Adherence to NICE guidelines on diabetes prevention in the UK: Effect on patient knowledge and perceived risk

Prim Care Diabetes. 2015 Dec;9(6):407-11. doi: 10.1016/j.pcd.2015.04.005. Epub 2015 May 13.

Abstract

Background: NICE Guidelines for prevention of diabetes include identifying people at risk followed by cost-effective intervention if necessary. Based on assessment of risk via a questionnaire and/or blood test the intervention may comprise a brief discussion of risk factors and preventive advice or referral to intensive lifestyle intervention.

Design and setting: In this cross-sectional study 59 subjects recruited from local GP practices were invited by letter to attend a screening for a diabetes prevention study.

Method: Following a telephone screening during which subjects were asked whether they had been informed if they were at high-risk of type 2 diabetes, eligible subjects completed a Risk Perception Survey for Developing Diabetes (RPS-DD), a validated diabetes risk score and underwent an oral glucose tolerance test (OGTT) at a medical screening.

Results: As measured by the Diabetes UK Risk Score, 44.1% were at high risk, 42.4% moderate risk and 13.6% at increased risk. 42% of patients had been informed they were at high-risk by a health professional. Those who had been informed of their risk had significantly higher perceived risk scores (p<0.001), higher knowledge scores (p<0.001) and decreased optimism scores (p=0.004), but were not more aware that diet (p=0.42) and weight management (p=0.57) can play a role in preventing diabetes.

Conclusions: People at high-risk of diabetes are not being informed of their risk status as recommended by NICE guidelines. There is scope for education for health professionals and the public.

Trial registration: ClinicalTrials.gov NCT01841073.

Keywords: Prediabetes; Prevention; Risk perception; Screening; Type 2 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cohort Studies
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Diet / adverse effects
  • Exercise
  • General Practice / methods*
  • General Practice / standards
  • Glucose Tolerance Test
  • Guideline Adherence* / standards
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Middle Aged
  • Patient Education as Topic* / standards
  • Perception
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'* / standards
  • Predictive Value of Tests
  • Primary Prevention / methods*
  • Primary Prevention / standards
  • Risk Assessment
  • Risk Factors
  • Risk Reduction Behavior*
  • Sedentary Behavior
  • Surveys and Questionnaires
  • Treatment Outcome
  • United Kingdom / epidemiology

Associated data

  • ClinicalTrials.gov/NCT01841073