The UK National Diabetes Audit (NDA) in 2015-16 looked at complications and mortality and found that people with diabetes are 32% more likely to die prematurely than people who don't have the condition.10

Between 2014 and 2017 there were an average each year of 8,793 leg, toe or foot amputations, a 19.4% increase from 2010-2013. Below-knee amputations increased by 4.1%, while amputations below the ankle increased 26.5%.7,11

It is also estimated that 30 people a week develop sight loss because of their diabetes. Other increased risks for people with diabetes highlighted by the NDA include chronic kidney disease and diabetic ketoacidosis, as well as a greater mortality at all ages up into the late 80s.7,12

T2D levels are increasing in young people, too: 6,836 children and young adults were diagnosed with T2D in England and Wales in 2016-17. “The condition is much more aggressive in children and young people than in adults, with a higher overall risk of complications that tend to appear much earlier,” said Diabetes UK.13

Lifestyle changes involving diet, exercise and weight loss can have a positive impact on diabetes progression, with improved insulin sensitivity and β-cell function. The combination of exercise and diet can result in a 40–70% reduction in the risk of developing T2D in people with impaired glucose tolerance, and taking action at the prediabetes stage can see a reversal of hyperglycaemia to normal levels.2,14,15

Even if this improvement is only temporary before progressive glucose intolerance starts to return, the patient will be at a reduced risk of T2D compared to those with stable prediabetes. Early intervention can also work to reduce complications should T2D later develop; up to 10% of patients with dysglycaemia in prediabetes develop microvascular conditions such as background retinopathy or neuropathy.2

As prediabetes “represents a state of clustered CVD risk factors, accelerated atherosclerosis, and increased risk for CVD events,” acting at the prediabetes stage should also help prevent or delay CVD.