Type of publication:
Journal article
Author(s):
*Morris, David Stuart
Citation:
Nurse Prescribing, 2016, vol./is. 14/Sup10(0-5)
Abstract:
This article will highlight best practice in managing type 2 diabetes in adults. HbA1c is the preferred diagnostic test for type 2 diabetes, the threshold for diagnosis being 48 mmol/ mol. Structured education is the cornerstone of management of type 2 diabetes with a focus on diet, exercise and weight loss. Multiple risk factors for complications need to be addressed including hypertension, dyslipidaemia and smoking (the most important factors in targeting macrovascular disease) and hyperglycaemia (more important in targeting microvascular disease). It is important to recognise that HbA1c targets need to be individualised. Metformin remains the first-line drug for hyperglycaemia in type 2 diabetes. Sulphonylureas, pioglitazone, DPP-4 inhibitors and SGLT-2 inhibitors are all recommended as possible add-on therapies to metformin, the choice again depending on individual circumstances. GLP-1 agonists and insulin can be considered in more intractable cases of hyperglycaemia.