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Type 2 Diabetes Clinical Update for Primary Care

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Summary

Type 2 diabetes training for primary care clinicians who already have experience of supporting people with diabetes and need to understand the significant changes introduced by the February 2026 NICE NG28 update.

This nine-hour clinical update is divided into three clearly defined modules: Assess, Individualise and Optimise. Each three-hour module combines current clinical guidance with realistic primary care cases and structured discussion.

The programme moves beyond simply describing what has changed. It helps Practice Nurses, GPs, Clinical Pharmacists and Advanced Clinical Practitioners develop a practical and repeatable approach to assessment, shared decision-making and treatment optimisation.

Explore our wider range of clinical skills and patient care training for NHS primary care teams.

Aims

This type 2 diabetes training for primary care helps experienced clinicians understand and apply the February 2026 update to NICE guideline NG28: Type 2 diabetes in adults – management.

The programme is divided into three sequential modules, each lasting three hours.

Module 1: Assess

Delegates will develop a structured approach to gathering and interpreting the information needed before selecting a treatment pathway.

  • Identify the significant changes introduced by the February 2026 NICE NG28 update.
  • Review the person’s current glycaemic control, treatment and response.
  • Assess cardiovascular disease, heart failure and future cardiovascular risk.
  • Assess renal function, obesity, frailty and other relevant comorbidities.
  • Recognise the implications of early-onset type 2 diabetes.
  • Consider treatment burden, tolerability and the possibility of an alternative diagnosis.
  • Bring the clinical information together to identify the relevant NICE treatment pathway.

Module 2: Individualise

Delegates will explore how to move from clinical assessment to an individualised treatment decision.

  • Understand the seven treatment pathways within the updated guidance.
  • Agree individualised glycaemic targets.
  • Identify which clinical priorities should take precedence when several comorbidities are present.
  • Discuss the benefits, risks and treatment burden associated with different options.
  • Involve people in decisions about starting, reviewing or changing medicines.
  • Consider personal circumstances, preferences and ability to follow the treatment plan.
  • Recognise and respond to inequalities in access to diabetes treatment.

Module 3: Optimise

Delegates will apply the updated recommendations to treatment initiation, intensification and review.

  • Apply the revised recommendations for first-line dual and triple therapy.
  • Review the changing roles of metformin, SGLT2 inhibitors, GLP-1 receptor agonists and tirzepatide.
  • Select and sequence additional glucose-lowering treatments appropriately.
  • Review treatment effectiveness, tolerability, safety and continuing clinical benefit.
  • Recognise when medicines should be continued, changed or stopped.
  • Provide individualised sick day guidance and appropriate safety-netting.
  • Apply the complete Assess → Individualise → Optimise framework to realistic primary care cases.
How Long Is The Course?

This programme provides nine hours of interactive learning, divided into three sequential three-hour modules:

  • Module 1: Assess
  • Module 2: Individualise
  • Module 3: Optimise

The modules can be delivered online or face to face. They are normally scheduled separately so that delegates have time to reflect on the guidance, consider its application in practice and bring questions or examples to the next session.

Who Should Attend?

This course is designed for experienced primary care clinicians who already contribute to the assessment, review or treatment of adults living with type 2 diabetes.

It is particularly suitable for:

  • Practice Nurses;
  • General Practitioners;
  • Clinical Pharmacists;
  • Advanced Clinical Practitioners; and
  • other registered clinicians with an established role in type 2 diabetes care.

This is a clinical update rather than a Foundation course. Delegates should already understand the principles of type 2 diabetes, routine monitoring and the role of commonly used treatments.

Additional Information

The February 2026 update to NICE NG28 represents a significant change in the management of type 2 diabetes. It introduces revised treatment pathways, earlier use of several medicines and a stronger emphasis on comorbidities, individualised targets and shared decision-making.

This type 2 diabetes training for primary care is designed for clinicians who already understand the foundations of diabetes care. Rather than presenting the updated guidance as a list of recommendations, the course provides a practical clinical framework that delegates can use when reviewing an individual patient.

The three modules follow the sequence of a well-reasoned clinical decision:

Assess the complete clinical picture. Individualise the aims and treatment pathway. Optimise treatment safely and effectively.

Type 2 diabetes training for primary care: Module 1 – Assess

The first module examines the information clinicians need before making or changing a treatment decision. Delegates will consider how the updated guidance broadens the assessment beyond HbA1c and establishes different pathways according to a person’s clinical circumstances.

The module will explore:

  • what changed in the February 2026 NICE NG28 update and why it matters in primary care;
  • current glycaemic control and individual treatment response;
  • atherosclerotic cardiovascular disease and future cardiovascular risk;
  • heart failure;
  • chronic kidney disease and renal function;
  • obesity and weight-related clinical priorities;
  • early-onset type 2 diabetes;
  • frailty, multimorbidity and treatment burden;
  • current medicines, adverse effects and tolerability; and
  • circumstances in which the diagnosis or treatment approach may need to be reconsidered.

Delegates will use clinical scenarios to decide which findings are relevant, what further information they need and which NICE pathway may apply.

Type 2 diabetes clinical update: Module 2 – Individualise

The second module focuses on translating assessment into an individualised plan. The updated guidance does not support a single treatment sequence for everyone. Clinicians must interpret the relevant pathway while involving the person in decisions about targets, medicines, benefits and risks.

The module will explore:

  • the seven treatment pathways within the updated guidance;
  • individualised HbA1c targets;
  • prioritising treatment when more than one comorbidity is present;
  • the effects of different medicines on glycaemia, weight, cardiovascular risk and renal outcomes;
  • contraindications and other factors influencing treatment choice;
  • shared decision-making when initiating, reviewing or changing treatment;
  • the person’s priorities, preferences and experience of treatment;
  • the practical and emotional burden of treatment;
  • health inequalities in access to and uptake of diabetes medicines; and
  • agreeing a plan that is clinically appropriate and realistic for the individual.

The module will help delegates explain treatment choices clearly and involve people more meaningfully in decisions about their care. This approach complements Striding Edge’s wider health coaching, behaviour change and personalised care training.

Module 3: Optimise

The final module examines how clinicians can initiate, intensify and review treatment within the updated NICE pathways. Optimisation is considered in terms of glycaemic control, cardiovascular and renal protection, weight, safety, tolerability and the person’s own priorities.

The module will explore:

  • the increased role of modified-release metformin;
  • first-line dual therapy with metformin and an SGLT2 inhibitor for many people;
  • the cardiovascular and renal benefits of SGLT2 inhibitors;
  • earlier use of GLP-1 receptor agonists and tirzepatide for defined groups;
  • first-line triple therapy for people with established atherosclerotic cardiovascular disease;
  • treatment considerations for early-onset type 2 diabetes, obesity, chronic kidney disease, heart failure and frailty;
  • the role of DPP-4 inhibitors and other additional glucose-lowering therapies;
  • sequential introduction and titration of medicines;
  • monitoring treatment response and adverse effects;
  • when treatment should be continued, reviewed, changed or stopped;
  • individualised sick day rules and SGLT2 inhibitor safety; and
  • changes to the recommendations for insulin therapy.

Delegates will complete the programme by applying the full Assess → Individualise → Optimise framework to realistic cases. They will identify the relevant pathway, explain their clinical reasoning and develop an individualised treatment approach.

This modular type 2 diabetes training for primary care gives experienced clinicians time to engage properly with the 2026 NICE NG28 update and return to practice with a clear, repeatable framework for making treatment decisions.

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