NICE consults on new draft guidance on preventing type 2 diabetes

NICE has today (Wednesday 9 November) opened a consultation on new draft guidance on identifying people at high risk of developing type 2 diabetes and the provision of clinically and cost effective interventions to help reduce the risk or delay the onset of the condition.

The risk of developing type 2 diabetes can be affected by factors such as age, body mass index, ethnicity, and waist circumference. The draft guidance sets out the best ways of identifying people at high risk of developing type 2 diabetes, encouraging those individuals to take steps to reduce their risk and maintain a lower-risk lifestyle.It also supports the NHS Health Check programme, the national vascular risk assessment and management programme for people aged 40-74 yearsi. The guidance recommends that younger people aged 25 and over and of South Asian descent and older people aged 75 and over from all ethnic groups should also be encouraged to have a risk assessment, so they can be offered advice to help them prevent or delay diabetes.

Health services, workplaces, local pharmacies, churches, libraries and shopping centres are encouraged to offer risk assessments so that everyone can understand their level of risk and get advice about reducing it.

This draft public health guidance complements work published earlier this year by NICE on preventing type 2 diabetes in the general population and among high risk groups.

Type 2 diabetes is a long-term (chronic) condition that occurs when the body does not produce enough insulinii for it to function properly, or when the body's cells do not use insulin properly. It currently affects around 3.1 million people in Englandiii. This is estimated to rise to 4.6 million - that is, nearly 10% of the population - by 2030. The cost of treating and long term care for diabetes is estimated to account for a tenth of the NHS budget each year.

Diabetes can lead to serious complications in the long term, and is the most common cause of visual impairment and blindness, kidney failure and non-traumatic lower limb amputations. It is also a major risk factor for cardiovascular disease and stroke.

The draft recommendations focus on a number of aspects including: intensive lifestyle-change programmes, diet, physical activity and weight management advice, and pharmaceutical and surgical interventions.

Recommendations include a two-stage strategy to encourage adults to:

  • assess their risk of type 2 diabetes using a validated risk assessment tooliv at least once every five years, and
  • if they are assessed as high risk, to ask their GP for a blood test to confirm if they are at high risk of, or if they already have, type 2 diabetes.

People who have been assessed as high risk and have had their risk confirmed by a blood test should be offered a referral to a local intensive lifestyle-change programmev which provides ongoing, practical, tailored advice, support and encouragement to help people be more physically active, achieve and maintain a healthy weight and eat a healthier diet.

Providers of type 2 diabetes risk assessments should explain to those attending the implications of being at high risk and the consequences of developing the condition, and that the condition can be prevented or delayed by making long term lifestyle changes

Providers of intensive lifestyle change programmes should use a tailored approach, which is sensitive and flexible to the needs, ability, and cultural and religious norms of black and minority ethnic and vulnerable groups.

Professor Mike Kelly, Director of the Centre for Public Health Excellence at NICE said: “Type 2 diabetes is becoming a significant heath problem in the UK, but it is preventable and there are steps that can be taken to reduce the risk of developing the condition. This guidance will help identify potentially thousands of people who, because of their lifestyle, diet, lack of physical activity or obesity, are at risk of developing type 2 diabetes, and sets out evidence-based interventions that are effective at reducing that risk. It is now open for consultation and I would welcome comment from stakeholders.”

This draft guidance has been issued for consultation; NICE has not yet issued final guidance.

The draft guidance is available for comment from Wednesday 9 November on the NICE website until Monday 9 January 2012.

Final guidance is expected to be published in May 2012.


Notes to Editors


i. The NHS Health Check programme aims to help prevent heart disease, stroke, diabetes and kidney disease. For more information please see the health check website.

ii. Insulin is a hormone made by the pancreas, and is central to regulating carbohydrate and fat metabolism in the body.

iii. Diabetes UK.

iv. An example is the Diabetes UK online diabetes risk score

v. Intensive lifestyle-change programmes are specially designed for groups of 10-15 people at high risk of developing type 2 diabetes. The groups should meet at least eight times over a period of 9-18 months and participants should have at least 16 hours of contact time. They use a combination of group and face to face sessions or they may use telephone or computer-based interactive media.

About the guidance

1. The draft guidance is available for comment from Wednesday 9 November on the NICE website

Please contact the press office for an embargoed copy.

2. The guidance on type 2 diabetes - Preventing type 2 diabetes - population and community interventions was published in May 2011, relates to the draft guidance.

3. The NICE public health guidance development process: An overview for stakeholders including public health practitioners, policy makers and the public (second edition, 2009) is available on the NICE website.

About NICE

1. The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for providing national guidance and standards on the promotion of good health and the prevention and treatment of ill health

2. NICE produces guidance in three areas of health:

  • public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
  • health technologies -guidance on the use of new and existing medicines, treatments, medical technologies (including devices and diagnostics) and procedures within the NHS
  • clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.

3. NICE produces standards for patient care:

  • quality standards - these reflect the very best in high quality patient care, to help healthcare practitioners and commissioners of care deliver excellent services
  • Quality and Outcomes Framework - NICE develops the clinical and health improvement indicators in the QOF, the Department of Health scheme which rewards GPs for how well they care for patients

4. NICE provides advice and support on putting NICE guidance and standards into practice through its implementation programme, and it collates and accredits high quality health guidance, research and information to help health professionals deliver the best patient care through NHS Evidence.

This page was last updated: 10 November 2011

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.