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T2DM risk

Five million at risk of developing T2DM in England

The new estimate further underlines the need to act on T2DM, especially as it already results in 22,000 early deaths and costs the NHS £8.8 billion every year

Five million people in England have blood sugar levels indicating a high risk of developing Type 2 diabetes mellitus (T2DM), according to a report published by Public Health England (PHE). The report, compiled by PHE’s National Cardiovascular Health Intelligence Network (NCVIN), provides the most accurate and robust estimate of how many people over 16 in England have blood sugar levels in a range indicating a high risk of developing T2DM (otherwise known as non-diabetic hyperglycaemia).

“We know how to lower the risk of developing Type 2 diabetes: lose weight, exercise and eat healthily, but it’s hard to do it alone,” said Duncan Selbie, Chief Executive of PHE. “PHE’s evidence review shows that supporting people along the way will help them protect their health and that’s what our prevention programme will do.”

It was commissioned by the NHS Diabetes Prevention Programme (NHS DPP), which will support people in reducing their risk of developing T2DM by helping them lose weight, be more active and have a healthier diet. The new estimate further underlines the need to act on T2DM, especially as it already results in 22,000 early deaths and costs the NHS £8.8 billion every year.

An evidence review also published by PHE shows programmes similar to the NHS DPP can be successful in preventing 26% of people at high risk of Type 2 diabetes from going on to develop the condition. People supported by diabetes prevention programmes lose on average 1.57kg more weight than those not on a programme aiming to significantly reduce diabetes risk.

Both reports have shaped what the NHS DPP will offer at least nine months of information, support, group and one-to-one sessions on weight loss, physical activity and diet. Practitioners, clinicians, academics and the public are currently being consulted on a proposed outline of the programme.

“There are too many people on the cusp of developing Type 2 diabetes and we can change that,” said Professor Jonathan Valabhji, National Clinical Director for Diabetes and Obesity, NHS England. “The growing body of evidence makes us confident that our NHS Diabetes Prevention Programme will reduce the numbers of those at risk going on to develop the debilitating disease.”

The data on non-diabetic hyperglycaemia is broken down by local authority (LA) for the first time, ranging from 8.5% of people in Brighton and Hove to 14% in Harrow. Higher rates are found in areas with large ethnic minority populations or older populations, or both: the groups traditionally at higher risk of Type 2 diabetes.

Lifestyle factors, including weight, physical activity levels and diet, are important like the inherent factors of ageing and ethnic background in determining the risk of developing Type 2 diabetes. The NHS DPP will focus on providing support to participants on changing their behaviour in these areas to reduce their risk.

According to the evidence review, programmes more aligned with the NICE guidance on preventing or delaying the onset of Type 2 diabetes help people lose on average 3kg more weight and significantly reduce blood sugar levels.

Aside from reducing incidences of Type 2 diabetes, the NHS DPP also aims to reduce the life-changing complications associated with the disease, like heart, stroke, kidney, eye and foot problems, and reduce costs to the NHS in the long term.

People identified with a high risk of developing Type 2 diabetes, either through an NHS Health Check or through an existing blood test result will be offered a place on the NHS DPP when it launches in 2016.

“Having high blood glucose levels significantly increases your risk of developing Type 2 diabetes, which is a serious health condition which affects 2.9 million people in England, and can lead to devastating complications such as blindness, amputations and stroke, and ultimately early death,” said Barbara Young, Chief Executive of Diabetes UK. “This is why it is really important that people at high risk of developing Type 2 diabetes are given evidence-based support to reduce their risk. As well as helping to reduce the human cost of Type 2 diabetes, this would also go a long way to helping to reduce costs to the NHS. The NHS spends 10% of its entire budget managing diabetes and unless we get better at preventing Type 2 diabetes this figure will rise to unsustainable levels.”

The NHS Diabetes Prevention Programme is a joint commitment from NHS England, Public Health England and Diabetes UK, to deliver evidence-based behaviour change interventions at scale to people at high risk of developing Type 2 diabetes to support them in reducing their risk

Consultation responses will further inform the programme, with a phased national rollout starting in 2016.

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