I recently joined an online update session hosted by NICE with brilliant guest speakers — Dr John Patterson, Dr Waqaar Shaw, Sharon McCarthy, and Anthony Walker. They shared some helpful insights, and below I’ve pulled together a friendly summary of the key points that stood out to me.
I would absolutely recommend taking a look at the full, updated guidelines when you get a moment — there are some incredibly helpful tables that make decision鈥憁aking in clinical practice much easier. These are found on the .
A stronger focus on truly individualised care
The panel really highlighted that the changes suggested by NICE should be introduced at the person with type 2 diabetes next review and are not intended to add enormously to everyone's workloads. Making the transition smooth and manageable for both healthcare professionals and patients.
A stronger focus on real individualised care
Individualised care is a key principle of nursing practise and the new guidelines really encourage us to focus on this and consider especially;
- each person’s individual circumstances and preferences
- whether their current medications are still appropriate, effective
- also any disabilities, especially visual impairments, that could influence their ability to manage their diabetes safely.
Setting targets together
HbA1c targets haven’t changed, but the approach to setting them has. NICE now encourages a much more collaborative, person鈥慶entred style of target鈥憇etting. Instead of telling someone what their target should be, we are encouraged to agree goals together. This helps people feel more engaged, empowered, and supported.
A big change: dual therapy right from diagnosis
One of the biggest updates is around first鈥憀ine medication for people newly diagnosed with type 2 diabetes. The new recommendation is to start with:
- Modified鈥憆elease metformin
- An SGLT2 inhibitor.
If someone is already taking and tolerating standard metformin, there’s no need to switch them to modified鈥憆elease — this applies mainly to new diagnoses. This initial combination aims to support overall health and reduce long鈥憈erm risks, thanks to the heart and kidney鈥憄rotective benefits of SGLT2 inhibitors.
Supporting younger adults with early-onset type 2 diabetes
For people diagnosed under the age of 40, the guidelines suggest considering:
- Modified鈥憆elease metformin
- SGLT2 inhibitors
- Earlier introduction of GLP鈥�1 receptor agonists.
Education still at the heart of good care
Structured education remains essential. NICE continues to highlight the importance of offering education right from diagnosis and signposting people to trusted resources.
These NG28 updates support personalised care, shared decision鈥憁aking, early protection of long鈥憈erm health, and education.
Read the full guidelines:
