Pre-diabetes / Non diabetic hyperglycaemia (NDH)

You may have been told you have “pre- diabetes”- this was based on the old idea that diabetes was a progressive condition and that developing diabetes was inevitable. Now after a large scale UK based trial- the DiRECT trial we now know this is not the case and people who can make achievable, sustained changes to their lifestyle can prevent pre-diabetes progressing to Type 2 Diabetes Mellitus (T2DM)…

What’s in a number ?

HbA1c is the blood test we use to check “your blood sugar”- to diagnose or monitor diabetic control

It actually tells us what your average blood sugar level has been over the preceding 3 months.

HbA1c

Less than 42 mmol/mol is within normal healthy range
42-47 mmol/mol is in the pre-diabetic range otherwise known as Non Diabetic Hyperglycaemia (NDH)
48 mmol/mol or means you have Type 2 Diabetes ( we usually repeat the test to confirm the diagnosis)

The UK DiRECT Trial

In Summary:

Patients with a diagnosis of Type 2 Diabetes (T2DM) within the last 6 years were randomised into either a weight loss programme(intervention group) or given dietary advice(control group).

At 12 months:

>15kg weight loss was recorded in 24% of the intervention group(those that had entered the weight loss programme) versus 0% in the control group (those that had had no support in weight loss management).
Of those that lost >15kg, 86% achieved diabetic remission ( their HbA1c moved into healthy range)
Of those that lost 5-10kg , 34% went into remission
74% of the intervention group were taking no anti diabetic medication and 68% did not require any medication for blood pressure either

In Conclusion :

Diabetes is not inevitable…”You can do something about this”

Pre- diabetes / Non Diabetic Hyperglycaemia (NDH)

HbA1c- 42-47 mmol/mol

You will be invited to a consultation with our practice nursing team, to discuss what this means for you, and what achievable , sustainable, affordable changes you can make to prevent further progression to diabetes.

It’s also important to get your blood pressure checked.

The results of the UK DiRECT trial show how important early lifestyle change is and so the NHS launched the NHS Diabetes Prevention Programme in 2016

You will be offered a referral to the NHS Diabetes Prevention Programme at your appointment with the nursing team.

Healthier You NHS Diabetes Prevention Programme

The Healthier You NHS Diabetes Prevention Programme, also known as the Healthier You programme, identifies people at risk of developing type 2 diabetes and refers them onto a nine-month, evidence-based lifestyle change programme.

The Healthier You programme is available both as a face-to-face group service and as a digital service. When referred into the programme, people are free to choose between the two.

People on the face-to-face group service receive personalised support to manage their weight, eat more healthily and be more physically active – which together have been proven to reduce a person’s risk of developing type 2 diabetes.

The digital service offers similar support but through the use of digital tools such as wearable technologies that monitor levels of exercise, apps where users can access health coaches, online peer support groups and the ability to set and monitor goals electronically.

Research shows the Healthier You NHS Diabetes Prevention Programme has reduced new diagnoses of type 2 diabetes in England, saving thousands of people from the potentially serious consequences of the condition. It cuts the risk of developing type 2 diabetes by more than a third for people completing the programme.

We really recommend getting involved – you do need to be referred so if you have a diagnosis of NDH or prediabetes and want to be referred let us know.

Alternative options are: