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The National Institute for Health and Care Excellence (NICE) is updating its guidance to support adults and children with diabetes and help them have as normal a life as possible.

The institute has opened consultation on two draft guidelines for adults with type 1 diabetes and children and young people with either type 1 or 2.

Diabetes is becoming more common in children and young people in the UK. Last year there were 24,000 children with type 1 diabetes and 450 with type 21.

Since the publication of the 2004 recommendations there have been major advances in managing type 1 diabetes in children and the updated guideline is the first national guidance to set out how to help children achieve blood sugar levels as near to the normal levels in healthy children.

The draft recommendations propose achieving better control by offering intensive insulin management either with multiple daily injections or portable devices (insulin pumps). Insulin therapy should be offered alongside dietary advice specific to treatments such as courses to help understand how carbohydrates affect blood sugar or medicines.

Children with type 2 diabetes are often overweight or obese and this can lead to further problems with their kidneys, blood pressure or cholesterol levels. The updated draft guideline also includes new detailed recommendations for healthcare professionals on how to diagnose and treat these complications.

There are over 370,000 adults with type 1 diabetes in the UK.

Most adults do not achieve their blood sugar targets and increasing numbers will go on to suffer kidney failure or ketoacidosis – a condition where the body starts to break down fats as a source of fuel and which in the worst cases can lead to dehydration, coma or swelling on the brain.

As with the draft guideline for children, there is a call for healthcare professionals to support adults to achieve normal blood sugar levels taking into consideration their personal preferences, day-to-day lifestyle and any potential complications.

This includes a draft recommendation for adults with type 1 diabetes to be seen at least every 3-6 months to have their blood sugar measured. It also calls for adults to be supported to self-monitor their blood sugar at least 4 times a day and even more frequently if they are not reaching targets or are carrying out certain activities such as driving or sport.

Other key priorities include making sure all adults with type 1 diabetes go on a structured education course to better understand their condition and offering multiple daily insulin injections as the treatment of choice.

Professor Mark Baker, director of clinical practice at NICE said: “In the past decade there have been major changes in how we routinely manage both adults and children with diabetes and it is now possible for many to achieve much stricter targets for their blood sugar levels. Both draft guideline updates cover new knowledge and technologies which support better diabetes control, with evidence-based advice on how to use this to support adults and children in living their lives to the fullest.

“There are recommendations on the appropriate diagnosis, insulin therapy, dietary advice, hospital care and education courses to offer adults and children with diabetes, as well as their family and carers. We now want to hear from all those involved in the care of adults and children with diabetes to inform our recommendations and shape the final guideline.”

Both draft guidelines are now open for consultation. All registered stakeholders and members of the public are now able to submit their comments via the NICE website until Wednesday 4 March 2015.

NICE is also updating its guidelines for type 2 diabetes in adults and diabetic footcare; these are due to open for consultation in January 2015.

For more information call the NICE press office on 0300 323 0142 or out of hours on 07775 583 813.

Notes to Editors

Further information

1. National Paediatric Diabetes Audit report 2012–13. Includes national and regional data on the number and demographics of children with diabetes in England and Wales.
2. Type 1 diabetes results from the destruction of cells that normally make insulin whilst type 2 occurs when the body doesn’t produce enough insulin or the body’s cells do no react to insulin. In both cases this leads to high blood sugar concentrations.

About the guidance

1. The draft guidance for type 1 diabetes in adults is available at /guidance/indevelopment/GID-CGWaveR122.
2. The draft guidance for diabetes in children and young people is available at /guidance/indevelopment/GID-CGWaveR118. 

About NICE

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for driving improvement and excellence in the health and social care system. We develop guidance, standards and information on high-quality health and social care. We also advise on ways to promote healthy living and prevent ill health.

Our aim is to help practitioners deliver the best possible care and give people the most effective treatments, which are based on the most up-to-date evidence and provide value for money, in order to reduce inequalities and variation.

Our products and resources are produced for the NHS, local authorities, care providers, charities, and anyone who has a responsibility for commissioning or providing healthcare, public health or social care services.

To find out more about what we do, visit our website:www.nice.org.uk and follow us on Twitter: @NICEComms.