Opinion Former Article

Diabetes UK: 7m in UK have 'prediabetes'

An estimated seven million people in the UK have prediabetes¹ - an under-diagnosed condition¹ that puts them up to 15 times more likely to develop Type 2 diabetes²,³ - according to a new report released today by leading health charity Diabetes UK.

People with prediabetes, also known as Impaired Glucose Regulation (IGR)4, have blood glucose (sugar) levels higher than normal but not high enough to be diagnosed as Type 2 diabetes5. Recent research has shown prediabetes may already be causing long-term damage to the body, especially the heart and circulatory system6.

Many people with prediabetes are overweight or obese at diagnosis and 90 per cent will either have a family history of prediabetes or have high blood pressure and high cholesterol1,7. Crucially, prediabetes can often be reversed and the risk of developing Type 2 diabetes reduced by 60 per cent simply through losing even just a moderate amount of weight, adopting a healthy, balanced diet and increasing physical activity levels7,8.

Diabetes UK is today also launching its Get Serious campaign, which aims to get as many people as possible to join Diabetes UK in the fight against diabetes, one of the UK's biggest health challenges. The charity is asking people to sign up to the campaign and show their support. This could be by pledging to make healthy lifestyle changes, fundraising, campaigning or volunteering.

Diabetes UK Chief Executive, Douglas Smallwood, said: "It's staggering that an estimated seven million people in the UK have prediabetes, which is often a precursor to Type 2 diabetes, a serious condition which can lead to long term complications such as heart disease, stroke, kidney failure, amputation and blindness.

"Identifying and educating people with prediabetes is vital as it's not too late for many to make healthy lifestyle changes, reverse the condition completely and reduce their risk of developing Type 2 diabetes.

"Recent figures show that more than 145,000 new cases of mainly Type 2 diabetes were diagnosed in the past year, bringing the total number of people with diabetes in the UK to 2.6 million. It's time for all of us to get serious about our health if we want to have any chance of defusing the ticking timebomb of Type 2 diabetes."

Diabetes UK welcomes the Government's NHS Health Checks programme as part of their recent commitment to 'Putting Prevention First'. The programme aims to assess and manage vascular risk in England and identify people at risk of prediabetes and Type 2 diabetes. Diabetes UK wants similar screening programmes to be established across the UK9.

Diabetes UK also recommends prediabetes be communicated by healthcare professionals in a clear and consistent manner to minimise misunderstandings9. The seriousness of prediabetes needs to be highlighted along with its potential risks and how those affected can prevent progression to Type 2 diabetes9.

If you are white and over 40 years old, or if you're Black or South Asian and over 25 years old and have one or more of the following risk factors, then you may be at risk of prediabetes:

. A close member of your family has Type 2 diabetes (parent or sibling)

. You're overweight or your waist is 31.5 inches or over for women; 37 inches or over for men, but 35 inches or over for South Asian men

. You have high blood pressure or you've had a heart attack or a stroke

. You're a woman with polycystic ovary syndrome and you are overweight

. You're a woman and you've had gestational diabetes

. You have severe mental health problems.

The more risk factors that apply, the greater the risk of prediabetes. If a person has one or more of these risk factors Diabetes UK recommends they consult their GP or healthcare team. The progression from prediabetes to Type 2 diabetes may be up to two to three times greater in South Asians compared to white people10. In the US prediabetes affects more than 56 million people, around 18 per cent of the population11 compared to around 15 per cent in the UK.

In 2006 Douglas Nichol, now 65, from Leicester, received a letter from his GP inviting him to a Diabetes UK-led awareness programme after screening revealed his blood glucose levels to be high.

Douglas said: "There is, to the best of my knowledge, no history of diabetes in my family. I realised that at almost 15 stones I was overweight and I also had a BMI of 29, both additional risk factors for diabetes on top of the high blood pressure and heart attack.

"I was told that if I took the appropriate steps I could halve the risk of developing Type 2 diabetes - the fear factor was a major consideration for me in becoming as proactive as I have.

"I now weigh just over 12 and a half stones, more than two stones less than at the time of diagnosis, my BMI has fallen from 29 to 25 and I have briskly walked over 2,000 miles in the last year or so - around five miles a day. My last three blood glucose readings have been normal and I understand my risk of developing Type 2 diabetes has been reduced."

To sign up to the Get Serious campaign, text SERIOUS to 84383 or visit www.diabetes.org.uk/GetSerious

For further media information please contact Huw Beale or Maria Lam in the Diabetes UK Media Relations Team on 0207 424 1165 or email pressteam@diabetes.org.uk. For urgent out of hours media enquiries, please call 07711 176 028.

