NICE publishes new guidance on Type 2 diabetes prevention
12 July 2012
New guidance on identifying and treating people at high risk of developing Type 2 diabetes has been published by the National Institute for Health and Clinical Excellence (NICE).
According to NICE the following groups should be encouraged to have a risk assessment, and if deemed at risk – offered advice to delay or prevent onset of the condition:
- people aged 40 and above (except pregnant women)
- people aged between 25-39 and of South Asian, Chinese, African-Caribbean or Black African descent and other high risk black and minority ethnic (BME) groups
- adults with conditions that increase the risk of Type 2 diabetes.
Blood test to confirm high risk
If a person is assessed as being at high risk, they should contact their GP to confirm their level of risk. The guidance recommends two blood tests for confirmation of risk – fasting blood glucose levels, or HBA1c levels.
Once a person is confirmed of being at high risk through a blood test – they should then be offered a referral to a local evidence-based, quality assured lifestyle intervention programme. These programmes are designed to offer practical and tailored advice; support and encouragement to help people become more physically active; advice on how to maintain a healthy weight and eat healthily.
Identifying people at high risk
Barbara Young, Chief Executive of Diabetes UK, said, “We welcome this excellent guidance document, which gives strong evidence that identifying people at high risk of Type 2 diabetes is a vital part of preventing the condition and can also help diagnose those who have it earlier so that they can be helped to avoid serious complications developing. We are particularly pleased that it recommends assessments for all those in high risk groups and we welcome the fact that it recognises the vital importance of the NHS Health Check programme for identifying people at high risk.
NHS Health Check needs improving
“But we are concerned that while the NHS Health Check programme is great in theory, it has not yet been implemented properly. Only about three quarters of the expected number of people were offered a Health Check last year and only half of these offers were taken up. There are some places where hardly anyone has been given a check. This means that many people who are high risk of Type 2 diabetes have missed out on the chance to get information that could help them make the kind of lifestyle changes that could prevent it. We hope that this guidance will spur the NHS across the country to improve the way it delivers the NHS Health Check.
Prevention is key in controlling rise in Type 2 diabetes
“We want to see the recommendations in this guidance to be fully implemented, because the number of people with Type 2 diabetes is increasing at an alarming rate and it is only through prevention that we will be able to stem the rising tide and cost of Type 2 diabetes.
“But with responsibility for public health being transferred to local authorities next year, we need to make sure that the progress that has been made does not now fall back and we will keep a close eye on whether these recommendations are implemented. Failure to do so would have grave consequences for the nation’s health and the continuing rise in Type 2 diabetes will threaten to bankrupt the NHS.
“At Diabetes UK, we are already working hard to prevent Type 2 diabetes and we run a series of healthy lifestyle roadshows with the support of Bupa and the National Lottery to try an identify those at high risk so they can get the help they need. The fact that this year 55 per cent of the people who have been risk assessed have been referred to their GP, shows that there are a large proportion of people at high risk of developing Type 2 diabetes and its potentially life-threatening complications.
Also, 77,000 people used our online Risk Score last year and we are pleased to see this mentioned in the NICE guidance as an example of good practice. I would urge everyone to use this tool to assess their risk of Type 2 diabetes.”
The Risk Score can be accessed at www.diabetes.org.uk/riskscore