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Diabetes Prevention

Diabetes Prevention

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Introduction

Standard one of the diabetes NSF is ‘Prevention of Type 2 diabetes’

 

 

The NHS will develop, implement and monitor strategies to reduce the risk of developing Type 2 diabetes in the population as a whole and to reduce the inequalities in the risk of developing Type 2 diabetes.’

 

'The number of people with Type 2 diabetes is rising, with an increasing number of young people being diagnosed. Some risk factors for developing diabetes (such as family history, increasing age and ethnic origin) are non-modifiable. However, other risk factors (such as being overweight or obese, having an adverse distribution of body fat and being physically inactive) are modifiable and need to be the focus of prevention strategies.’

  

Key Interventions are:

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Increasing physical activity levels

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Improving diet and nutrition

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Preventing and reducing overweight and Obesity
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Approaches to Reducing Type 2 Diabetes

There are two complementary approaches to reducing the incidence of Type 2 diabetes:

 

 

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The ‘population approach’, to reduce the average level of risk for developing diabetes across the whole population.  These initiatives involve many national and local agencies and are not further considered here.  They are, however, of fundamental importance for the future health of the country.

 

 

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The ‘high - risk approach’, which aims to identify those at increased risk of developing diabetes and offering them appropriate advice on how to reduce the risk.

   
 Some Individuals are at increased risk of developing Type 2 diabetes
  
 

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Overweight and central obesity
 

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Family history
 

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Previous gestational diabetes
 

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Impaired glucose tolerance
 

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Other cardiovascular problems
 

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Polycystic Ovarian Syndrome
 

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Certain ethnic minorities

 

 

Strategies have been developed to address these ‘at risk’ groups.  Many risk factors for coronary heart disease are similar to those of diabetes. Initiatives to identify patients at risk of developing cardio vascular disease and giving them systematic advice and treatment to reduce this risk will therefore reduce their risk of developing diabetes as well.

  

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Diabetes Prevention

 
NICE have issued guidance on the prevention of Type 2 diabetes (PH 38) (See - Useful Resources and Links section)
 
This recommends a two stage approach
 
1. Identifying those at high risk of developing type 2 diabetes using a validated risk-assessment score and a blood test – either the fasting blood glucose or the HbA1c test to confirm high risk.
2. Providing those at high risk with a quality-assured, evidence-based, intensive lifestyle-change programme to prevent or delay the onset of type 2 diabetes.
 

 

   
 Primary Prevention 
   
 

Primary prevention covers activities aimed at preventing diabetes from occurring in susceptible individuals/ populations.

 
   
   
   
 

Implementation of prevention in general practice

 
    
 

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Initiating life long eating habits based on the Eat Well Plate starting in childhood

 
 

 

 

 
 

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Encouraging maintenance of ideal body weight starting in childhood

 
 

 

 

 
 

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 Emphasizing on the importance of exercise

 
 

 

 

 
 

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Screening and early detection

 
 

 

 

 
 

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Raising awareness by ongoing health education

 
    
  
 Interventions
  
 

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Self-management interventions for physical activity promoting physical activity in the work place

  

 

 

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Involvement of individuals & families in on-going health decision-making Healthy Under 5's and Eat Well.

  

 

 Bullet PointDeveloping successful interventions for minority groups requires a number of stages, careful planning, assessment of cultural characteristics of the target population and a systematic approach to implementation
   
  

NICE recommends  considering the use of Metformin:

 

 

• in adults at high risk whose blood glucose measure (fasting plasma glucose or HbA1c) shows they are still progressing towards type 2 diabetes, despite their participation in an intensive lifestyle-change programme
• in adults at high risk whose blood glucose measure (fasting plasma glucose or HbA1c) shows they are still progressing towards type 2 diabetes, despite their participation in an intensive lifestyle-change programme
 

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Useful External Resources / Links

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NICE Guidance on Preventing type 2 diabetes: risk identification and interventions for individuals at high risk

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Eat Well Plate
 

Food Standards Agency - The Eat Well plate encourages you to choose different foods from the first four groups every day, to help ensure you obtain the wide range of nutrients your body needs to remain healthy and function properly.

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NICE PH35 - Type 2 diabetes prevention: Population and community - level interventions

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Promoting Physical Activity in the Work Place
 

Intervention guidance on workplace health promotion with reference to physical activity. This guidance is for employers and professionals in small, medium and large organisations, especially those working in human resources or occupational health.

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Healthy Under 5's
 

The Healthy Under 5’s is a unique award programme aimed at improving the lifestyles of children under five years old, who are cared for outside their homes in Bedfordshire.

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