World Diabetes Day: New GP guideline adds focus on remission, sleep, and weight management interventions

A new guideline released on World Diabetes Day will give GPs and other health professionals positive recommendations for optimal diabetes management including new sections on weight management interventions and type 2 diabetes remission.

For 25 years, the Royal Australian College of GPs (RACGP) and Diabetes Australia have been working together to provide GPs and other members of the clinical team with the latest evidence-based recommendations thorough the Management of type 2 diabetes: A handbook for general practice guidelines, also known as the “Diabetes Handbook”.

The latest edition of the Handbook includes developments in the evidence that supports lifestyle choices for people living with diabetes, including recent developments in therapeutics including SGLT2 inhibitors and GLP-1 agents like Ozempic, and developments in the evidence supporting the importance of sound lifestyle choices for people living with diabetes. The new edition of the Diabetes Handbook provides new guidance on these and other topics, including:

• New sections covering remission of type 2 diabetes, weight management interventions, sleep, and disability, dementia, cognitive decline, and hearing impairment
• Significant updates to sections including medical management of diabetes through newer therapeutic agents like combined glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonists, early onset diabetes, complications accompanying mental health, and technology for type 2 diabetes management.

Type 2 diabetes affects 1.3 million Australians, and the number of patients living with diabetes continues to increase as the disease is closely linked with rising overweight and obesity rates. Diabetes is part of 11.8% of GP consultations.

Following new research and a period of intense interest pharmacological weight management options, including agents such as semaglutide, and the resulting shortages, RACGP Diabetes Specific Interest Group Chair Dr Gary Deed said GPs, other health professionals, and patients will benefit from updated advice in the Handbook.

“The medication shortages since 2022 caused a lot of distress among people living with diabetes, and the guidelines do explore the evidence base for the use of these medicines that has expanded rapidly since the last edition,” Dr Deed said.

“The updated Diabetes Handbook will give GPs and other health professionals clear recommendations based on the evidence. This information is now in its own section, along with new sections on sleep and diabetes management with disability, dementia, cognitive decline and hearing impairment.

“The new section on remission of type 2 diabetes will also be exciting for GPs and patients. Research has shown some people with type 2 diabetes, particularly when it’s diagnosed early, can reduce their average glucose level to achieve an HbA1c of under 6.5% and sustain it there, without glucose-lowering medication. We call this remission. It’s a best-case scenario, and the new section will help GPs and patients achieve it where possible.

Diabetes Australia Group CEO Justine Cain welcomed the updated Diabetes Handbook, highlighting its essential role in providing quality diabetes care.

“With so many advances in research, medicines, and technologies in recent years, the treatment of type 2 diabetes has changed dramatically,” Ms Cain said.

“This updated handbook is an important resource that will help GPs to support people living with diabetes.

“Diabetes can lead to severe complications including heart attack, kidney disease, limb amputation, and vision loss, so it’s critical that people get up-to-date advice from their GP early-on in their journey.

“The latest guidelines, with their new focus on remission, weight management, and lifestyle interventions, represent a major advance that will support people to achieve better health outcomes.”

RACGP President Dr Nicole Higgins says the updated Diabetes Handbook will be an important tool for GPs, diabetes educators, and health professionals.

“People living with type 2 diabetes can avoid complications and live long and healthy lives by working with a GP and care team who knows them and their history well,” Dr Higgins said.

“Having a regular GP who knows what has worked for you in your diabetes management, what you’ve tried, and utilising these RACGP evidence-based guidelines and recommendations is the best way to set yourself up to live well with diabetes and in some cases, even reach remission. There’s no substitute for that relationship.”

~ENDS

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