Cox, Practice Nurse 2018;48(04):14-18

‘Clinical inertia’ is defined as the failure of healthcare professionals to initiate or intensify therapy when indicated. If clinicians were to avoid inertia in terms of lifestyle change, glycaemic control, blood pressure and lipid management, the impact on outcomes in diabetes could be substantial.

The importance of achieving target HbA1c in the early years

Judy Downey, Practice Nurse 2018;48(01):12-16

Achieving good glycaemic control in the early years after diagnosis of type 2 diabetes reduces the time spent in a hyperglycaemic state and thus decreases the ‘glycaemic legacy’ – so can be expected to lessen or delay the occurrence of complications.

Management dilemmas in complex diabetes

Beverley Bostock-Cox, Practice Nurse 2017;47(12):34-38

Diabetes is a complex condition, which requires the management of multiple factors in order to optimise outcomes and reduce the risk of complications. This article considers some of the aspects of diabetes that make it challenging to manage, and discusses possible solutions when addressing these issues, which include renal impairment, co-morbidities and psychological problems.

Managing type 2 diabetes – beyond glycaemic control

Beverley Bostock-Cox, Practice Nurse 2018;48(10):25-29

Recent studies of newer glucose-lowering therapies indicate that some may also help to protect against cardiovascular and other complications of diabetes, beyond simply lowering blood glucose levels. In this article we will consider the increasing body of evidence for an extended role for some of the agent used in the management of type 2 diabetes.