My name is Fernando Florido and I am a GP in the United Kingdom. With this video I continue with the series on the monthly “NICE News” bulletin, which includes new guidance published in that month as well as any updates, also in that particular month, to already published guidelines. However, I will only address guidance which is relevant to Primary Care.

In today’s video, I go through the NICE Guidance and advice published in March 2023.

 There is a YouTube version of this and other epipsodes that you can access here:

 NICEGP YouTube channel:  

·      NICE GP - YouTube 

The Full NICE News bulleting for March 2023 can be found at:  

·      https://www.nice.org.uk/guidance/published?from=2023-03-01&to=2023-03-31

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 Transcript

Hello everyone and welcome. My name is Fernando Florido and I am a GP in the United Kingdom.

With today’s episode I go through the summary of NICE Guidance and advice published in March 2023 and relevant to Primary Care. 

Remember that there is also a Youtube version of these episodes so have a look in the episode description.

The first guideline that we are looking at refers to a brand-new technology appraisal of: Semaglutide for managing overweight and obesity

And it says that Semaglutide can now be used by weight management specialists for weight loss. Although it will be prescribed by specialists, in primary care we need to know when to refer these patients. Semaglutide for weight loss can be given only if:

·      it is used for a maximum of 2 years within a specialist service and

·      the patient has at least 1 weight-related comorbidity and:

• a BMI of at least 35.0, or
• a BMI of 30-34.9 and meets specialist referral criteria
• BMI thresholds will be usually reduced by 2.5 for people from non-White ethnic family background. This is because people from some minority ethnic family backgrounds have an equivalent risk from obesity at a lower BMI levels.

Semaglutide should be stopped if less than 5% of the initial weight has been lost after 6 months of treatment.

These recommendations are made because clinical trials show that:

·      semaglutide promotes weight loss

·      more weight is lost with semaglutide than with liraglutide

·      semaglutide helps normalise blood glucose in prediabetes

·      semaglutide may decrease the risk of cardiovascular disease.

The next guideline update is in Type 1 diabetes in adults

The main three quality statements are:

·     Patients with type 1 diabetes are offered choice between real-time and intermittently scanned continuous glucose monitoring.

·     Adults with type 1 diabetes aged 40 and over are offered statins for the primary prevention of CVD and

·     Every 12 months patients should have 9 processes recorded: urine ACR, HbA1c, blood pressure, creatinine, cholesterol, BMI, a foot check, eye screening and smoking status

·     The other statements refer to patient education, eating disorders and foot risk assessment in hospital

The next and final guideline update is in Type 2 diabetes in adults

And the main quality statements are four:

·     Adults at high risk of type 2 diabetes are offered a referral to the NHS Diabetes Prevention Programme

·     Adults with insulin-treated type 2 diabetes who cannot self-monitor because of a disability or that have their blood glucose monitored by a care professional are offered continuous glucose monitoring

·     Adults with type 2 diabetes are offered an SGLT2 inhibitor if they have co-existing chronic heart failure, CVD or CKD.

·     Every 12 months patients should have 9 processes recorded: urine ACR, HbA1c, blood pressure, creatinine, cholesterol, BMI, a foot check, eye screening and smoking status

·     The other statements refer to patient education and foot risk assessment in hospital.

We have come to the end of this episode. I hope that you have found it useful. Thank you for listening and good-bye