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CAMHS won't see you now

BNP misleading in black patients

I read with interest your article highlighing the difference between BHS and NICE hypertension guidelines (Clinical, February 19). I was also interested to note that you had reproduced the NICE quick reference guide.

This appears to have an obvious error with respect to the diagnosis of 'pre-diabetes'.

Impaired glucose tolerance is diagnosed using the oral glucose tolerance test not a fasting plasma glucose. And the FPG value of 6.5mmol/L given by NICE is neither diagnostic for IGT nor impaired fasting glycaemia.

I have witnessed this guidance being

reproduced erroneously in prescibing meetings too. This is a direct error from the guidelines and not a typo.

With the recent emphasis in Pulse regarding the possible introduction of obesity monitoring into Q&O measures, the NSF for diabetes' declared

aim to reduce the incidence of type 2 diabetes, and the difficulty that these diagnostic terms pose for many GPs, I am surprised that all GPs have not

yet been issued with an official correction from NICE.

Dr JDG Fearn-Smith


Editor's note

According to WHO:

·Impaired glucose tolerance is a fasting blood sugar <7 and="" a="" two-hour="" blood="" sugar="" (as="" part="" of="" a="" glucose="" tolerance="" test)="" of="">

·Impaired fasting glycaemia is FBS =6.1 Ã7mmol/L.

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