PHARMAMINT
TYPE 2 DIABETES MELLITUS
(T2DM)
THE ULTIMATE PHARMACY STUDY GUIDE & CLINICAL CHEAT SHEET
____________________________________________________
Reflecting NICE Guideline NG28 & February 2026 Medicines Update
High-Yield Study Notes for Pharmacy Students BY a Pharmacy Student
For personal use only. Commercial redistribution of this file as-is is prohibited.
, T2DM Pharmacy Study Guide | NICE NG28 Guidelines
Table of Contents
Table of Contents .................................................................................. Error! Bookmark not defined.
1. Glucose Regulation (Normal Physiology) .......................................................................................... 4
Pancreatic Hormones ......................................................................................................................... 4
Insulin Signalling Cascade ................................................................................................................. 4
Incretin System & Renal Handling ..................................................................................................... 4
2. Pathophysiology of T2DM .................................................................................................................. 5
3. Epidemiology and Risk Factors ......................................................................................................... 5
4. Diagnosis and Monitoring .................................................................................................................. 6
Asymptomatic vs. Symptomatic Presentations .................................................................................. 6
Continuous Glucose Monitoring (CGM) in T2DM .............................................................................. 6
5. Clinical Pathway Overview................................................................................................................. 7
The 2026 'Seven-Track' Comorbidity-Based Approach ..................................................................... 7
6. Pharmacology of Antidiabetic Medicines ........................................................................................... 8
6.0 Current First-Line Treatment Approach (NICE February 2026 Update)...................................... 8
Summary Comparison of Major Antidiabetic Drug Classes ............................................................... 8
6.1 Metformin (M/R vs. IR) ................................................................................................................. 9
6.2 SGLT2 Inhibitors (e.g. Dapagliflozin, Empagliflozin) ................................................................... 9
6.3 DPP-4 Inhibitors (Gliptins - e.g. Sitagliptin, Linagliptin) ............................................................... 9
6.4 GLP-1 Receptor Agonists (e.g. Semaglutide, Liraglutide, Dulaglutide)....................................... 9
6.5 Tirzepatide (Dual GIP/GLP-1 Receptor Agonist) ....................................................................... 10
6.6 Sulfonylureas (e.g. Gliclazide) ................................................................................................... 10
6.7 Pioglitazone (Thiazolidinedione) ................................................................................................ 10
6.8 Insulin & Biosimilars ................................................................................................................... 11
7. Formulation Science ........................................................................................................................ 11
8. Patient Education and Counselling .................................................................................................. 11
9. Complications................................................................................................................................... 12
Microvascular Complications ........................................................................................................... 12
Macrovascular Complications .......................................................................................................... 12
10. Comorbidities and Special Populations ......................................................................................... 13
11. Holistic and Person-Centred Care ................................................................................................. 13
12. Interpreting and Applying NICE NG28 in Practice......................................................................... 14
13. Red Flags & Urgent Issues ............................................................................................................ 14
14. Interprofessional & Pharmacist Roles ........................................................................................... 15
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TYPE 2 DIABETES MELLITUS
(T2DM)
THE ULTIMATE PHARMACY STUDY GUIDE & CLINICAL CHEAT SHEET
____________________________________________________
Reflecting NICE Guideline NG28 & February 2026 Medicines Update
High-Yield Study Notes for Pharmacy Students BY a Pharmacy Student
For personal use only. Commercial redistribution of this file as-is is prohibited.
, T2DM Pharmacy Study Guide | NICE NG28 Guidelines
Table of Contents
Table of Contents .................................................................................. Error! Bookmark not defined.
1. Glucose Regulation (Normal Physiology) .......................................................................................... 4
Pancreatic Hormones ......................................................................................................................... 4
Insulin Signalling Cascade ................................................................................................................. 4
Incretin System & Renal Handling ..................................................................................................... 4
2. Pathophysiology of T2DM .................................................................................................................. 5
3. Epidemiology and Risk Factors ......................................................................................................... 5
4. Diagnosis and Monitoring .................................................................................................................. 6
Asymptomatic vs. Symptomatic Presentations .................................................................................. 6
Continuous Glucose Monitoring (CGM) in T2DM .............................................................................. 6
5. Clinical Pathway Overview................................................................................................................. 7
The 2026 'Seven-Track' Comorbidity-Based Approach ..................................................................... 7
6. Pharmacology of Antidiabetic Medicines ........................................................................................... 8
6.0 Current First-Line Treatment Approach (NICE February 2026 Update)...................................... 8
Summary Comparison of Major Antidiabetic Drug Classes ............................................................... 8
6.1 Metformin (M/R vs. IR) ................................................................................................................. 9
6.2 SGLT2 Inhibitors (e.g. Dapagliflozin, Empagliflozin) ................................................................... 9
6.3 DPP-4 Inhibitors (Gliptins - e.g. Sitagliptin, Linagliptin) ............................................................... 9
6.4 GLP-1 Receptor Agonists (e.g. Semaglutide, Liraglutide, Dulaglutide)....................................... 9
6.5 Tirzepatide (Dual GIP/GLP-1 Receptor Agonist) ....................................................................... 10
6.6 Sulfonylureas (e.g. Gliclazide) ................................................................................................... 10
6.7 Pioglitazone (Thiazolidinedione) ................................................................................................ 10
6.8 Insulin & Biosimilars ................................................................................................................... 11
7. Formulation Science ........................................................................................................................ 11
8. Patient Education and Counselling .................................................................................................. 11
9. Complications................................................................................................................................... 12
Microvascular Complications ........................................................................................................... 12
Macrovascular Complications .......................................................................................................... 12
10. Comorbidities and Special Populations ......................................................................................... 13
11. Holistic and Person-Centred Care ................................................................................................. 13
12. Interpreting and Applying NICE NG28 in Practice......................................................................... 14
13. Red Flags & Urgent Issues ............................................................................................................ 14
14. Interprofessional & Pharmacist Roles ........................................................................................... 15
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