Care Pathways

26.05.20

Pre-diabetes: a hidden healthcare problem

Dr Russell Muirhead, Clinical Director of Living Well, Taking Control

A third of adults in England have pre-diabetes, according to research published in The BMJ. The study also found that, over eight years, the number of people diagnosed with pre-diabetes tripled. By 2025, it is estimated that five million people will have diabetes in the UK – 90% of which is Type 2 diabetes.

Pre-diabetes is related to increasing rates of obesity and has grown to become one of the most prevalent health conditions in the UK. The use of the prefix ‘pre-’, which could be quite easily interpreted as ‘not quite’ a health condition, may make patients wonder if it is something they even need to worry about.

But just because a condition is widespread, and in its early stages, does not mean that it should simply be accepted. Indeed, intervention now could prevent pre-diabetes from turning into Type 2 diabetes – a lifelong condition which carries a range of associated health problems. In case we needed any more reminders of how seriously this condition must be taken, NHS England reported this month that a quarter of all Covid-19 patients who died in hospitals had diabetes.

Muirhead

Dr Russell Muirhead, Clinical Director of Living Well, Taking Control
 

Pre-diabetes remains a largely hidden healthcare problem, but this is a critical phase for people ‘at risk’ of Type 2 diabetes to turn things around. Early diagnosis and support will avoid complications and reduce the future burden on our health service. So, how can we make sure patients have the opportunity to take control of their own health?

Identifying and diagnosing patients at risk

According to Diabetes UK, pre-diabetes is characterised by the presence of blood glucose levels that are higher than normal, but not yet high enough to be classed as diabetes. GPs will consider a range of factors – including age, ethnicity, weight and family medical history – to assess risk and put patients forward for testing.

Early diagnosis can prevent progression to Type 2 diabetes, or delay its onset thus reducing long term complications. It is often too late if we rely on patients reporting symptoms, so it is vital health practitioners check in with patients from at risk groups to assess their risk factors. We must proactively ask the questions to lower the numbers of those with pre-diabetes.

Communicating the condition

Pre-diabetes must be taken seriously by patients to prevent future health problems, but they can be reassured that reducing their risk of developing Type 2 diabetes does not require a complete lifestyle overhaul. They can still enjoy their favourite things. It's all about small and achievable changes that get patients eating healthier and moving more. Small changes can have dramatic effects.

Encouraging lifestyle changes

New patterns of behaviour can reverse pre-diabetes. However to achieve this requires more than a short-term diet or health kick; it is a lifestyle change that needs to be maintained. Step one is to recognise unhealthy behaviours. Food and exercise diaries may sound a little elementary, but they can provide a realistic insight into how much patients are really moving and how much sugar, fat and alcohol they are consuming. These are useful benchmarks for individuals to set personal goals to make simple, but important, changes to their lifestyle.

Supporting educational initiatives

Often, patients will only be motivated to make significant lifestyle changes if they fully understand the long term detrimental effects of Type 2 diabetes and how they can prevent disease progression. A critical step is the education people need on food labelling, healthy eating and physical activity plans to make good choices. With a third of the population at risk, the healthcare sector is under pressure to deliver mass educational support. This is the key to empowering patients to take control of their own health.

Building support networks

We know that bringing people with pre-diabetes together encourages a more supportive conversation and local groups (whether that is in-person or digitally) tend to be more effective. This is because people can usually find more things in common, and build more trust, with a neighbour than with a stranger on the internet. Community programmes are also an excellent opportunity to get inspired by people who have successfully reversed the condition.

Pre-diabetes is prevalent across the UK, yet few people talk openly about having the condition. It is possible that the stigma associated with Type 2 diabetes extends to its precursor. We have a joint responsibility to bring pre-diabetes back to the fore and focus on prevention before treatment. Intervening at this stage will help more people to turn it around and halt the development of Type 2 diabetes altogether.

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

PCN Network: Important people access primary care in way which suits them

10/07/2020PCN Network: Important people access primary care in way which suits them

Following the release of the findings from the latest GP Patient Survey, NHS Confederation’s PCN Network have stressed the importance of en... more >
NHS Test and Trace data shows 97.5% of tests returned the next day

10/07/2020NHS Test and Trace data shows 97.5% of tests returned the next day

As NHS Test and Trace have published the statistics for the fifth week of the service operating, demonstrating that 97.5% of in-person coron... more >
NHS SBS framework launched to help safe return of employees

09/07/2020NHS SBS framework launched to help safe return of employees

A new procurement framework has been launched by NHS Shared Business Services (NHS SBS) to help facilitate the safe return of NHS and other publi... more >

editor's comment

26/06/2020Adapting and Innovating

Matt Roberts, National Health Executive Editorial Lead. NHE May/June 2020 Edition We’ve been through so much as a health sector and a society in recent months with coronavirus and nothing can take away from the loss and difficulties that we’ve faced but it vital we also don’t disregard the amazing efforts we’v... read more >

last word

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad, president of the Association of the British Pharmaceutical Industry (ABPI), sits down with National Health Executive as part of our Last Word Q&A series. Would you talk us th... more > more last word articles >

the scalpel's daily blog

NHS at 72: Managing mental health services going forward

03/07/2020NHS at 72: Managing mental health services going forward

Sean Duggan, Chief Executive of the Mental Health Network Let’s take this opportunity to reflect on the amazing achievements of our health system over the past few months. But as we recognise the best of the NHS and its response to the Covid-19 crisis we must not forget that for mental health the peak has yet to come. Covid-19 ... more >
read more blog posts from 'the scalpel' >

comment

NHS England dementia director prescribes rugby for mental health and dementia patients

23/09/2019NHS England dementia director prescribes rugby for mental health and dementia patients

Reason to celebrate as NHS says watching rugby can be good for your mental health and wellbeing. As the best rugby players in the world repr... more >
Peter Kyle MP: It’s time to say thank you this Public Service Day

21/06/2019Peter Kyle MP: It’s time to say thank you this Public Service Day

Taking time to say thank you is one of the hidden pillars of a society. Being on the receiving end of some “thanks” can make communit... more >
Nurses named as least-appreciated public sector workers

13/06/2019Nurses named as least-appreciated public sector workers

Nurses have been named as the most under-appreciated public sector professionals as new research reveals how shockingly under-vauled our NHS, edu... more >
Creating the Cardigan integrated care centre

10/06/2019Creating the Cardigan integrated care centre

Peter Skitt, county director and commissioner for Ceredigion Hywel Dda University Health Board, looks ahead to the new integrated care centre bei... more >

interviews

Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

24/10/2019Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

Today, speaking at the Royal College of General Practitioners (RCGP) annual conference, Matt Hancock highlighted what he believes to be the three... more >
NHS dreams come true for Teesside domestic

17/09/2019NHS dreams come true for Teesside domestic

Over 20 years ago, a Teesside hospital cleaner put down her mop and took steps towards her midwifery dreams. Lisa Payne has been delivering ... more >
How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >

health service focus

View all News