NICE has published an update to NICE Public Health Guideline (PH) 38 on Type 2 diabetes: prevention in people at high risk.

In the UK, 3.9 million people live with diabetes; 90% of whom will have type 2 diabetes. People with type 2 diabetes have an increased risk of cardiovascular disease, including coronary heart disease and stroke, and they are more likely to have high blood pressure. Type 2 diabetes occurs more frequently in people who are overweight or obese and the risk increases with body weight.

In September 2017, NICE reviewed the evidence for intensive lifestyle-change programmes and evidence for metformin for people at risk of type 2 diabetes, and implemented the following changes:

  • recommendation 1.5 on matching interventions to risk and recommendation 1.6 on reassessing risk were added
  • recommendation 1.19.1 on when to offer metformin in the context of lifestyle change was updated.

The areas covered by the recommendations in PH38 include:

  • risk assessment and risk identification
  • physical activity
  • weight management and dietary advice
  • vulnerable groups
  • metformin and orlistat.