NICE guideline on type 1 diabetes

In August 2015, NICE published its new guideline on the management of type 1 diabetes in adults (NG17), an update of the 2004 guideline.^1,2 This article reviews selected aspects of NG17 that impact most on primary care.

Diagnosis
The guideline lists clinical features that make the diagnosis of type 1 diabetes likely (Box 1). In the younger, non-obese patient with symptoms of thirst, polyuria and rapid weight loss, it is clinically appropriate to make the diagnosis of type 1 diabetes (and the immediate need for insulin) until proven otherwise. A family history of type 1 diabetes or a personal or family history of autoimmune disease (eg, thyroid disease, Addison’s disease, pernicious anaemia, coeliac disease or vitiligo) strengthen the possibility of type 1 diabetes.