There is a growing epidemic of type 2 diabetes in the UK and globally, and yet this is a largely preventable condition. Public Health England estimates that 4.6 million people in England alone will have diabetes by the year 2030 yet Diabetes UK believes that around 80% of type 2 diabetes could be avoided through better lifestyle behaviours. It is imperative then that general practice nurses are vigilant to any opportunity to support people at risk.
Obesity is the most important modifiable risk factor for developing type 2 diabetes. Practice nurses should be able to provide help and support to people who need to achieve and maintain a healthy weight. Although healthy eating, portion control and increased activity levels remain the mainstay of weight management strategies, practice nurses should be aware of and open to newer approaches to achieving weight loss such as very low calorie diets, the 5:2 diet and bariatric surgery.
In 2012 the National Institute for Health and Care Excellence (NICE) produced guidance on the prevention of diabetes. This guidance suggested that risk assessment tools should be used to identify those at risk of developing type 2 diabetes. Simple to use risk assessment tools can be found on the Diabetes UK website. Appropriate interventions can then be implemented depending on each individual’s level of risk. These interventions should focus on lifestyle change, specifically activity levels, dietary advice and weight management.
According to Public Health England the NHS Health Check programme, if fully implemented, could prevent 4000 people a year from developing diabetes. This programme offers opportunities for prevention and early diagnosis of diabetes but implementation has been patchy across the country – in 2013-14, less than half of the population who had been offered an NHS health check actually had one.
Diabetes UK argues that both the prevention and improved management of diabetes need to be a priority for the NHS and practice nurses are perfectly placed to offer support to patients to understand their risks and to make change happen.
Beverley Bostock-Cox, nurse practitioner and clinical lead for Health Education for Warwick