Type 2 diabetes in adults: management - NICE guideline

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The guideline covers the care and management of type 2 diabetes in adults (aged 18 and over). It focuses on patient education, dietary advice, managing cardiovascular risk, managing blood glucose levels, and identifying and managing long-term complications.

What is Type 2 diabetes?

Type 2 diabetes is a chronic metabolic condition characterised by insulin resistance (that is, the body's inability to effectively use insulin) and insufficient pancreatic insulin production, resulting in high blood glucose levels (hyperglycaemia). Type 2 diabetes is commonly associated with obesity, physical inactivity, raised blood pressure, disturbed blood lipid levels and a tendency to develop thrombosis, and therefore is recognised to have an increased cardiovascular risk. It is associated with long‑term microvascular and macrovascular complications, together with reduced quality of life and life expectancy.

In 2013, over 3.2 million adults were diagnosed with diabetes, with prevalence rates of 6% and 6.7% in England and Wales respectively. It is estimated that about 90% of adults currently diagnosed with diabetes have type 2 diabetes. Type 2 diabetes is more common in people of African, African‑Caribbean and South Asian family origin. It can occur in all age groups and is increasingly being diagnosed in children.

It is estimated that about 90% of adults currently diagnosed with diabetes have type 2 diabetes.

Multiple vascular risk factors and wide‑ranging complications make diabetes care complex and time‑consuming, and many areas of healthcare services must be involved for optimal management. Necessary lifestyle changes, the complexities and possible side effects of therapy make patient education and self‑management important aspects of diabetes care. Diabetes care is estimated to account for at least 5% of UK healthcare expenditure, and up to 10% of NHS expenditure.

This guideline contains recommendations for managing type 2 diabetes in adults, and focuses on patient education, dietary advice, managing cardiovascular risk, managing blood glucose levels, and identifying and managing long‑term complications. The guideline does not cover diagnosis, secondary diabetes, type 1 diabetes in adults, diabetes in pregnancy and diabetes in children and young people.

Who is it for?

  • Healthcare professionals that care for adults with diabetes
  • Commissioners and providers of diabetes services
  • Adults with type 2 diabetes, and their families and carers

You can read the guideline on NICE's website.