Treatment of glycaemia in type 2 diabetes

Abstract

The prevalence of type 2 diabetes is rising rapidly in the UK, and most practices will now have at least 5% of their registered population living with diabetes. The care of people with diabetes has in the last 20 years moved from being a principally hospital-based activity to one largely carried out in primary care. The quality and outcomes framework of the new GP contract introduced in 2004 has provided encouragement and incentive for primary care to take on this work. All qualified GPs and Associates in Training therefore need to have an understanding of up to date diabetes management. The treatment of type 2 diabetes has been the subject of two recent National Institute for Health and Care Excellence (NICE) guidelines. NICE Clinical Guideline CG 66 was published in May 2008. A rapid update of the glycaemic control section of this guideline was published on 27 May 2009 as NICE Clinical Guideline CG 87. This occurred because a number of new glucose-lowering medications were launched after the scope of guideline CG 66 had been agreed and work had started on it. In this article glucose-lowering medications will be reviewed and their use discussed in light of the NICE guidance.