The eagerly awaited NICE guidance on type 2 diabetes in adults (NG 28) was finally published in December 20151 after two substantial revisions and not a small amount of controversy.2
NG28 emphasises the importance of an individualised approach to diabetic care according to the needs, circumstances and preferences of the patient. Co-morbidities, the risks of polypharmacy and reduced life-expectancy should all be factored into decision making.
As discussed in the previous NICE guideline of 20093 structured education should be offered to the patient, family members or carers at the time of diagnosis (and the need for further education reviewed annually). Group education is the preferred option with programmes meeting the cultural, linguistic and literary needs within the local group.
Dietary advice sensitive to culture and beliefs from an appropriate health care professional, physical exercise and weight loss are central lifestyle issues to be addressed. While a 5-10% weight loss is suggested as a target it is accepted that any weight loss will be beneficial.