RCNi Learning modules updated with 2026 NICE diabetes guideline
Six RCNi Learning modules have been updated in line with latest 2026 NICE diabetes guideline on medication, assessment and multidisciplinary referral systems
‘Major changes’ to type 2 diabetes management are expected following an update of the National Institute for Health and Care Excellence (NICE) guideline.
Under the revised guideline, people with type 2 diabetes will be offered sodium-glucose cotransporter-2 (SGLT-2) inhibitors, known as ‘flozins’, much earlier in their management pathway. NICE suggests that the NHS could save millions of pounds because one of the most commonly prescribed SGLT-2 inhibitors, dapagliflozin, is now available as a clinically equivalent generic version.
The institute suggests that the move, along with the introduction for some people of glucagon-like peptide-1 (GLP-1) receptor agonists such as tirzepatide, commonly known by its brand name Mounjaro, could prevent about 17,000 deaths over a three-year period across the UK.
NICE notes that SGLT-2 inhibitors are often under-prescribed to women, older people and patients who are black, so the new guideline includes recommendations to monitor those who receive these treatments and to take action to close any gaps in prescribing if necessary.
Updated diabetes learning modules from RCNi Learning
These six evidence-based peer-reviewed RCNi Learning modules on diabetes have been updated to reflect the new guidance.
- Personalised care for people with newly diagnosed type 2 diabetes (2 hours CPD)
- Assessment and management of patients with diabetes-related foot ulcers (2 hours CPD)
- Blood glucose management in diabetes (2 hours CPD)
- Improving self-management of type 1 and type 2 diabetes (2 hours CPD)
- How to monitor blood glucose (1 hour CPD)
- Blood glucose monitoring and management in acute stroke care (2 hours CPD)
Subscribers can add CPD hours from RCNi Learning straight into their Revalidation Portfolio with an RCNi Plus subscription.
What’s in the revised guideline
- SGLT-2 inhibitors as first-line therapy: SGLT-2 inhibitors are now recommended alongside modified-release metformin for most people with newly diagnosed type 2 diabetes, regardless of whether they have established heart or kidney disease, or obesity.
- Triple therapy first-line for cardiovascular disease: For adults with established atherosclerotic cardiovascular disease (ASCVD), the recommendation is to initiate modified-release metformin, an SGLT-2 inhibitor and subcutaneous semaglutide (1mg) to maximise cardiorenal protection.
- Emphasis on modified-release metformin: The guideline now prefers modified-release metformin over standard-release metformin to improve tolerability and patient adherence.
- Specific pathway for early-onset diabetes: New recommendations for those diagnosed under 40 years of age include metformin, SGLT-2 inhibitors and consideration of early GLP-1 receptor agonist or tirzepatide use.
- Formal inclusion of tirzepatide: Tirzepatide is now included as an option in the treatment pathway for adults with type 2 diabetes who are living with obesity or in cases of early-onset diabetes.
- Frailty-specific guidance: A new pathway for patients with significant frailty advises caution with SGLT-2 inhibitors, prioritising modified-release metformin and potential dipeptidyl peptidase-4 (DPP-4) inhibitor use.
- Revised clinical focus: The guideline moves away from a solely glucose-centric (HbA1c) model to a cardiorenal protection model, aimed at reducing heart attacks, strokes and kidney failure.