Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

May NICE Guidance

The National Institute of Health and Clinical Excellence has published new guidance for the month of May.

The published guidance includes Clinical Guidelines that cover Lipid Modification and an update to the Type 2 Diabetes Guideline.

The former guideline (Quick Reference PDF) provides advice for risk management by lipid modification in patients at high risk of cardiovascular disease and those who have already had a cardiovascular event or have cardiovascular disease. This guideline has been reported in the general media (BBC) due to the prediction that an additional 1.5 million people could be prescribed a statin.

The update to the Diabetes guideline (Quick Reference PDF) covers:

  • Lifestyle Management
  • Appropriate use of self monitoring of blood glucose
  • Medication
  • Blood pressure targets and management
  • CVD Risk prediction
  • Lipid targets and management
  • Antithrombotics
  • Eye, Kidney and Nerve Damage

These guidelines are the first National Policy documents to contain secondary prevention cholesterol targets of 4mmol/L for total cholesterol and 2mmol/L for LDL. These targets also apply to patients with diabetes who are started on lipid lowering drugs. NICE also recommend auditing based on a total cholesterol of 5mmol/L in recognition of the fact that half of patients will not achieve these targets.

Simvastatin 40mg is the recommended first line therapy for all patients. There is no recommended target for primary prevention and moving high intensity statins is not recommended as routine.

Action: Clinicians should be aware of these recent guidelines and ensure that current practice is updated to reflect the latest recommendations.

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3 Comments to “May NICE Guidance”

  1. [...] MeReC covers some of key recommendations from the updated NICE guideline on type 2 diabetes. It includes a discussion in the following [...]

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  2. [...] Lipid Modification Guideline recently published by the National Institute for Health and Clinical Excellence (NICE) has sparked debate in the [...]

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  3. […] Lipid Modification Guideline recently published by the National Institute for Health and Clinical Excellence (NICE) has sparked debate in the […]

    Pingback by NICE Lipid Guideline Sparks Debate | Prescribing Advice For GPs — June 13, 2008 #
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