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NICE finalises guidance for GPs to refer to diabetes prevention scheme


It is perplexing that we are still suggested to be looking "for people confirmed as being at high risk of DM because of a fasting plasma glucose of 5.5–6.9 mmol/l or HbA1c of 42–47 mmol/L". It seems that a blood result is what we should need to raise concerns about DM. DM is endemic and it would not be shifting a sign-post to 5.5 mmol/L (which has been the case for a while now) to make the difference. If we really want to make a difference instead, we should not wait for that long and for a blood test result. As a matter of fact, observation and just using a simple weight scale could be an immediate, cheap, and helpful starting point. It can be argues that when blood tests start to show some degree of derangement, something is already going "wrong". We have known for many years that lifetime diabetes risk at 18 years of age increases significantly with BMI. It has been suggested that this varies from 7.6 to 70.3% between underweight and very obese men and from 12.2 to 74.4% for women. The promise of early intervention is that not only does it mean providing effective, timely support to those at risk to prevent poor later life outcomes and the intergenerational cycle of disadvantage, but it delivers savings to both local and national agencies at a time of increasing budgetary pressures.

Posted date

16 Sep 2017

Posted time