Diabetes Type 2 Support Group
Type 2 Diabetes is a condition in which the body either does not produce enough insulin or does not make efficient use of it. Insulin is a hormone needed to convert food into glucose, a sugar that the body uses for energy. Without enough insulin, glucose can accumulate in the blood, and can cause serious health problems such as heart disease and strokes and organ damage...
This proposal for the UK is by NICE they are the body in the UK who try to save money by denying people medications because they are deemed too expensive
I guess this is just another measure to get people off the diabetic list and save money.
When drugs are available in the rest of Europe or the USA but deemed not cost effective in the UK its those NICE people trying to save Cash
Latest headlines
Diabetes type 2 HbA1c targets to be changed
The blood glucose target for people with diabetes type 2 should be relaxed to 7.5% from 7%, according to the National Institute for Health and Clinical Excellence (NICE).
Read full article
Reviewed by Dr Sheena Meredith
9th August 2010 - The blood glucose target for people with diabetes type 2 should be relaxed to 7.5% from 7%, according to the National Institute for Health and Clinical Excellence (NICE).
Its issued guidance for consultation, saying the old targets may have unintended consequences in terms of patient care, because to achieve the target reading on average, individual patients and their doctors would have to aim below that level.
Levels
An HbA1c of 7.0% equates to a blood glucose reading of 53 mmol/mol.
NICE will now have three target levels for individual patients - 59, 64 and 75 mmol/mol - which it says it designed to provide an incentive to improve glycaemic control. It admits the lower level may not be achievable or appropriate for all patients.
NICE points to research which says a 1% higher HbA1c is associated with a 28% higher risk of death. However, other research has highlighted risks of adopting aggressive treatment strategies for patients at risk of cardiovascular disease (CVD), although not all studies have confirmed this.
Other studies have suggested there is no benefit in reducing HbA1c below 7.5%.
The draft guidance will be reviewed by the General Practitioners Committee and NHS departments before updated targets are published.
Clinical management
The new clinical guidelines for the management of type 2 diabetes identifies these priorities to help patients achieve better glycaemic control:
Offer structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review. Inform people and their carers that structured education is an integral part of diabetes care.
Provide individual and ongoing nutritional advice from a healthcare professional with specific expertise and competencies in nutrition.
When setting a target glycated haemoglobin (HbA1c):
involve the person in decisions about their individual HbA1c target level
encourage the person to maintain their individual target unless the resulting side effects (including hypoglycaemia) or their efforts to achieve this impair their quality of life
offer therapy (lifestyle and medication) to help achieve and maintain the HbA1c target level
inform a person with a higher HbA1c that any reduction in HbA1c towards the agreed target is advantageous to future health
avoid pursuing highly intensive management to levels of less than 6.5%.
Reaction
Stella Valerkou, Senior Policy Officer at Diabetes UK says in a statement: The decision to raise the lowest target indicator for HbA1c is concerning as it removes the incentive to support those people with diabetes who would benefit from tighter glycaemic management, as recommended by various clinical guidelines. This underscores both the requirement for individually agreed treatment targets, and the need for an indicator based on the merits of achieving a reduction in HbA1c.
In other treatment guidance, Diabetes UK welcomes the inclusion of foot care indicators which it says are more closely aligned to clinical guidelines.
It has concerns about blood pressure targets which it says contradict clinical guidelines and could impact negatively on the care of some people with diabetes with existing complications.
Valerkou says: Diabetes UK advocates that clinical targets are tailored to an individuals needs and agreed with them. The QOF indicator of 150/90 for people with existing complications is contrary to recommendations for tighter blood pressure management for these individuals.
V
I guess this is just another measure to get people off the diabetic list and save money.
When drugs are available in the rest of Europe or the USA but deemed not cost effective in the UK its those NICE people trying to save Cash
Latest headlines
Diabetes type 2 HbA1c targets to be changed
The blood glucose target for people with diabetes type 2 should be relaxed to 7.5% from 7%, according to the National Institute for Health and Clinical Excellence (NICE).
Read full article
Reviewed by Dr Sheena Meredith
9th August 2010 - The blood glucose target for people with diabetes type 2 should be relaxed to 7.5% from 7%, according to the National Institute for Health and Clinical Excellence (NICE).
Its issued guidance for consultation, saying the old targets may have unintended consequences in terms of patient care, because to achieve the target reading on average, individual patients and their doctors would have to aim below that level.
Levels
An HbA1c of 7.0% equates to a blood glucose reading of 53 mmol/mol.
NICE will now have three target levels for individual patients - 59, 64 and 75 mmol/mol - which it says it designed to provide an incentive to improve glycaemic control. It admits the lower level may not be achievable or appropriate for all patients.
NICE points to research which says a 1% higher HbA1c is associated with a 28% higher risk of death. However, other research has highlighted risks of adopting aggressive treatment strategies for patients at risk of cardiovascular disease (CVD), although not all studies have confirmed this.
Other studies have suggested there is no benefit in reducing HbA1c below 7.5%.
The draft guidance will be reviewed by the General Practitioners Committee and NHS departments before updated targets are published.
Clinical management
The new clinical guidelines for the management of type 2 diabetes identifies these priorities to help patients achieve better glycaemic control:
Offer structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review. Inform people and their carers that structured education is an integral part of diabetes care.
Provide individual and ongoing nutritional advice from a healthcare professional with specific expertise and competencies in nutrition.
When setting a target glycated haemoglobin (HbA1c):
involve the person in decisions about their individual HbA1c target level
encourage the person to maintain their individual target unless the resulting side effects (including hypoglycaemia) or their efforts to achieve this impair their quality of life
offer therapy (lifestyle and medication) to help achieve and maintain the HbA1c target level
inform a person with a higher HbA1c that any reduction in HbA1c towards the agreed target is advantageous to future health
avoid pursuing highly intensive management to levels of less than 6.5%.
Reaction
Stella Valerkou, Senior Policy Officer at Diabetes UK says in a statement: The decision to raise the lowest target indicator for HbA1c is concerning as it removes the incentive to support those people with diabetes who would benefit from tighter glycaemic management, as recommended by various clinical guidelines. This underscores both the requirement for individually agreed treatment targets, and the need for an indicator based on the merits of achieving a reduction in HbA1c.
In other treatment guidance, Diabetes UK welcomes the inclusion of foot care indicators which it says are more closely aligned to clinical guidelines.
It has concerns about blood pressure targets which it says contradict clinical guidelines and could impact negatively on the care of some people with diabetes with existing complications.
Valerkou says: Diabetes UK advocates that clinical targets are tailored to an individuals needs and agreed with them. The QOF indicator of 150/90 for people with existing complications is contrary to recommendations for tighter blood pressure management for these individuals.
V
Of course it is better to have lower readings but not always easy for some which I think makes it easier to give up on trying for them.
Making it higher again would maybe make it too easy to cheat more for some. And have complications. You know we keep getting bounced around because of all the controversy about meds and all the diabetics running around now.
Follow the road.......which one????