Type 2 Diabetes in Adults: NICE Guidance, Treatment & Primary Care Management

Type 2 diabetes management is no longer focused on HbA1c alone. In this A4Medicine video, we simplify the updated NICE NG28 approach to glucose control, cardiovascular protection, kidney health and individualised prescribing in primary care. Topics covered: Healthy living, dietary advice and weight management Individualised HbA1c targets and monitoring Choosing initial glucose-lowering medicines Modified-release metformin and SGLT2 inhibitors Treatment for cardiovascular disease, heart failure and chronic kidney disease The role of GLP-1 receptor agonists and tirzepatide When to add further medicines or start insulin Managing hypoglycaemia, frailty and treatment burden Reviewing medication effectiveness and adverse effects Monitoring and preventing long-term diabetes complications Practical prescribing points and common AKT pitfalls The updated NICE approach emphasises improving overall health—including cardiovascular and renal outcomes—rather than treating the HbA1c result in isolation. For most adults, medicine selection is now shaped by comorbidities, frailty, treatment priorities and individual circumstances. Designed for GP trainees, GPs, ANPs, pharmacists and other UK primary care clinicians, including candidates preparing for the RCGP AKT. Based on NICE guideline NG28: Type 2 diabetes in adults—management, last reviewed on 18 February 2026. The update revised recommendations on initial and subsequent medicines, common comorbidities and insulin treatment. Key message: Treat the whole patient—not just the glucose result—by combining individualised glycaemic management with cardiovascular and renal risk reduction. This video is for medical education and should be used alongside the current NICE guideline, local prescribing policies and individual clinical assessment. #Type2Diabetes #DiabetesManagement #NICEGuidelines #NG28 #PrimaryCare #GPTraining #GPtrainee #AKTRevision #SGLT2 #Metformin #GLP1 #CardiovascularRisk #KidneyHealth #A4Medicine