Insulin Therapy

Pioglitazone

Metformin

GLP-1 & Incretin

Dietary advice

• encourage high fibre, low glycaemic index sources of carbohydrates
• include low-fat dairy products and oily fish
• control the intake of foods containing saturated fats and trans fatty acids
• limited substitution of sucrose-containing foods for other carbohydrates is allowable, but care should be taken to avoid excess energy intake
• discourage the use of foods marketed specifically at people with diabetes
• initial target weight loss in an overweight person is 5-10%

HbA1c

**HbA1c targets**

This is an area which has changed in 2015

• individual targets should be agreed with patients to encourage motivation
• HbA1c should be checked every 3-6 months until stable, then 6 monthly
• NICE encourage us to consider relaxing targets on 'a case-by-case basis, with particular consideration for people who are older or frail, for adults with type 2 diabetes'
• in 2015 the guidelines changed so HbA1c targets are now dependent on treatment:

Lifestyle or single-drug treatment