Non-diabetic hyperglycaemia (NDH) or prediabetes refers to blood glucose levels that are above the normal range but not high enough for a diagnosis of diabetes. There are no obvious signs or symptoms of prediabetes so most people may not be aware they have an increased risk. Risk factors are the same as for type 2 diabetes: overweight, older age, poor diet and nutrition, lack of physical activity, smoking and a family history. 

While glycated haemoglobin (HbA1c) levels of 48mmol/mol (6.5 per cent) or above are suggestive of type 2 diabetes, there is no international consensus for diagnosing prediabetes.

Financial burden

The financial burden on the NHS is immense. Almost 10 per cent of the annual NHS budget – just under £10 billion – is spent on treating diabetes, with the bulk – around £8.8 billion – going on managing preventable complications such as premature death and disability. 

Patients with diabetes have double the risk of heart attack and stroke. Diabetes also increases the risk of kidney disease, blindness and amputations. In addition, depression is more prevalent among people with type 2 diabetes compared to the population without diabetes.

The pharmacy team has a crucial role to play in helping to prevent type 2 diabetes in those at risk by providing support and education to help them manage and reduce their risk. Community pharmacies should proactively seek to engage with their National Diabetes Prevention Programme (NHS DPP) and their local CCGs to create new ways of working and supporting people with risk factors for developing type 2 diabetes.