Access to information key to diabetes care
Access to information and patient-centred care are key priorities set out in National Institute for Clinical Excellence guidance
on the diagnosis and management of people with type 1 diabetes published this week.
The guideline is divided into two parts: one section relating to children
and young people and one section relating to adults.
The guideline for children and young people, developed by the National
Collaborating Centre for Women’s and Children’s Health, says
that children and young people with type 1 diabetes should be offered
an integrated package of care by a multidisciplinary care team. It says
that this group should be offered home-based or inpatient management
according to clinical need, and 24-hour telephone access to advice. A
key priority is access to information for this group of patients and
their families to help informed decision making.
An HbA1c level of less than 7.5 per cent is stated as the target for
long-term glycaemic control, and children, young people and their families
should be informed of this. The guideline, to be used in conjunction
with the diabetes and children’s national service frameworks, also
prioritises screening for complications and associated conditions such
as coeliac disease and thyroid disease, and emphasises the importance
of psychosocial support. It recommends that local health communities
review their practice for type 1 diabetes against the guideline and suggests
that implementation be as rapid as possible.
The guideline for adults, developed by the National Collaborating Centre
for Chronic Conditions, also recommends having a multidisciplinary team
to cover areas such as education, nutrition, foot care and psychological
care. Patient-centred care is a key theme in the guidance, which says
that staff should be trained to encourage integrating patients’ views
into their care. HbA1c targets should be less than 7.5 per cent or 6.5
per cent in those at increased risk. The guideline also prioritises annual
assessment for arterial risk factors and early markers of complications.
The guideline can be accessed here
Acute coronary syndrome In
separate guidance issued this week, NICE recommends that clopidogrel,
together with low dose aspirin,
should be used for people with non-ST-segment-elevation acute coronary
syndrome who have a moderate to high risk of a major heart attack
or death.
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