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GPs should refer immediately when type 1 diabetes is suspected in young patients, says NICE

NICE has updated diabetes guidelines to promote better adherence to normal blood glucose levels among young people with type 1 or 2 diabetes, and to ensure suspected cases of type 1 diabetes have rapid referrals.

The guidance for children and young patients recommends giving a same-day referral to the multidisciplinary paediatrics diabetes team when type 1 diabetes is suspected, to ensure quick diagnosis and care can be provided.

It also recommends explaining to young patients and their families that achieving daily blood glucose and HbA1c levels as near to normal as possible will help prevent long-term complications, and that they should routinely take five capillary blood glucose tests a day to help monitor this.

The new guidelines also cover adults with type 1 diabetes and recommend lowering target HbA1c levels for adults, to 48mmol/mol (6.5%) or lower.

Sir Andrew Dillon, chief executive of NICE, said: ‘The standard of diabetes care varies across the NHS. These updated guidelines are designed to help more people to receive the best treatment and support.

‘They recommend effective and cost effective care and advice to NHS organisations on such things as setting up specialist services to reduce risk of diabetes-related amputation. Implementing these recommendations will help prevent serious illnesses linked to diabetes.’

Readers' comments (9)

  • Well, yeah, obviously. What next? NICE suggest same day assessment for new onset facial droop and hemiparesis? For Pete's sake....what is with them these days?

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  • Vinci Ho

    Is this really something new?
    A bit of telling me my mother is a woman!
    On the other hand , NICE is still very obsessed with SU in type 2 DM.
    Sigh! I really don't know ......

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  • The national institute for stating the obvious?

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  • You really shouldn't be a qualified GP if you didn't know this. State the bleeding obvious. Is NICE writing for nurse practitioners/ANP/physicians assisistants/paramedics? I wonder....

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  • @10:55 & 9:10

    Maybe it's obvious to you but for some it seems they are unaware of what constitutes safe practice for T1s. For example...

    "It also recommends.......that they should routinely take five capillary blood glucose tests a day to help monitor this."

    Diabetes UK has had to campaign about this issue as some GPs were wrongly applying CCG diktats concerning T2 to T1 patients and consequently denied Type 1s access to adequate and safe numbers of test strips.

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  • @Anonymous | Other healthcare professional | 27 August 2015 0:14am

    If that is really the case these individuals or CCGs should be named and shamed

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  • Bob Hodges

    Nation Institute for the Bleeding Obvious indeed.

    As for 'GPs denying test strips to Type 1s - that's a fitness to practice issue, not a 'campaign' for a NGO.

    Put up some names or SHUT UP.

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  • Why named and shamed? It seems like it's an educational issue that is not confined to one or two individuals. The point of the NICE guidance is to highlight safe practices so that patients don't suffer.

    http://www.pulsetoday.co.uk/clinical/diabetes/dh-to-investigate-bonkers-rationing-of-diabetes-testing-strips/20001583.article#.Vd78_4uJWIw

    "Of about 1,300 people who answered a question about their access to test strips as part of the online survey, 46 per cent had had prescriptions refused or restricted within the last 12 months.

    Of the respondents who said they had experienced restrictions 39 per cent were people with Type 1 diabetes, which Diabetes UK has described as “alarming” because everyone with Type 1 needs to use test strips every day."
    https://www.diabetes.org.uk/About_us/News/People-with-diabetes-not-allowed-vital-prescriptions/

    http://www.theyworkforyou.com/whall/?id=2013-01-09a.77.0#g95.0

    http://www.theyworkforyou.com/whall/?id=2013-01-09a.77.0#g96.0

    DOI: As a T1, I frequently encounter both 1ry and 2ndry care doctors who don't understand the difference between T1 and T2 and don't understand how tests are used to make adjustments to insulin in T1.

    Surely better education is key, not naming and shaming?

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  • If any professional didn't know Type 1s need referring stat, then they have been promoted beyond their competence

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