The Scottish Intercollegiate Guidelines Network (SIGN) has updated SIGN 116: Management of diabetes and updated SIGN 154: Pharmacological management of glycaemic control in people with type 2 diabetes.

In Scotland and worldwide, diabetes is a major cause of morbidity. An aging population and increases in obesity have contributed to the increasing burden represented by diabetes. It is estimated that 90% of all adults and children with diabetes have type 2 diabetes.

SIGN 116: Management of diabetes provides recommendations on:

  • lifestyle interventions for type 1 and type 2 diabetes
  • managing psychosocial issues; managing type 1 diabetes
  • managing cardiovascular, kidney and foot diseases
  • preventing visual impairment
  • managing type 1, type 2, and gestational diabetes during pregnancy.

Prevention of diabetes and prediabetes are not covered in SIGN 116.

SIGN 154: Pharmacological management of glycaemic control in people with type 2 diabetes provides recommendations on:

  • optimal targets for glucose control for the prevention of microvascular and macrovascular complications in people with type 2 diabetes (recommendations were moved unchanged from SIGN 116)
  • the risks and benefits of the principal therapeutic classes of glucose-lowering agents and insulins currently available for people with type 2 diabetes who require measures beyond diet and exercise to achieve glucose targets (recommendations updated from SIGN 116)

SIGN 154 includes an updated algorithm to guide the choice of first-, second- and third-line glucose-lowering agents, which incorporates the summarised evidence and the clinical experience of the guideline development group.