In August 2015, NICE published its new guideline on the management of type 1 diabetes in adults (NG17), an update of the 2004 guideline.1,2 This article reviews selected aspects of NG17 that impact most on primary care.
Diagnosis
The guideline lists clinical features that make the diagnosis of type 1 diabetes likely (Box 1). In the younger, non-obese patient with symptoms of thirst, polyuria and rapid weight loss, it is clinically appropriate to make the diagnosis of type 1 diabetes (and the immediate need for insulin) until proven otherwise. A family history of type 1 diabetes or a personal or family history of autoimmune disease (eg, thyroid disease, Addison’s disease, pernicious anaemia, coeliac disease or vitiligo) strengthen the possibility of type 1 diabetes.
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