Management of Pre-Diabetes

As part of Implementing the Framework for Type 2 Diabetes Prevention, Early Detection and Early Intervention pathways and resources are being implemented to support people identified as being at risk of Type 2 diabetes.

click here to view full size pdf of the pathway with active hyperlinks

 

Who to Refer

  • Diagnosis of Pre-diabetes HbA1c 42-47.9 mmol/mol
  • Aged 18 years and over
  • Not pregnant at time of referral
  • Person is suitable or able to engage in a behaviour change and weight loss programme, e.g. does not have a new life-threatening diagnosis or severe learning disability

 

Who Not to Refer

  • There is emerging evidence that age of onset is inversely related to progression (glucose control, complications and survival). There is also evidence that current intense weight management in those aged >70 has very little benefit on diabetes progression and almost no benefit in those above 75. Clinicians should consider the intervention and whether their patients age >70 would benefit
  • Pregnant at time of referral
  • The person is not suitable or unable to engage in a behaviour change and weight loss programme, e.g. has a new life-threatening diagnosis or severe learning disability

 

How to Refer

At the moment the only available intervention specifically for Pre-diabetes is the Oviva Diabetes Prevention 9 month programme.  Other programmes will be added as they become available. 

Oviva Diabetes Prevent programme: Information for clinicians

Oviva Diabetes Prevent programme: Information for patients

 

Referrals should be made to the Tayside Adult Weight Management Service (AWMS) via SCI-Gateway and should include:

  • Request for Diabetes Prevention Programme
  • Most recent HbA1c, weight, height.

 

Alternative to Referral

If the patient does not wish referral to AWMS for the intervention there are other resources the patient could be signposted to:

 

 

There is good evidence that healthcare professional support and ‘brief interventions’ to encourage exercise and dietary modification in patients at moderate and high risk of diabetes can be effective in producing weight loss and thus in preventing the development of diabetes. Resources available for healthcare professionals

  • The MAP of Health Behaviour Change is a module for health and social care professionals whose role involves helping people to make positive health and lifestyle related changes.  It can be found within TURAS.
  • To support conversations about physical activity with people with diabetes and other long term conditions the Moving Medicine Website is a helpful resource