Guidance

Update information

Update information

May 2023: We have reviewed the evidence on glucose-lowering agents for managing blood glucose levels in children and young people with type 2 diabetes. We have amended or made new recommendations in the sections on:

  • education and information

  • at diagnosis

  • monitoring blood glucose levels and reviewing treatment

  • when to reduce insulin for people who have been on it from diagnosis

  • adding liraglutide, dulaglutide, or empagliflozin

  • insulin therapy

  • changing treatments and updating healthcare plans.

These recommendations are marked [2015, amended 2023] or [2023].

June 2022: We have reviewed evidence on periodontitis in children and young people with type 1 and type 2 diabetes. We have amended recommendation 1.2.1 and made new recommendations. The amended recommendation and the new recommendations are marked [2022].

March 2022: We have reviewed the evidence and made new recommendations on continuous glucose monitoring (CGM) for children and young people with type 1 diabetes. These recommendations are marked [2022].

We have also made one change without an evidence review: in the section on monitoring capillary blood glucose, wording has been added to the heading and recommendations to make it clear that recommendations apply to children and young people who are using capillary blood glucose monitoring rather than CGM. These recommendations are marked [2015, amended 2022].

Recommendations marked [2004], [2015], [2004, amended 2015] or [2020] last had an evidence review in that year. In some cases, minor changes have been made to the wording to bring the language and style up to date, without changing the meaning.

December 2020: We have reviewed the evidence and made new recommendations on fluid therapy for children and young people with diabetic ketoacidosis. These recommendations are marked [2020].

We have also amended recommendations 1.2.4, 1.2.125 and 1.3.84 without an evidence review. This is to provide clarity about eye examinations and to bring them in line with the diabetic eye screening programme. These recommendations are marked [2015, amended 2020].

We have also amended recommendation 1.2.1 to highlight a Medicines and Healthcare products Regulatory Agency (MHRA) safety update reminding patients to rotate insulin injection sites within the same body region to avoid cutaneous amyloidosis.

Minor changes since publication

October 2024: Empagliflozin is now licensed in children aged 10 and over, so the off label note about this medicine has been removed from recommendations 1.3.50 and 1.3.53.

August 2024: We added links to NICE's guideline on diabetic retinopathy.

February 2024: We removed reference to 'or a combination of them' from the first bullet of recommendation 1.3.54, because this was included in error.

October 2022: In recommendation 1.4.24 we updated the volume of fluid bolus used for intravenous fluid therapy from 20 ml/kg to 10 ml/kg for children and young people with diabetic ketoacidosis and signs of shock. See the surveillance report for more information.

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