Publication, Part of National Diabetes Audit: Non-Diabetic Hyperglycaemia, Diabetes Prevention Programme
Non-Diabetic Hyperglycaemia, 2021-22, Diabetes Prevention Programme, Detailed Analysis Report
Changes to NDA reporting
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3 June 2024 00:00 AM
Care processes
‘People at high risk of developing type 2 diabetes should be offered a blood test and assessment of their BMI at least once a year.’
NICE(PH38, recommendation 1.6.5): Type 2 diabetes: prevention in people at high risk
Care processes in 2021-22
Following a drop in BMI and glycaemic tests during the COVID-19 pandemic, recording of both care processes has increased in 2021-22, although rates of BMI measurement are still below 2019-20 levels.
The percentage of people who received a HbA1c check in 2021-22 increased compared to 2019-20, likely due to the inclusion in the QOF (Quality & Outcomes Framework) of glycaemic testing for people registered with non-diabetic hyperglycaemia1.
Anyone who has been newly diagnosed with non-diabetic hyperglycaemia (NDH) should have a recent supporting glycaemic test. Glycaemic test rates will therefore be much higher for people who are newly diagnosed, and both BMI and glycaemic tests are shown below for all patients, and all patients diagnosed prior to the audit period.
Table 3: BMI and glycaemic test rates within the audit period2,3, GP-recorded non-diabetic hyperglycaemia (NDH), 2019-20 - 2021-22, England
| Care Process | 2019-20 | 2020-21 | 2021-22 | |||
|---|---|---|---|---|---|---|
| All people | Diagnosed before 2019 | All people | Diagnosed before 2020 | All people | Diagnosed before 2021 | |
| Any glycaemic test | 78.1% | 71.8% | 67.2% | 61.5% | 79.5% | 75.6% |
| - Fasting plasma glucose | 4.7% | 4.0% | 2.7% | 2.3% | 2.4% | 2.1% |
| - HbA1c | 77.3% | 71.1% | 66.8% | 61.1% | 79.3% | 75.4% |
| Body Mass Index | 63.9% | 60.3% | 45.9% | 42.9% | 55.5% | 52.8% |
| BMI and glycaemic test | 56.0% | 50.5% | 38.9% | 34.8% | 51.0% | 47.5% |
| All people | 2,140,090 | 1,547,305 | 2,378,485 | 1,938,225 | 2,712,825 | 2,130,005 |
Footnotes:
- NICE Quality and Outcomes Framework indicator NM150 - The percentage of people with non-diabetic hyperglycaemia who have had an HbA1c test or fasting plasma glucose (FPG) test in the preceding 12 months (https://www.nice.org.uk/standards-and-indicators/qofindicators/the-percentage-of-patients-with-non-diabetic-hyperglycaemia-who-have-had-an-hba1c-or-fpg-test-in-the-preceding-12-months)
- People registered at a GP practice that participated in the audit in-year (NDA 2019-20, NDA 2020-21, NDA 2021-22)
- Body mass index (BMI) may be recorded by the GP practice as a single BMI measurement, or as a set of height and weight measurements. The set of SNOMED codes used to identify height and weight measurements does not include codes representing self-reported heights or weights, but values obtained by this route may have been recorded under more general SNOMED height and weight codes.
Geographical variation
The level of recording for glycaemic tests varies across England, with some ICBs recording higher or lower levels of tests than average. Geographical variation has reduced between 2020-21 and 2021-22.
Figure 2: Glycaemic test rates within the audit period1,2, distribution by ICB, GP-recorded non-diabetic hyperglycaemia (NDH), diagnosed prior to the audit period, 2019-20 - 2021-22, England
Footnotes:
- People with a pre-existing non-diabetic hyperglycaemia diagnosis, registered at a GP practice that participated in the National Diabetes Audit in-year (NDA 2019-20, NDA 2020-21, NDA 2021-22)
- The NDH-DPP dashboard has more detailed geographical breakdowns of measures included in the main annual report.
The level of recording for BMI measurements varies across England, with some ICBs recording higher or lower levels of tests than average. Variation has not reduced between 2020-21 and 2021-22.
