The National Institute of Health and Clinical Excellence (NICE) has published new public health guidance for the prevention of type 2 diabetes.
The guidance contains recommendations regarding risk assessment and stratification as well as interventions appropriate to the level of risk.
Initial assessment of the risk of developing type 2 diabetes, using tools like the Diabetes UK Risk Score tool, is recommended for adults aged 40 and over, people of South Asian and Chinese descent aged 25–39, and adults with conditions that increase the risk of type 2 diabetes, other than pregnant women. Blood tests (fasting plasma glucose or HbA1c) are recommended to those with a high risk score or those aged 25 and over of South Asian or Chinese descent whose body mass index (BMI) is greater than 23 kg/m2.
Lifestyle advice, including advice about diet, weight management and physical activity, is recommended in all cases with the intensity increasing with the assessed level of risk.
In addition, metformin is recommended for people who are at high risk and are still progressing towards type 2 diabetes, despite their participation in an intensive lifestyle-change programme or who unable to participate in lifestyle-change programmes. Orlistat is recommended for adults who have a BMI of 28 kg/m2 or more and who are still progressing towards type 2 diabetes.
Action: Clinicians should be aware of this new guidance and implement any necessary changes to practice.