NICE guideline review: type 2 diabetes in children and young people – diagnosis and management (NG18)

Isabella Weber, Benjamin G Fisher, Cliodhna Myles, A Emile J Hendriks, M Loredana Marcovecchio
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Abstract

Type 2 diabetes (T2D) is becoming progressively more common among young people concomitantly with the epidemic of childhood obesity.1 The incidence of youth-onset T2D is projected to rise by >600% by 2060,2 and the UK has the fastest increase in incidence rate globally.3 Compared with type 1 diabetes (T1D), youth-onset T2D is associated with higher rates and earlier onset of complications and a 50% higher mortality rate.1 Appropriate intervention is therefore key to improve outcomes.4 In May 2023, the National Institute for Health and Care Excellence (NICE) updated the section on T2D of the guideline on ‘Diabetes (type 1 and type 2) in children and young people: diagnosis and management’.5 Additionally, relevant guidelines have been recently published by the (UK) Association of Children’s Diabetes Clinicians (ACDC) and the International Society for Pediatric and Adolescent Diabetes (ISPAD) (box 1). Here, we focus on updates to NICE guideline relevant to T2D. Box 1 ### Resources National Institute for Health and Care Excellence (NICE) guideline (2023)5: https://www.nice.org.uk/guidance/ng18 Association of Children’s Diabetes Clinicians (ACDC) guideline (2023): https://www.a-c-d-c.org/wp-content/uploads/2012/08/TYpe-2-guideline-ACDC-format-publish-2.pdf International Society for Pediatric and Adolescent Diabetes (ISPAD) guideline (2022): https://www.ispad.org/page/ISPADGuidelines2022 ### Immediate actions at T2D diagnosis A child or young person (CYP) with suspected T2D should be referred to a multidisciplinary paediatric diabetes team to ‘confirm diagnosis and provide immediate and continuing care’ (box 2).5 CYP with T2D should be given tailored information about T2D and offered dietary advice and support including weight management, metformin therapy and equipment for capillary blood glucose (BG) monitoring. Additionally, they should be offered long-acting …
NICE 指南审查:儿童和青少年 2 型糖尿病--诊断和管理 (NG18)
随着儿童肥胖症的流行,2 型糖尿病(T2D)在年轻人中也越来越常见。1 预计到 2060 年,青少年发病的 T2D 发病率将上升 600%以上,2 而英国是全球发病率上升最快的国家。3 与 1 型糖尿病(T1D)相比,青少年发病的 T2D 与并发症发病率高、发病时间早以及死亡率高 50%有关。2023 年 5 月,美国国家健康与护理卓越研究所(NICE)更新了 "儿童与青少年糖尿病(1 型和 2 型):诊断与管理 "指南中有关 T2D 的部分。5 此外,英国儿童糖尿病临床医师协会(ACDC)和国际儿童与青少年糖尿病学会(ISPAD)最近也发布了相关指南(方框 1)。在此,我们重点介绍与 T2D 相关的 NICE 指南的更新内容。方框 1 ### 资源 国家健康与护理卓越研究所 (NICE) 指南 (2023)5: https://www.nice.org.uk/guidance/ng18 儿童糖尿病临床医师协会 (ACDC) 指南 (2023): https://www.a-c-d-c.org/wp-content/uploads/2012/08/TYpe-2-guideline-ACDC-format-publish-2.pdf 国际儿童和青少年糖尿病学会 (ISPAD) 指南 (2022): https://www.ispad.5 患有 T2D 的儿童和青少年应获得有针对性的 T2D 信息,并获得饮食建议和支持,包括体重管理、二甲双胍治疗和毛细血管血糖 (BG) 监测设备。此外,还应为他们提供长效...
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