Management algorithm for type 2 diabetes

The NZSSD working group, with support of the Ministry of Health, develops national up-to-date and evidence-based guidance for the management of type 2 diabetes in adults that will continue to be updated as evidence and practice changes. 

In the new 2023 algorithm, lifestyle management and metformin remain the first-line interventions and the recent shift towards reducing CV, renal risk and obesity are emphasised, in addition to improving glycaemic control.

Changes to the updated guidance

Specific changes to the updated guidance include the following.

• Changes in lifestyle management.
• Changes for glucose-lowering medicines to recognise ‘off-label’ prescribing given the delay in updating data sheets and the availability of liraglutide (Victoza®) under the same Special Authority as dulaglutide.
• Management of hypoglycaemia in Type 2 has been simplified to prevent both under and over-treatment.
• Other changes include the target LDL has been lowered from 1.8 mmol/L to < 1.4 mmol/L.