NICE guide to Type 1 diabetes management

What’s going on? The final NICE consultation has just finished on the diagnosis and management of Type 1 diabetes in primary and secondary care.

When are the guidelines published?

This May, assuming the timetable goes according to plan. They will look at the management, monitoring and support of people with the condition.

Anything likely to cause a stir?

NICE says there’s ‘nothing particularly controversial’ about it but stresses the issue is important.

So who has been lobbying for what?

Reconciling the problems of insulin replacement therapy with patients’ lifestyles will be central to any new guidelines, so approaches addressing that are likely to be viewed favourably. Big players such as Novo Nordisk want greater patient choice on how insulin is delivered, while charity Diabetes UK is arguing for more emphasis on allowing self-management of the condition on entry to hospital.

Will the guidelines cover just adults?

No, they have been designed to cover kids too, including the support and advice that the NHS should offer to creches, nurseries and schools.

That doesn’t seem to miss anyone out.

It won’t take in women with diabetes who want to conceive or who are pregnant, or who develop the condition during pregnancy. NICE is thinking about separate guidelines for these cases.

How much input do stakeholders have? There was consultation as far back as summer 2001, with evidence to be submitted by the end of 2002. Stakeholders were consulted on the first draft last October. Three versions will be issued: a full guideline, a short-form guide and information for the public.

Is this the last word on Type 1 diabetes?

It needs to be taken in context with other organisations’ work on the issue: for example, the Department of Health’s National Service Framework, the NHS Information Authority’s information strategy and the Commission for Healthcare Audit and Inspection’s national clinical audit. NICE has already completed guidelines on Type 2 diabetes.

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