Non-Diabetic Hyperglycaemia, 2021-22, Diabetes Prevention Programme, Detailed Analysis Report

In the 2017-18 NDH audit, 1,294,495 people were identified with GP-recorded non-diabetic hyperglycaemia. This group of people includes people diagnosed up to 31 March 2018. Over the next 4 years - their progression to diabetes was followed using the subsequent NDA Core and NDH audit collections. The diabetes/NDH status could not be identified for all members of the original NDH cohort in later years. Figure 5 shows the number of people diagnosed with NDH during the 2017-18 audit period and their progression through each subsequent audit period

Figure 5: Cumulative rates of diabetes progression for people¹ known to have NDH in 2017-18, GP-recorded non-diabetic hyperglycaemia (NDH), 2017-18 – 2021-22, England

Footnotes:

1. People are included who had non-diabetic hyperglycaemia recorded in the data taken for the 2017-18 annual report. People recorded with NDH in subsequent audit periods only, are not considered.
2. People with a diabetes diagnosis were almost all subsequently diagnosed with type 2 diabetes.
3. It is not known why someone no longer has a diagnosis of non-diabetic hyperglycaemia. People may no longer be registered with a participating England GP practice, or their diagnosis may have been removed from their GP record.
4. People identified as deceased in an audit period did not appear in the NDH or NDA collection for the audit period, and are known to have died by the end of that timeframe.

Table 7: Cumulative rates of diabetes progression for people known to have NDH in 2017-18, by demographic breakdown^1,2,3, GP-recorded non-diabetic hyperglycaemia (NDH), 2017-18 – 2021-22, England

Footnotes:

1. People are included who had non-diabetic hyperglycaemia recorded in the data taken for the 2017-18 annual report. People recorded with NDH in subsequent audit periods only, are not considered.
2. Breakdowns are univariate and do not consider any potential interactions between characteristics.
3. Index of Multiple Deprivation (IMD) used to assign levels of deprivation by person’s home address where IMD1 is for the most deprived and IMD5 is for the least deprived areas.

In order to show the effectiveness of the Diabetes Prevention Programme, the cohort of people identified in 2017-18 with non-diabetic hyperglycaemia was used as a baseline. People were excluded from that group if they had died before 2020. The remaining group was then split into 4 sections, which were dependent on the extent of their interaction with DPP prior to 2020.

All remaining members of the cohort were classified as one of the following:

• Completed the NHS DPP - where the person had attended a (course provider dependent) minimum number of DPP interventions resulting from a single referral (at least 60% of sessions attended).
• Attended but did not complete DPP - where the person had attended DPP interventions but not enough to meet the threshold for completion (60% of sessions attended).
• Referred but did not attend DPP - where the person had a referral to DPP, but had attended no interventions.
• Not referred to the NHS DPP - where the person had no referral to DPP recorded by the service providers. People with NDH may not be referred to the NHS DPP for various reasons, including not being considered clinically appropriate for referral by their GP practice or declining referral when offered.

Figure 6 shows the diabetes progression of people known to have NDH in 2017-18 by their DPP status at the start of 2020. The size of this cohort is the 1,294,495 people who had NDH recorded in the 2017-18 annual report, excluding the 55,630 people who had died before 2020.

From this cohort, 1,086,280 people had no contact with DPP before 2020. 71.6% of these people continued to have NDH in the 2021-22 audit period, and 16.6% progressed to diabetes.

Out of the 68,015 people who were referred to but did not start DPP before 2020, 71.1% still had NDH in 2021-22, and 21.2% progressed to diabetes.

Out of the 56,390 people who started but did not complete DPP before 2020, 73.3% still had NDH in 2021-22, and 19.8% progressed to diabetes.

Out of the 28,180 people who had completed DPP before 2020, 79.1% still had NDH in 2021-22, and 15.1% progressed to diabetes.

Figure 6: Diabetes progression of people known to have NDH¹ in 2017-18, by their DPP status² at the start of 2020, GP-recorded non-diabetic hyperglycaemia (NDH), 2017-18 – 2021-22, England

Footnotes:

1. People are included who had non-diabetic hyperglycaemia recorded in the data taken for the 2017-18 annual report, and who were alive at the start of 2020.
2. The DPP status reflects a person's interactions with the DPP before 2020. People may have attended further interventions or accepted referrals after that date.