Notes to editor:

1 The Handbook for Vascular Risk Assessment, Risk Reduction and Risk Management - A report prepared for the UK National Screening Committee by the University of Leicester, March 2008, p 30-31.

2 Type 2 diabetes develops when the body can still make some insulin, but not enough, or when the insulin that is produced does not work properly (known as insulin resistance). In most cases this is linked with being overweight. This type of diabetes usually appears in people over the age of 40, though in South Asian and African-Caribbean people it often appears after the age of 25. However, recently, more children are being diagnosed with the condition, some as young as seven. Type 2 diabetes is the most common of the two main types and accounts for between 85 and 95 per cent of all people with diabetes. There are currently 2.6 million people with diabetes in the UK and up to half a million people with diabetes who have Type 2 diabetes but don't know it. Type 1 diabetes develops if the body is unable to produce any insulin. This type of diabetes usually appears before the age of 40. Type 1 diabetes is the least common of the two main types and accounts for between 5 and 15 per cent of all people with diabetes. You cannot prevent Type 1 diabetes.

3 Santaguida PL, Balion C, Hunt D, et al. Diagnosis, prognosis, and treatment of impaired glucose tolerance and impaired fasting glucose. Summary, Evidence Report/Technology Assessment No. 128. August 2005.

4 Diabetes UK recommends that the presence of Impaired Fasting Glucose (IFG) and/or Impaired Glucose Tolerance (IGT) should be known as Impaired Glucose Regulation (IGR), Non-Diabetic Hyperglycaemia (NDH) or prediabetes. IFG is diagnosed with a fasting plasma glucose (FPG) between 6.1-6.9 mmol/l. IGT is diagnosed with a fasting plasma glucose (FPG) <7 mmol/l and an OGTT > 7.8 mmol/l and <11.1 mmol/l.>

5 Nathan DM et al. Impaired Fasting Glucose and Impaired Glucose Tolerance: Implications for care. Diabetes Care 30:753-759, 2007. American Diabetes Association. Screening for type 2 diabetes. Diabetes Care 2004; 27 Suppl 1: S11-S14

6 American Diabetes Association

7 Knowler WC et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002 Feb 7; 346(6):393-403.

8 Tuomilehto J et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001 3;344(18):1343-50. 42.
Gillies C L et al. Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. BMJ 2007;334:299

9 Diabetes UK prediabetes position statement

10 Srinivasan BT, Davies MJ, Webb D et al. (2007). Baseline characteristics and risk of progression from pre-diabetes to Type 2 diabetes in a multi-ethnic population based screening. Diabetes Medicine: 24(Supplement 1): 73

11 Jellinger, Paul S. "What You Need to Know about Prediabetes." Power of Prevention, American College of Endocrinology. Vol. 1, issue 2, May 2009. http://www.powerofprevention.com/

12 Diabetes UK is the leading charity for the three million people in the UK with diabetes. We aim to spend more than more than £6.5 million on research in 2009 as well as campaigning and providing information and support. During our 75th Anniversary year, we hope you will be able to join in and support us so that we can carry on improving the lives of people with diabetes into the future. For more information visit www.diabetes.org.uk.

13 In the UK, there are currently 2.6 million people diagnosed with diabetes and it is estimated that up to half a million people have the condition but do not know it.

14 The Diabetes UK Careline (0845 120 2960) offers information and support on any aspect of managing diabetes. The line is a low cost number and opens Monday to Friday between 9am and 5pm (operates a translation service). Recorded information on a number of diabetes-related topics is also available on this number 24 hours a day.

15 Supporting our work to fund vital research into the care, treatment and hopefully a cure for diabetes as a Diabetes UK Supporting Member entitles you to a range of benefits including our bi-monthly magazine Balance, reliable information booklets on diabetes, our confidential Diabetes UK Careline, over 400 local Diabetes UK support groups, and access to an exclusive personalised Supporting Members Area on our website.

Search the web and raise funds for Diabetes UK at www.everyclick.com/diabetesuk/

Diabetes UK, the charity for people with diabetes

Diabetes UK is the operating name of The British Diabetic Association, a company limited by guarantee. Registered as a company in England & Wales No. 339181. Registered as a charity in England & Wales (No. 215199) and in Scotland (No. SC039136) VAT registration No. 232 3801 96. Registered address: Macleod House, 10 Parkway, London NW1 7AA.

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