Adult patients with type 1 diabetes must be better supported to maintain blood glucose levels within target levels that minimise the risk of complications, according to latest guidance.
The National Institute for Health and Care Excellence has today published an updated guideline on the diagnosis and management of type 1 diabetes in adults.
“Currently most adults with type 1 diabetes do not maintain the average HbA1c associated with fewer complications”
Patients should be “supported” to aim for a target HbA1c level of 48mmol/mol (6.5%) or lower, to minimise the risk of long-term vascular complications, it stated.
Meanwhile, patients should be offered multiple, daily injection basal-bolus insulin as the “regimen of choice”, rather than twice-daily mixed insulin regimens, it said.
In tandem, patients should also be provided with guidance on using multiple daily injection basal-bolus insulin regimens.
The guidance makes a wide range of other recommendations including that all adults with type 1 diabetes be offered a structured education programme of “proven benefit”.
NICE cited the DAFNE (dose-adjustment for normal eating) programme as an example, adding that it should be offered six to 12 months after diagnosis.
Professor Stephanie Amiel, from King’s College London and chair of the group that developed the NICE guideline, said the document provided “evidence-based, practical advice” on supporting patients to “live life to the full with few restrictions and to avoid the serious complications”.
“Currently most adults with type 1 diabetes do not maintain the average amount of glucose in their blood (HbA1c) associated with fewer complications – life expectancy is reduced by over 10 years and rates of kidney failure have increased,” she said.
“The new recommendations aim to ensure adults with type 1 diabetes can gain the information, support, skills and confidence they need to manage treatment regimens designed to improve HbA1c levels, and to make the most of technology improvements to support more normal blood glucose levels,” said Professor Amiel.
“These updated guidelines are designed to help more people to receive the best treatment and support”
She added: “These steps should result in improved outcomes for adults with type 1 diabetes – reduced complications and better health.”
NICE chief executive Sir Andrew Dillon noted that 10% of the three million people with diabetes in the UK had the type 1 form of the condition, totalling around 370,000 adults.
He added: “The standard of diabetes care varies across the NHS. These updated guidelines are designed to help more people to receive the best treatment and support.”