Rates of Non-Diabetic Hyperglycaemia (NDH) and Gestational Diabetes Mellitus (GDM) are rising across the UK, creating high-risk populations for type 2 diabetes. These conditions disproportionately affect people in deprived communities and those from Black and South Asian backgrounds, exacerbating health inequalities.
- NDH: Around 6.3 million people in the UK have NDH, with 1 in 9 adults in England affected. Excess weight and inactivity are the main drivers of progression to type 2 diabetes.
- GDM: Affects 10–20% of pregnancies in the UK. Up to 50% of women with GDM develop type 2 within five years, and their children face increased risks of obesity and diabetes later in life.
Key Challenges
- Inequalities: Higher prevalence in deprived areas and among ethnic minority groups, coupled with barriers to accessing health checks and prevention programmes.
- Stigma: NDH and GDM are associated with stigma, which reduces engagement in self-care and increases mental health risks.
- System Gaps: Limited systematic follow-up, inconsistent referral pathways, and inadequate data linkage hinder effective prevention.
Our Recommendations
Improve Identification and Follow-Up
- Systematically screen and monitor women with GDM and people with NDH.
- Embed postpartum glucose testing and annual monitoring.
- Expand NHS Health Checks to younger high-risk groups (25–39).
Guarantee Support for Prevention
- Ensure timely referral to diabetes prevention programmes for all diagnosed with NDH or GDM.
- Strengthen recall systems and referral pathways.
Advance Health Equity
- Remove barriers through culturally tailored, accessible care.
- Provide practical support for childcare, transport, and digital inclusion.
Tackle Stigma and Mental Health
- Apply Language Matters guidance.
- Embed routine screening for depression and ensure referral to psychological support.
Use Data to Drive Improvement
- Improve coding and linkage of NDH and GDM data.
- Develop dashboards to track identification, referral, and completion by deprivation and ethnicity.
Embed Prevention into Routine Care
- Integrate type 2 prevention into primary and maternity care using system levers like QOF indicators.
- Provide clear information and support in community settings.
What we want to see
A coordinated UK-wide approach to reduce progression to type 2 diabetes, tackle health inequalities, and embed prevention into routine care.
Read our Type 2 Prevention for High-Risk Groups Position Statement January 2026 (PDF, 559KB)
