Statement 1 Adults at high risk of type 2 diabetes are offered a referral to an intensive lifestyle-change programme. [new 2016]
Statement 2 Adults with type 2 diabetes are offered a structured education programme at diagnosis. [2011, updated 2016]
Statement 3 Adults with type 1 diabetes are offered a structured education programme 6 to 12 months after diagnosis. [2011, updated 2016]
Statement 4 Adults with type 2 diabetes whose HbA1c level is 58 mmol/mol (7.5%) or above after 6 months with single-drug treatment are offered dual therapy. [new 2016]
Statement 5 Adults at moderate or high risk of developing a diabetic foot problem are referred to the foot protection service. [2011, updated 2016]
Statement 6 Adults with a limb-threatening or life-threatening diabetic foot problem are referred immediately for specialist assessment and treatment. [2011, updated 2016]
Statement 7 Adults with type 1 diabetes in hospital receive advice from a multidisciplinary team with expertise in diabetes. [2011, updated 2016]
In 2016, this quality standard was updated, and statements prioritised in 2011 were updated (2011, updated 2016) or replaced (new 2016). For more information, see update information.
Statements from the previous versions of this quality standard that are still supported by the evidence may still be useful at a local level:
People with diabetes receive personalised advice on nutrition and physical activity from an appropriately trained healthcare professional or as part of a structured educational programme.
People with diabetes participate in annual care planning which leads to documented agreed goals and an action plan.
People with diabetes agree with their healthcare professional a documented personalised HbA1c target, and receive an ongoing review of treatment to minimise hypoglycaemia.
People with diabetes agree with their healthcare professional to start, review and stop medications to lower blood glucose, blood pressure and blood lipids in accordance with NICE guidance.
Trained healthcare professionals initiate and manage therapy with insulin within a structured programme that includes dose titration by the person with diabetes.
Women of childbearing age with diabetes are regularly informed of the benefits of preconception glycaemic control and of any risks, including medication that may harm an unborn child. Women with diabetes planning a pregnancy are offered preconception care and those not planning a pregnancy are offered advice on contraception.
People with diabetes receive an annual assessment for the risk and presence of the complications of diabetes, and these are managed appropriately.
People with diabetes are assessed for psychological problems, which are then managed appropriately.
People with diabetes with an active foot problem that is not limb-threatening or life-threatening are referred to the multidisciplinary foot care service or foot protection service within 1 working day and triaged within 1 further working day.
People admitted to hospital with diabetic ketoacidosis receive educational and psychological support prior to discharge and are followed up by a specialist diabetes team.
People with diabetes who have experienced hypoglycaemia requiring medical attention are referred to a specialist diabetes team.
The previous version of the quality standard is available as a pdf.