Quality Prescribing Guidance for Cardiovascular Risk Reduction 2026-2029
Diabetes
- Primary care healthcare professionals should implement a two-stage strategy to identify people at high risk of type 2 diabetes (and those with undiagnosed type 2 diabetes)
- Firstly, a risk assessment should be offered
- Secondly, for those with high-risk scores, a blood test should be offered to investigate if they have type 2 diabetes or prediabetes
- Reassess people with a high-risk score, but with a Glycated Haemoglobin (HbA1c) less than 42mmol/mol (6.0%) or a fasting plasma glucose less than 6.1mmol/L or, every three years
- Reassess people with a low or intermediate risk score every five years using a validated risk-assessment tool
- Use clinical judgement to determine when someone might need to be reassessed more frequently, based on their combination of risk factors
- Metformin should be considered as the first-line oral treatment option for people with type 2 diabetes
- NICE 28 flowchart should be utilised when choosing medication considering the individual's cardiovascular status, risk of developing cardiovascular disease in the future, renal status and if considered clinically significantly frail