Doctors ‘outraged’ by NICE diabetes guidance

Exchanges between doctors captured via a study on social media have revealed that many have strong feelings towards new draft guidelines on the treatment of type 2 diabetes published by NICE.

Research conducted by Creation Healthcare looked at the responses by healthcare professionals to NICE draft guidance for diabetes documents that were released at the beginning of 2015.

It notes that specialists, doctors, and nurses have joined in an online conversation questioning NICE’s recommendations on the use of repaglinide and pioglitazone, with trepidations centering on patient safety and confusion in primary care.

Online reactions indicate many have formed sturdy opinions around type 2 diabetes in adults, which seems to be the most controversial element found in NICE’s guidelines that attempt to modernise aspects of diabetes management based on latest clinical research – and include recommendations on diet, patient education, drug treatment and self-monitoring.

Chief executive of Creation Heathcare, Daniel Ghinn, says: “In today’s digitally connected world we often see doctors’ first reactions to policy guidance expressed through their online conversations in public social media such as Twitter. This study provides an early indication to possible future direction from NICE when the final recommendations are published in August.”

Key figures in diabetes such as Wasim Hanif, Professor of Diabetes at University Hospital Birmingham, among others, were said to have highlighted their concerns – and the study found no positive support from healthcare professionals for the NICE recommendations.

Partha Kar, who is a consultant for Diabetes and Endocrinology at Portsmouth Hospitals NHS Trust and a clinical advisor to the Quality Care Commission, tweeted: “Met >15 diabetes specialists over last few days. Not a single person thinks the draft Type 2 diabetes [NICE] document makes any sense”.

The overriding worry appears to be the recommended use of repaglinide as a substitute monotherapy when metformin cannot be used instead of a sulfonylurea, due to a perceived lack of evidence.

According to Pulse NICE has declined to respond to specific criticisms while the public consultation is still underway, but says views would be fully considered to ‘help inform the final guideline’.

A spokesperson added: “The public consultation on the NICE guideline for type 2 diabetes will run until Wednesday 4 March. As is the usual NICE process we are now actively seeking feedback from healthcare professionals and stakeholder organisations.”

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