Home4 posters
New NICE guidelines for T2
Two Collies- Member
- Status :
Online Offline 
Posts : 133
Join date : 2014-08-14
Location : Rossendale
Eddie- Member
- Status :
Online Offline Posts : 3807
Join date : 2014-08-13
Age : 74
Location : London
Two Collies wrote:http://www.nice.org.uk/guidance/ng28
".3.3 Emphasise advice on healthy balanced eating that is applicable to the general population when providing advice to adults with type 2 diabetes. Encourage high‑fibre, low‑glycaemic‑index sources of carbohydrate in the diet, such as fruit, vegetables, wholegrains and pulses; include low‑fat dairy products and oily fish; and control the intake of foods containing saturated and trans fatty acids. [2009]
Meet the new boss, same as the old boss.
chris c- Member
- Status :
Online Offline
Posts : 4520
Join date : 2015-07-26
I'll re-read this again later when I've calmed down, but in brief
EAT MORE STARCH and lose weight
take more drugs, but in a different order
EAT MORE STARCH and lose weight
take more drugs, but in a different order
graham64- Member
- Status :
Online Offline Posts : 3730
Join date : 2014-08-10
Location : Lancs
Diabetes guidelines expected to increase prescribing costs
Guidelines on the management of type 2 diabetes, released by the National Institute for Health and Care Excellence (NICE), anticipates a “resource impact” and potential increased prescription costs.
The report says that clinical commissioning groups (CCGs) should monitor type 2 diabetes prescribing practices after the guidance has been implemented, the guidance stated, as a shift in the drugs used could lead to an increase from an £841 annual spend on a type 2 diabetes patient to a spend of £4,312 each year.
This is as the previous guideline, from 2009, recommended sulfonylurea as the second drug choice after metformin (either as the initial drug treatment when metformin is contraindicated or not tolerated, or in addition to metformin), however the new guideline recommends more expensive DPP-4 inhibitors.
Treatment with sulfonylureas is estimated to have an average cost of £841 per patient per year compared with an estimated average cost of £4,312 for DPP-4 inhibitors.
http://www.managementinpractice.com/editors-pick/diabetes-guidelines-expected-increase-prescribing-costs?
Trust a BDA dietitian the eatwell plate and you could be on a triple therapy with: metformin, a DPP-4 inhibitor and a sulfonylurea; or metformin, pioglitazone and a sulfonylurea
chris c- Member
- Status :
Online Offline
Posts : 4520
Join date : 2015-07-26
I can't remember now if it was NICE or someone else's algorithm for doctors but it contained the line "Monitor for the expected decline in health" and in those days you had to let the patient's A1c reach 8 before you were permitted to increase or add medications. Now it's "only" 7.5%. I also notice the line about "do not use intensive treatment to reduce A1c below 6.5%" has been toned down, but they are still discouraging truly normal results.
Anyone else thing a "personal health budget" would be a good plan so long as they gave us the £4000/year to spend on real food?
Anyone else thing a "personal health budget" would be a good plan so long as they gave us the £4000/year to spend on real food?