The Pharmaceutical Journal
Vol 269 No 7223 p667
9 November 2002

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NICE issues type 2 diabetes guidance

People with type 2 diabetes who have not yet developed cardiovascular disease should have their coronary heart disease risk estimated at least annually, according to recommendations from the National Institute for Clinical Excellence.

NICE's latest guidance, covering the management of blood pressure and blood lipid levels of people with type 2 diabetes, recommends annual blood pressure checks for people with type 2 diabetes whose blood pressure is below 140/80mmHg. If blood pressure is found to be 140/80mmHg or higher, lifestyle management advice and drug treatment should be offered.

In addition, blood lipid levels should be checked once a year and those whose blood lipid levels are found to be high should initially be offered advice on lifestyle changes.

The guidance, issued to the National Health Service in England and Wales last week, is the fourth in a series supporting the care of people with diabetes. It includes recommendations for the pharmacological management of raised blood pressure and lipid levels, and the use of antiplatelet drugs. Irene Gummerson, a community pharmacist with a special interest in diabetes, told The Journal that to help with implementation of the guidance pharmacists can promote a healthy lifestyle — not smoking, having a healthy diet and taking regular physical activity.

She said that community pharmacists thinking about providing a funded diabetes screening service should consider linking this with measuring blood pressure and blood lipids. She added that it is advisable to discuss when to refer patients with local GPs.

"Pharmacists involved in medication review in GP practices or secondary care may also have the opportunity to influence doctors and nurses into following this guidance," she said. Mrs Gummerson added that interventions by pharmacists, especially when giving out new medication, could increase adherence to treatment.

Copies of both full and short forms of the new guidelines are available on the NICE website (www.nice.org.uk) and on the National Electronic Library for Health's website (www.nelh.nhs.uk). Copies can also be obtained from the NHS response line, 0870 155 455, quoting reference number N0167.