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Guideline review
NICE guideline review: type 2 diabetes in children and young people – diagnosis and management (NG18)
  1. Isabella Weber1,
  2. Benjamin G Fisher2,
  3. Cliodhna Myles2,
  4. A Emile J Hendriks2,3,
  5. M Loredana Marcovecchio2,3
  1. 1 School of Clinical Medicine, University of Cambridge, Cambridge, UK
  2. 2 Department of Paediatric Diabetes and Endocrinology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  3. 3 Department of Paediatrics, University of Cambridge, Cambridge, UK
  1. Correspondence to Dr Isabella Weber; isabella.weber1{at}nhs.net

https://doi.org/10.1136/archdischild-2024-326911

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    Background

    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

    Information about the current guideline

    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

    Key issues the guideline addresses

    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 …

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    Footnotes

    • X @l_marcovecchio

    • Contributors MLM developed the concept for this article. IW produced and BGF reviewed the initial draft. All authors provided their expert opinion, helped in editing the manuscript and approved the final draft.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; externally peer reviewed.