Key points

Key points

  • The NICE guideline on type 2 diabetes in adults recommends adopting an individualised approach to diabetes care.

  • The NICE guideline recommends that self-monitoring of blood glucose levels for adults with type 2 diabetes should not routinely be offered. See the guideline for details on when self-monitoring is appropriate.

  • Diabetes features in the NHS Long Term Plan published in January 2019.

  • Options for local implementation:

    • Involve people with type 2 diabetes in decisions about their individual glycated haemoglobin (HbA1c) target, and reassess their individual needs and circumstances at each review. Consider stopping any medicines that are not effective.

    • Consider carefully, with an individualised approach, the benefits and risks of controlling blood glucose and the use of blood glucose lowering medicines. Review and, if appropriate, optimise prescribing to ensure that it is in line with NICE guidance taking into account the person's preferences, comorbidities, risks from polypharmacy, and their life expectancy and consequent chances of benefiting from long-term interventions.

    • When choosing and reviewing medicines, take into account the person's individual clinical circumstances, preferences and needs; the medicines' efficacy (based on metabolic response), safety and tolerability; and the licensed indications or combinations available. Consider also the cost of medicines: the NICE guideline recommends choosing medicines with the lowest acquisition cost if 2 in the same class are appropriate.