This guideline covers how to identify adults at high risk of type 2 diabetes. It aims to remind practitioners that age is no barrier to being at high risk of, or developing, the condition. It also aims to help them provide those at high risk with an effective and appropriate intensive lifestyle-change programme to prevent or delay the onset of type 2 diabetes. The recommendations in this guideline can be used alongside the NHS Health Check programme.

For information on related topics see our cardiometabolic disease prevention and treatment summary page.

In September 2017, we reviewed the evidence for intensive lifestyle-change programmes and metformin for people at risk of type 2 diabetes. We added new recommendations on lifestyle-change programmes (recommendations 1.5.5 and 1.5.6) and changed the recommendation about offering metformin (recommendation 1.19.1).


This guideline includes recommendations on:

Who is it for?

  • Commissioners and managers in the NHS, local authorities and the wider public, private, voluntary and community sectors
  • GPs, nurses, pharmacists, occupational health specialists, optical practitioners and other health professionals
  • People at high risk of developing type 2 diabetes, their families and other members of the public

Is this guideline up to date?

March 2018: We found no new evidence that affects the recommendations of this guideline. See the review decision for more information.

Guideline development process

How we develop NICE guidelines

This guideline was previously called preventing type 2 diabetes: risk identification and interventions for individuals at high risk.

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.