Management of Diabetes Mellitus in Primary Care

This week’s episode is designed for primary care clinicians wanting an overview of current diabetes management. Doctors Lisa and Sara are joined by Dr Marlon Morais and Nicola Milne to talk first about Type 1 diabetes briefly (from the GP point of view) before going on to discuss the recent changes to the NICE guidelines for management of Type 2 Diabetes Mellitus. We cover useful ways of sifting through the options for medicines and the importance of a holistic approach and the NHS low calorie programmes. The resource list is incredibly useful. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

• Visual Summary of NICE Guidelines (Feb 2022): https://www.nice.org.uk/guidance/ng28/resources/visual-summary-full-version-choosing-medicines-for-firstline-and-further-treatment-pdf-10956472093#page=2

• Diabetes UK Emotional Wellbeing Module CPD: https://www.diabetes.org.uk/professionals/training--competencies/courses/emotional-wellbeing-module

• Diabetes on the Net Six Steps to Insulin Safety Module for Healthcare Professionals (based on key recommendations by NICE in 2017): https://diabetesonthenet.com/diabetes-news/six-steps-to-insulin-safety-e-learning-module/

• Trend Diabetes Injection Technique Matters: https://trenddiabetes.online/injection-technique-matters/

• NICE Clinical Knowledge Summaries: Type 2 Diabetes Mellitus Management for Adults: https://cks.nice.org.uk/topics/diabetes-type-2/management/management-adults/

• Diabetes in Control, When and When Not to use an SGLT2 Inhibitor (traffic light system): http://www.northoftyneapc.nhs.uk/wp-content/uploads/sites/6/2021/12/SGLT-2-Top-Tips-V7.pdf

• SGLT2 inhibitors: Indications, doses and licences from Diabetes & Primary Care: https://diabetesonthenet.com/wp-content/uploads/Brown_Need-to-know-SGLT2is.pdf

• Diabetes drugs and renal impairment: Updated GPnotebook Shortcuts (Nov 2021): https://diabetesonthenet.com/journal-diabetes-nursing/diabetes-drugs-and-renal-impairment-updated-gpnotebook-shortcuts/

• Diabetes on the Net At a Glance Factsheets: https://diabetesonthenet.com/tag/at-a-glance-factsheet/

• Diabetes UK: What is a Healthy, Balanced Diet for Diabetes: https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/what-is-a-healthy-balanced-diet

• The DiRECT Trial: Weight Management Interventions in Type 2 Diabetes Mellitus (informing the Low Calorie Diet Pilots): https://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30068-3/fulltext

• Sick Day Rules for Type 1 Diabetes Mellitus Leicester: https://static1.squarespace.com/static/5c2ccb867c93271f5edc9718/t/5ed7a143ee2bfa731b017aac/1591189828264/Sick_Day_Rules_T1_Infographic_V4%5B1438%5D.pdf

• Sick Day Rules for Type 2 Diabetes Mellitus Leicester: 
  https://static1.squarespace.com/static/5a6439bab7411c94f2ebe216/t/6000117d2a88fe77419f655a/1610617215447/Sick_Day_Rules_T2DM.pdf

• NHS Very Low Calorie Diets: https://www.england.nhs.uk/diabetes/treatment-care/low-calorie-diets/https://preventing-diabetes.co.uk/know-your-risk-dtc/

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This podcast has been made with the support of Greater Manchester Health and Social Care Partnership, GP Excellence, Greater Manchester Training Hub and the GP Fellowship Programme, as well as Wigan Borough CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.