[ Diabetes Type 2 ]

Identifying risk to help prevent type 2 diabetes is everyone’s business, says NICE in new

They suggest the campaign failed to offer those who might be at high risk of Type 2 diabetes something practical they could do about it. We calculated sensitivity, specificity and the area under the receiver operating characteristic (ROC) curve, indicative of the ability of a risk score to correctly identify those with undiagnosed diabetes. 42% of patients had been informed they were at high-risk by a health professional. If you have diabetes, your body is unable to break down glucose into energy. We all live in a much more sedentary society now where it’s easy to spend the majority of each and every day sat down either at our desk working, socialising and shopping as well as banking. After Bonferroni correction, seven individual single-nucleotide polymorphisms were associated with Type 2 diabetes in the combined Malaysian sample. The partnership was a multifaceted one, and included a flagship £2m awareness campaign about type 2 diabetes which launched in September.

Combining the max-IMT with the risk scores improved the identification of subjects with stenotic lesions, in particular, those in the first, second and third tertiles of the FRS, first and second tertiles of the UKPDS and first and second tertiles of the JALS-ECC (P=0.054, P=0.056, P=0.015, P=0.082, P=0.060, P=0.007, and P=0.080, respectively). Diabetes UK staff will offer free diabetes risk assessment tests, which indicate a person’s risk of developing Type 2 diabetes in the next 10 years. The Leicester Diabetes Centre is an international centre of excellence in diabetes research, education and innovation and is led by Professor Melanie Davies and Professor Kamlesh Khunti. Our healthy lifestyle volunteers raise awareness of diabetes, the risk factors associated with Type 2 diabetes and promote healthy lifestyle messages through delivering talks or holding stands in their local area. For example, the NHS Health Checks Programme was aimed at identifying and treating vascular disease risk in all individuals between 40 and 74 years of age; the prevention of diabetes is a primary aim of the programme. Robert carried out the risk assessments at Bury Market, and also chatted through the results with people. These distinctions were something we explained to people at the time.

• Identifying people at risk of developing type 2 diabetes using a staged (or stepped) approach. This involves a validated risk-assessment score and a blood test – either the fasting blood glucose or, importantly, the HbA1c testviii to confirm high risk. • assess their risk of type 2 diabetes using a validated self-assessment questionnaire (paper based or online)ix ,or GP practices can use a computerised risk score based on information contained in patient records. • if they are assessed as high risk, to contact their GP or practice nurse for a blood test, either the fasting blood glucose or the HbA1c test to confirm their level of risk and discuss how to reduce it, or whether they already have type 2 diabetes. Measuring HbA1c levels has been used for diabetes management for a number of years, but it has not been used for the identification of people who are at high risk of developing diabetes. Insulin acts as a key unlocking the cells, so if there is not enough insulin, or it is not working properly, the cells are only partially unlocked (or not at all) and glucose builds up in the blood. The Diabetes Research Centre is based at the Leicester Diabetes Centre.


It is also important to explain to people why, even though they feel healthy, they can still be at risk of developing type 2 diabetes. It is available from your Health Care Professional, so ask for it the next time you see a GP, Diabetes Specialist Nurse, Dietician, Podiatrist, Physio etc. iii. Diabetes is a major risk factor for cardiovascular disease and stroke among people of working age. An estimated 850,000 people in the UK may have diabetes but don’t know it and may remain undiagnosed. Many more may have blood glucose levels above the normal range, (impaired glucose regulation) but not high enough for a diabetes diagnosis. vi.

In the UK, type 2 diabetes is more prevalent among people of South Asian, Chinese, African–Caribbean and black African descent than among the white population. People in these groups tend to develop it at a younger age. They also tend to progress from impaired glucose tolerance to diabetes much more quickly (more than twice the rate of white populations). vii. Particular conditions can increase the risk of type 2 diabetes. These include: cardiovascular disease, hypertension, obesity, stroke, polycystic ovary syndrome, a history of gestational diabetes and mental health problems. In addition, people with learning disabilities and those attending accident and emergency, emergency medical admissions units, vascular and renal surgery units and ophthalmology departments may be at high risk.

In particular participants thought the course was very informative and were motivated to try and modify their health behaviour through increased physical activity and the adoption of a healthy diet. Glycated haemoglobin (HbA1c) forms when red cells are exposed to glucose in the plasma. The HbA1c test reflects average plasma glucose over the previous eight to 12 weeks. Unlike the oral glucose tolerance test, an HbA1c test can be performed at any time of the day and does not require any special preparation such as fasting. HbA1c is a continuous risk factor for type 2 diabetes. This means there is no fixed point when people are (or are not) at risk. The World Health Organization recommends a level of 48 mmol/mol (6.5%) for HbA1c as the cut-off point for diagnosing type 2 diabetes in non-pregnant adults.

For the purposes of this guidance, the range 42–47 mmol/mol (6.0–6.4%) is considered to be ‘high risk‘. x. Intensive lifestyle-change programmes are specially designed for groups of 10–15 people at high risk of developing type 2 diabetes. The groups should meet at least eight times over a period of 9–18 months and participants should have at least 16 hours of contact time, either within a group, on a one-to-one basis or a mixture of both approaches, or they may use telephone or computer-based interactive media. 1. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance and standards on the promotion of good health and the prevention and treatment of ill health. • Quality and Outcomes Framework – NICE develops the clinical and health improvement indicators in the QOF, the Department of Health scheme which rewards GPs for how well they care for patients.

4. NICE provides advice and support on putting NICE guidance and standards into practice through its implementation programme, and it collates and accredits high quality health guidance, research and information to help health professionals deliver the best patient care through NHS Evidence.

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