Alternative programmes of equal standard should be made available for people unable to participate in group education. Adults with type 2 diabetes are offered a structured education programme at diagnosis. The joint team should provide the woman with advice, including why gestational diabetes occurs, potential risks and complications, and treatments aimed at reducing those risks. Examples of how our guidance and standards have been put into practice in the NHS, local authorities, voluntary sector and a range of other organisations. A timescale of 6 months allows time to improve diet, lifestyle and adherence to drug treatment, while also ensuring that first intensification is not unnecessarily delayed. Proportion of pregnant women with pre-existing diabetes who have their HbA1c levels measured at their booking appointment. In addition, 30 June 2020 Ranibizumab for treating diabetic retinopathy (terminated appraisal) (NICE technology appraisal 637) added to, 11 February 2020 Sotagliflozin with insulin for treating type 1 diabetes (NICE technology appraisal guidance 622) added to, 19 November 2019 Fluocinolone acetonide intravitreal implant for treating chronic diabetic macular oedema in phakic eyes after an inadequate response to previous therapy (NICE technology appraisal guidance 613) added to, 27 August 2019 Dapagliflozin with insulin for treating type 1 diabetes (NICE technology appraisal guidance 597) added to. Denominator – the number of pregnant women with type 1 diabetes. If you are assessed at high risk you will probably be asked to contact your GP or practice nurse for a blood test (either the fasting glucose test or the HbA1c) to confirm the level of risk and to discuss how to reduce it through lifestyle changes. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. To allow informed choice by the person with hypertension, discuss the following with them: substantial potential gains from small improvements in blood pressure control, possible negative consequences of therapy, Start a trial of a renin–angiotensin system blocking drug as first-line therapy for hypertension in adults with type 1 diabetes, Provide information to adults with type 1 diabetes on the potential for lifestyle changes to improve blood pressure control and associated outcomes, and offer assistance in achieving their aims in this area. All NICE products on diabetes. c) Proportion of adults with type 2 diabetes who complete a structured education programme. Proportion of women diagnosed with gestational diabetes who are seen by members of the joint diabetes and antenatal care team within 1 week of diagnosis. Pathway created: May 2011 Last updated: September 2020. Denominator – the number of adults with type 1 diabetes who are referred for a structured education programme. Numerator – the number in the denominator who are referred at their booking appointment for retinal assessment. 25 August 2015 Major update on publication of the type 1 diabetes guideline update NG17. The recommendations in this guideline can be used alongside the NHS Health Check programme . neuropathy and non-critical limb ischaemia together, neuropathy in combination with callus and/or deformity. Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. NICE has produced resources to help implement its guidance on: NICE has written information for the public on each of the following topics. Read the Guidelines in Practice article Type 1 diabetes in adults: new recommendations support coordinated care for more information on the implementing NICE guideline 17 on Type 1 diabetes in adults: diagnosis and management, Core principles of asthma management, inhaler selection and use, and referral guidance, from the All Wales Medicines Strategy Group. Some women with type 2 diabetes and all women with gestational diabetes will not have been monitoring their blood glucose levels at all before pregnancy and will start doing so. Pav Kalsi, a clinical adviser from diabetes UK debunks some lifestyle tips and explains some of the NICE recommendations for prevention. Preventing type 2 diabetes from occurring in the first place would have a significant positive impact in terms of public health and the life of millions of people in this country. Relevance Denominator – the number of pregnant women with pre-existing diabetes attending a booking appointment who have not had retinal assessment in the last 3 months. Assess cardiovascular risk factors annually, including: full lipid profile (including HDL and LDL cholesterol and triglycerides), For guidance on tools for assessing risk of cardiovascular disease in adults with type 1 diabetes, see the NICE guideline on, For guidance on the primary prevention of cardiovascular disease in adults with type 1 diabetes, see the NICE guideline on, Give adults with type 1 diabetes who smoke advice on smoking cessation and use of smoking cessation services, including NICE guidance-recommended therapies. Proportion of women who have had gestational diabetes who have an annual HbA1c test. (6), COVID-19 rapid guidelines Glucose ' ) adults with type 2 diabetes, accounting for about 90 % will have type diabetes! Nice quality standard covers managing diabetes and antenatal care team by 10 of! 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