Five million people in England 'at risk' of developing Type 2 diabetes

Diabetes Blood Check

New data from Public Health England (PHE) indicates that up to five million adults in England could be pre-diabetic, or at risk of developing Type 2 diabetes.

Type 2 diabetes, which is closely associated with obesity and poor diet, currently affects around 3.2 million people but PHE believes this number will rise significantly unless more people take steps to lose weight, exercise and improve diet.

Complications of diabetes include blindness, cardiovascular damage, amputation and early death. PHE says the condition already accounts for 22,000 early deaths per year and costs the NHS £8.8 billion annually.

The report, says PHE, provides "the most accurate and robust estimate" of how many people aged over 16 in England have pre-diabetic blood sugar levels, or non-diabetic hyperglycaemia. This is where where the blood sugar is at the higher end of what is considered normal and is said to indicate an increased risk of developing Type 2 diabetes.

This pre-diabetic measure has previously faced criticism from some experts saying not all those who have non-diabetic hyperglycaemia will go on to develop Type 2 diabetes.

But charity Diabetes UK has previously said that being identified as high risk is useful because it offers people the opportunity to implement the changes required to potentially prevent themselves from developing the condition.

The report was commissioned by the NHS Diabetes Prevention Programme (NHS DPP), which has been set up to help individuals lower their risk via dietary and exercise changes and weight loss support. PHE says evidence has shown that this kind of intervention can prevent as many as 26% of those deemed to be at risk from going on to develop Type 2 diabetes.

Barbara Young, Chief Executive of Diabetes UK, says: "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.

"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."

Prevention programme

The proposed NHS DPP is likely to offer patients a package of support to include a minimum of nine months of information, support, group and one-to-one sessions on weight loss, physical activity and diet.

Professor Jonathan Valabhji, National Clinical Director for Diabetes and Obesity, NHS England says of the proposals: "There are too many people on the cusp of developing Type 2 diabetes and we can change that. 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 proposals are currently open for consultation and PHE is seeking input from GPs, Nurse practitioners, clinicians, academics and the general public with a phased national rollout expected as early as next year.

People identified as high risk of developing Type 2 diabetes, either through an NHS Health Check or through a blood test result are likely to be offered a place on the DPP, which is to be delivered jointly by NHS England, Public Health England and Diabetes UK.

Type 2 diabetes - who is at risk of developing it?

Diabetes UK has developed a useful tool that may help you identify whether you are at increased risk of developing Type 2 diabetes via a series of questions. Please click here to start questionnaire on the Diabetes UK website.

The risk score was developed in partnership with the University of Leicester and determines the likelihood of getting Type 2 diabetes based on seven different risk factors, including family history, age and body mass index, but doesn't take blood glucose levels into account. If you are at all concerned, visit your GP.

What is considered a normal blood sugar range?

Still subject to some debate around what is 'normal' from person to person, a generally accepted 'normal' range for most people is between 4.4 mmo and 6.1mmo, with levels temporarily increasing or decreasing slightly prior to or following mealtimes.

Nurse Diabetes

What can I do to lessen my risk of developing Type 2 diabetes?

Keep active

Regular exercise and physical activity including household tasks such as vacuuming the stairs or gardening increases insulin sensitivity which helps prevent the primary cause of diabetes Type 2, where insulin no longer does its job properly. Regular exercise can also help to reduce cholesterol and high blood pressure, both factors linked to developing Type 2 diabetes.

Eat a healthy diet

We've all heard the term 'balanced diet', but this can mean different things to different people. Generally, starchy, high carbohydrate foods such as white bread, potatoes and pasta, saturated fats and salt and sugar should be consumed as minimally as possible.

High fibre foods such as wholegrain bread, pasta and rice are good choices, paired with lean meat and fish and a generous serving of vegetables. While fruit is considered a healthy option for the majority of people, those at high risk of developing Type 2 diabetes need to monitor their intake of sugar to try and maintain steady blood sugar levels.

Some fruits, such as grapes, mango and pineapples, and fruit juices and smoothies can be very high in natural fruit sugar or fructose so think carefully about which fruit you choose and in what quantity.

Maintain a healthy body weight

Following a healthy diet and exercising regularly should both contribute to maintaining a healthy weight or body mass index (BMI) within the healthy range. Being overweight increases the risk of developing Type 2 diabetes.

Maintain Healthy Body Weight

I've heard a lot about low GI helping to keep blood sugar steady. What is GI?

The glycaemic index (GI) can be a useful tool for those wanting to maintain stable blood sugar levels, whether you have Type 2 diabetes already or are at risk of developing the condition. Foods are given a rating between 0-100, with pure glucose setting the maximum 100.

The index measures how quickly carbohydrates in various foods affect blood sugar, and are rated low, medium or high. Making the switch to low and medium GI choices can help to keep blood sugar levels stable and avoid the peaks and troughs in energy levels associated with the regular consumption of high GI foods such as sugary drinks, cakes and biscuits.

Foods with a rating of 55 or below are low GI, and include most fruits and vegetables and some wholegrain products.

According to Diabetes UK, choosing low-GI foods can help those diagnosed with Type 2 diabetes to manage their blood sugar levels but this can prove more complex when meals include a combination of foods. In addition, cooking methods can change the GI of some foods, particularly when other ingredients such as oils and fats, sugar or salt are added during cooking or gravies and condiments at the table.

Estimating the glycaemic load of a meal in its entirety can therefore be useful for meal planning and maintaining stable levels day-to-day.

For more information on managing  diabetes, how to estimate glycaemic load and for healthy recipes and cooking tips, visit Diabetes UK.

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