Figure 3: BMI measurement rates within the audit period1,2, distribution by ICB, GP-recorded non-diabetic hyperglycaemia (NDH), diagnosed prior to the audit period, 2019-20 - 2021-22, England
Footnotes;
- People with a pre-existing non-diabetic hyperglycaemia diagnosis, registered at a GP practice that participated in the National Diabetes Audit in-year (NDA 2019-20, NDA 2020-21, NDA 2021-22)
- The NDH-DPP dashboard has more detailed geographical breakdowns of measures included in the main annual report.
Demographic variation
Glycaemic testing rates varied across different demographics and across audit years, as shown in table 4.
Table 4: Glycaemic test rates within the audit period1, GP-recorded non-diabetic hyperglycaemia (NDH) diagnosed before the audit period, demographic breakdown, 2019-20 - 2021-22, England
| Characteristic | Breakdown | 2019-20 (%) | 2020-21 (%) | 2021-22 (%) |
| Sex | Male | 70.8 | 60.1 | 73.8 |
| Female | 72.8 | 62.7 | 77.2 | |
| Duration (years) | 1 to 4 | 73.1 | 61.9 | 75.7 |
| 5 to 9 | 69.5 | 60.8 | 75.6 | |
| 10 to 14 | 66.3 | 59.2 | 74.4 | |
| Ethnicity | Asian | 72.5 | 61.3 | 74.3 |
| Black | 69.0 | 56.2 | 68.4 | |
| White | 72,8 | 62.7 | 77.1 | |
| Age | Under 40 | 53.4 | 46.0 | 58.7 |
| 40 - 64 | 67.0 | 56.2 | 70.0 | |
| 65 - 79 | 77.6 | 66.9 | 81.3 | |
| 80 + | 75.6 | 67.1 | 81.0 | |
| Deprivation | IMD1 | 72.2 | 60.7 | 74.1 |
| IMD2 | 71.8 | 60.9 | 74.7 | |
| IMD3 | 72.1 | 62.0 | 76.0 | |
| IMD4 | 71.9 | 62.1 | 76.5 | |
| IMD5 | 71.2 | 61.9 | 76.8 |
Footnotes:
- People with a pre-existing non-diabetic hyperglycaemia diagnosis, registered at a GP practice that participated in the National Diabetes Audit in-year (NDA 2019-20, NDA 2020-21, NDA 2021-22) Not all demographic groups are shown on the figure.
BMI measurement rates also varied across demographics and audit years, as shown in table 5.
Table 5: BMI measurement rates within the audit period1, GP-recorded non-diabetic hyperglycaemia (NDH) diagnosed before the audit period, demographic breakdown, 2019-20 - 2021-22, England
| Characteristic | Breakdown | Audit year (%) | ||
| 2019-20 | 2020-21 | 2021-22 | ||
| Sex | Male | 59.6 | 42.2 | 51.8 |
| Female | 61.0 | 43.5 | 53.6 | |
| Duration (years) | 1 to 4 | 60.5 | 42.7 | 52.6 |
| 5 to 9 | 60.3 | 43.5 | 53.3 | |
| 10 to 14 | 58.6 | 42.4 | 52.1 | |
| Ethnicity | Asian | 57.9 | 39.8 | 50.1 |
| Black | 59.1 | 41.0 | 50.5 | |
| White | 62.8 | 44.9 | 54.6 | |
| Age | Under 40 | 50.1 | 36.6 | 44.1 |
| 40-64 | 55.7 | 39.0 | 48.4 | |
| 65-79 | 64.4 | 45.5 | 56.1 | |
| 80+ | 65.2 | 48.6 | 58.2 | |
| Deprivation | IMD1 | 64.5 | 45.4 | 54.6 |
| IMD2 | 62.4 | 44.3 | 54.3 | |
| IMD3 | 59.9 | 42.8 | 53.1 | |
| IMD4 | 58.6 | 41.5 | 51.6 | |
| IMD5 | 55.7 | 40.0 | 49.9 | |
Footnotes:
- People with a pre-existing non-diabetic hyperglycaemia diagnosis, registered at a GP practice that participated in the National Diabetes Audit in-year (NDA 2019-20, NDA 2020-21, NDA 2021-22). Not all demographic groups are shown on the figure.
Recommendation 2
ICBs are recommended to explore their data on glycaemic and BMI monitoring, seek to understand variation and patterns of inequity, and implement local programmes that address the findings.
Last edited: 3 June 2024 10:21 am