Lifestyle Programs 'Could Prevent Diabetes'

Peter Russell

September 15, 2017

People who have the highest risk of developing type 2 diabetes should be offered a place on an intensive lifestyle change program, says the NHS standards watchdog.

Updated guidance from the National Institute for Health and Care Excellence (NICE) says around 1.7 million people could benefit from advice on their diet and physical activity levels.

Prevention Program Rollout

The NHS Diabetes Prevention Program started in 2016 with a first wave of 27 areas covering 26 million people and making up to 20,000 places available. The program is scheduled to roll out across England by 2020 with an expected 100,000 referrals available each year after.

NICE says it is currently cost-effective to target people with a fasting glucose between 5.5–6.9 mmol/l. However, it says those with a higher reading (6.5-6.9mmol/l) should be prioritised for inclusion because of their increased risk of developing type 2 diabetes.

Professor Mark Baker, director of the centre for guidelines at NICE, says in a statement: "We know that helping someone to make simple changes to their diet and exercise levels can significantly reduce their risk of developing type 2 diabetes. And that this approach is a cost-effective way of managing an illness that currently costs the NHS around £8.8 billion a year.

"We need to make sure that the people most at risk have access to the care they need."

Assessing Risk

The guidance also identifies specific groups that should be encouraged to see their GP or local community pharmacy for a diabetes risk assessment. These are:

  • All adults aged 40 and above, except pregnant women

  • People aged 25-39 and of South Asian, Chinese, African-Caribbean or Black African descent, and other high risk black and minority ethnic groups (except pregnant women)

  • Adults with conditions that increase the risk of type 2 diabetes, such as obesity, stroke or high blood pressure

Once assessed, those at higher risk should be offered advice to help them delay or prevent the condition.

There are currently 2.8 million people with type 2 diabetes in England with around 200,000 new diagnoses every year. While type 1 diabetes cannot be prevented and is not linked to lifestyle, type 2 diabetes is largely preventable through lifestyle changes.

Type 2 diabetes is a leading cause of preventable sight loss in people of working age and is a major contributor to kidney failure, heart attack, and stroke.

Emphasis on Prevention

Dan Howarth, Diabetes UK's head of care, says in an emailed statement: "Type 2 diabetes is a serious condition that can lead to harrowing complications, so preventing it from developing in those at higher risk is hugely important. We welcome these updated guidelines from NICE, which recognise the importance of preventing the condition, and the serious harm it causes to those living with it.

"We know that globally, diabetes prevention programs do work, and we know that with the right advice and support, people at increased risk of developing type 2 diabetes can take simple but significant steps to prevent the condition developing.

"The success of initiatives such as the Diabetes Prevention Program depend on everyone across the health service pulling together with a shared goal. We hope this updated guidance will give clinicians the confidence to make prevention their priority, identify those at high risk, and refer them into the Diabetes Prevention Program."


Type 2 diabetes: prevention in people at high risk, National Institute for Health and Care Excellence (NICE)

Diabetes UK

NHS England