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The video version of this episode can be found here:
· • 2024 Diabetes Update: ...
This episode makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". Please note that the content on this channel reflects my professional interpretation/summary of the guidance and that I am in no way affiliated with, employed by or funded/sponsored by NICE.
My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In the first part of this episode, I go through the NICE guideline [NG28] on Type 2 diabetes in adults, always focusing on what is relevant in Primary Care only. In the second part I go through a thorough review of the guideline with a series of multiple-choice questions. Each question is paired with quotation, aiming to clarify key concepts and enhance understanding. This informative segment is created to support continuous learning in Primary Care.
I am not giving medical advice; this video is intended for health care professionals; it is only my summary and my interpretation of the guidelines and you must use your clinical judgement.
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Transcript
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Hello and welcome, I’m Fernando, a GP in the UK. Today we are going to do an up to date revision of the NICE guideline on type 2 diabetes. This episode is longer because it has two parts. In the first part, which lasts or about 20 minutes, I go through the NICE guideline itself, always focusing on what is relevant in Primary Care only. In the second part, I will present you with a series of multiple-choice questions so that you can test yourself. After each question, you are given the right answer, which is paired with a guiding quotation. This pairing is designed to clarify key concepts and enhance your continuous learning and retention.
I have created time stamps throughout the video so that you can skip to the section that you wish whenever you want.
Right, let’s jump into it.
Firstly, I will just state that this episode does not cover the management of pregnant women with type 2 diabetes.
We will offer structured education to patients at the time of diagnosis, with annual reinforcement and, if possible, this should be in the form of group education programmes.
The dietary advice should be the same healthy eating advice as the general population, which includes:
· high-fibre, low-glycaemic-index sources of carbohydrates
· low-fat foods and
· oily fish
And we will discourage foods marketed specifically for people with diabetes.
If the person is overweight, we should aim for an initial body weight loss target of 5% to 10%, remembering that even a small amount of weight loss may still be beneficial.
The guideline on type 2 diabetes makes reference to the bariatric surgery guideline which says that we should refer people with type 2 diabetes for consideration of bariatric surgery if they have a BMI of 35 or more. If they have Asian or African-Caribbean family background, we will do so if the BMI is 32.5 or more.
The recommendations on hypertension are broadly the same as for other people so we will simply follow the NICE guideline on hypertension because, when a different approach is needed for people with type 2 diabetes, this is specified in the hypertension guideline.
Additionally, we will not offer antiplatelet therapy (aspirin or clopidogrel) without cardiovascular disease.
In respect of blood glucose management, broadly speaking we will measur...