Publication, Part of National Diabetes Audit: Non-Diabetic Hyperglycaemia, Diabetes Prevention Programme
Non-Diabetic Hyperglycaemia, 2021-22, Diabetes Prevention Programme, Detailed Analysis Report
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3 June 2024 00:00 AM
Introduction
Introduction
The NHS Diabetes Prevention Programme (NHS DPP) is a joint commitment from NHS England, Office for Health Improvement and Disparities (formerly Public Health England) and Diabetes UK to deliver, at scale, evidence based behavioural interventions that can prevent or delay the onset of type 2 diabetes in adults who have been identified as having non-diabetic hyperglycaemia (NDH).
This report primarily uses data from English GP practice systems for the period January 2021 to March 2022 inclusive, and data generated by providers of the Diabetes Prevention Programme relating to referrals up to March 2022 inclusive. The GP data is only for people diagnosed and recorded with non-diabetic hyperglycaemia.
What is non-diabetic hyperglycaemia?
Non-diabetic hyperglycaemia (NDH) refers to blood glucose levels that are above normal but not in the diabetic range. These are: HbA1c 42-47 mmol/mol or fasting plasma glucose (FPG) 5.5-6.9 mmol/L.
Table 1: Status of patients as defined by HbA1c range and FPG range
| Status | HbA1c (mmol/mol) | FPG (mmol/L) |
|---|---|---|
| Normal | ≤ 41 | ≤ 5.4 |
| Non-diabetic hyperglycaemia | 42 - 47 | 5.5 - 6.9 |
| Type 2 diabetes | ≥ 48 | ≥ 7.0 |
People with non-diabetic hyperglycaemia are at increased risk of developing type 2 diabetes. They are also at increased risk of cardiovascular conditions.
How many people are diagnosed with non-diabetic hyperglycaemia?
In 2015, Public Health England estimated1 that there were 4 million people with type 2 diabetes (T2DM) and 5 million people with non-diabetic hyperglycaemia (NDH) in England, and in the 2021-22 audit, there were 3.3 million people with T2DM and 2.7 million people with NDH recorded in England. This is a shortfall of 0.7 million with T2DM and 3.3 million with NDH between the 2015 estimated figures and the 2021-22 recorded figures
Table 1a: Prevalence of high blood glucose conditions2, GP-recorded non-diabetic hyperglycaemia (NDH) and type 2 diabetes, 2021-22, England
| Registered at GP Practice | Diagnosis of type 2 diabetes recorded | Diagnosis of non-diabetic hyperglycaemia recorded | ||
|---|---|---|---|---|
| Number | Per cent | Number | Per cent | |
| 49,618,185 | 3,291,155 | 6.6% | 2,712,825 | 5.5% |
Footnotes:
- Public Health England (2015): Diabetes prevalence estimates for local populations and Analysis of non-diabetic hyperglycaemia prevalence in England.
- People registered at a GP practice that participated in the National Diabetes Audit 2021-22.
Diagnosis of people with non-diabetic hyperglycaemia
Until 2019, there was a consistently increasing trend in the number of people newly diagnosed with non-diabetic hyperglycaemia. However, although people continued to be diagnosed during 2020, the impact of COVID-19 meant that fewer NDH diagnoses were made in 2020 than in 2018. This increasing trend in diagnoses has resumed in 2021, with more people being diagnosed in 2021 (443,125) than in any previous audit year (2019: 439,905 diagnoses).
The Diabetes Prevention Programme was first rolled out in seven sites in March 2015, and was nationally accessible in England by 2018.
2,607,675 people in the 2021-22 audit collection were diagnosed with non-diabetic hyperglycaemia from 2010 onwards.
Figure 1: Diagnosis1 by year of earliest diagnosis2,3,4, GP-recorded non-diabetic hyperglycaemia (NDH), 2021-22, England
Footnotes:
- People registered at a GP practice that participated in the National Diabetes Audit 2021-22. People who have been diagnosed with NDH and have subsequently progressed to diabetes, or have died prior to this period are not included.
- People may have been recorded with multiple dates of diagnosis related to non-diabetic hyperglycaemia. Diagnoses are only included where the NDH is current during NDA 2021-22; people with a current diagnosis of diabetes are not included.
- People may have experienced elevated levels of blood glucose for some time before they were diagnosed with non-diabetic hyperglycaemia.
- Diagnoses of NDH made in 2022 are not shown.
Recommendation 1
ICBs should continue supporting activities to identify people with NDH. It is recommended that ICBs access available data on missing recording of NDH and take action to help improve coding and thereby support appropriate invitation for monitoring.
Last edited: 3 June 2024 10:21 am