This article describes recent changes in the NICE guideline on type 2 diabetes (T2DM), NG28, followed by comments on the rationale behind these changes and the implications for clinical practice.1
Individualising targets and treatments
A strong theme running through the NICE guideline is that of individualised management of T2DM.
Targets for glycaemic control
Whilst ideal HbA1c targets and thresholds for drug intervention for T2DM remain the same, NICE stresses that HbA1c targets should be discussed and agreed on an individual basis taking into account risk of hypoglycaemia and impact on quality of life. Circumstances when it may be necessary to relax target HbA1c are listed in table 1. A patient decision aid has been produced by NICE to help people decide whether a lower or higher HbA1c target is better for them.2