Children and adults with diabetes in the UK should be provided greater support and education on their condition, according to new draft guidelines.
The National Institute for Health and Care Excellence (NICE), which provides healthcare guidance for the NHS in England and Wales, is asking for feedback on two draft guidelines: one covering adults with type 1 diabetes and the other covering children and young people with either type 1 or type 2 diabetes.
The updates are a response to the growing number of people with diabetes in the country, with recent data suggesting there are 4,000 children with type 1 diabetes and 450 with type 2 in the UK, while more than 370,000 adults have type 1 diabetes.
As seen in Public Health England’s diabetes atlas, despite the prevalence of the condition current standards of diabetes care across the county vary greatly between regions, and the main three treatment targets for diabetes – controlling blood pressure, blood sugar and cholesterol – are met for only one in three people with diabetes in England.
The new draft NICE guidelines are an attempt to address this issue, and the guidance for adults with type 1 diabetes has a strong focus on education and evaluation.
NICE recommends that adults with type 1 diabetes be seen at least every three to six months to have their blood sugar measured by a trained professional and to be supported to self-monitor their blood sugar at least four times a day. This self-monitoring should be more frequent if targets are not being met.
The guidance also recommends that adults with type 1 diabetes go on a structured education course to better understand their condition. Multiple daily insulin injections should also be offered as the treatment of choice for these patients.
The guidance for children and young people intends to update recommendations made in 2004 to address the “major advances” that have been made in diabetes care since then.
NICE proposes that children and young people with type 1 diabetes should be offered intensive insulin management either with multiple daily injections or insulin pumps to maintain better control of their condition.
This insulin therapy should be offered alongside dietary advice and courses to better understand how carbohydrates affect blood sugar or medicines. Education on diabetes treatment is especially importance considering the poor adherence associated with diabetes.
For children with type 2 diabetes, the draft guidance has recommendations for healthcare professional on how to diagnose and treat common complications, including problems with the kidneys, high blood pressure and high cholesterol.
Both guidelines are up for consultation until March 2014. NICE is also updating its guidelines for adults with type 2 diabetes and for footcare in people with diabetes.