In September 2017, NICE updated its Public Health guidance PH38, 'Type 2 diabetes: prevention in people at high risk', first issued in 2012. The new version includes the addition of recommendations €on intensive lifestyle-change programmes and metformin for people at risk of type 2 diabetes.€ In other words, €healthcare professionals, from GPs to community nurses and pharmacists, should refer people with elevated blood sugars to exercise classes and nutrition courses,€ says NICE.3,5

The recommendation follows NICE having identified 1.7 million people as having the highest risk of developing type 2 diabetes, that is a fasting glucose between 6.5-6.9mmol/l. A fasting glucose of less than 5.6mmol/l is considered normal.

NICE PH38 says primary care and other sectors should publicise local opportunities for risk assessment as well as the benefits of preventing, or at least delaying, the onset of type 2 diabetes.3

To identify risk: €Pharmacists, opticians, occupational health nurses and community leaders should offer a validated self-assessment questionnaire to adults aged 40 and over, people of South Asian and Chinese descent aged 25€“39, and adults with conditions that increase the risk of type 2 diabetes, other than pregnant women. Or they should tell people how to access specific, validated online self-assessment tools, such as the Diabetes Risk Score featured on the Diabetes UK website.€ 3

People with a high-risk score should be encouraged to contact the GP or practice nurse for a blood test.3