NHS Diabetes Prevention Programme

A report published in the journal Diabetic Medicine indicates the ‘Healthier You: Diabetes Prevention Programme’ has signed up significantly more people than expected.  Progress of the Healthier You: NHS Diabetes Prevention Programme: referrals, uptake and participant characteristics summarises the positive impact made by the programme during the early phase of its roll-out.  Characteristics of attendees suggest that the programme is reaching those who are both at greater risk of developing Type 2 diabetes and who typically access healthcare less effectively. Additional link: NHS England press release


Commissioning guidance for improved diabetic foot care


The Royal College of Podiatry has launched an online commissioner’s guide aimed at improving diabetic foot care.  The online toolkit resource aims to support CCGs in England to commission improved services for diabetic foot disease. It provides information on: the impact of diabetic foot ulcers and amputations on patients’ lives and on NHS costs; the potential for improved care to transform lives and reduce NHS expenditure, and what good care looks like and how to restructure services and pathways.

People at high risk of diabetes should undergo intensive lifestyle change, says NICE

All people in England at high risk of developing type 2 diabetes should be offered a place on an intensive lifestyle change programme, says updated guidance from NICE | BMJ


The guidance now states that anyone with a fasting glucose concentration between 5.5 and 6.9 mmol/L should be offered a place on such a programme but that priority should be given to anyone with a reading between 6.5 and 6.9 mmol/L, because of their increased risk of developing diabetes.

The guidance also states that anyone aged over 40 (except pregnant women), people aged 25-39 of south Asian, Chinese, African Caribbean, or black African origin, and people from other high risk ethnic minority groups should be offered a diabetes risk assessment, carried out at a general practice or a community pharmacy.

Expert reaction to study looking at drinking alcohol and risk of diabetes

In new research published in Diabetologia scientists report that alcohol drinking frequency is associated with a reduced risk of diabetes and that consumption of alcohol over 3-4 days per week is associated with the lowest risk of diabetes | Science Media Centre


Dr Graham Wheeler, Bayesian Medical Statistician, UCL, said:

“Whilst this large study has found an association between moderate weekly alcohol consumption and a reduced risk of diabetes, this alone does not prove a causal link.

“Establishing a biological mechanism for how this protective effect might work is key to understanding the findings of these types of study.

“In the Danish study, participants were asked to recall drinking habits only once.  So participants may under- or over-report their true alcohol consumption.  We also don’t know how their drinking habits changed as they were followed up.

“Researchers looked at the association between diabetes onset and lots of different categories of drinking behaviour, which increases the chance of claiming at least one association is statistically significant, when actually it isn’t.

“Whilst drinkers may want to raise a glass upon hearing this news, alcohol has been linked to the increased risk of alcoholic hepatitis, liver cirrhosis and several cancers.  Further research will help us piece together the complex relationship between alcohol consumption and diabetes.”

Read the full analysis here

Expert reaction from to two studies looking at coffee consumption and risk of death

Two studies publishing in the Annals of Internal Medicine assess the association between higher coffee consumption and reduced risk of death | Science Media Centre


Dr Tim Chico, Reader in Cardiovascular Medicine / consultant cardiologist, University of Sheffield, said:

“These two studies followed many thousands of people for 16 years and compared death rates in coffee drinkers with non-coffee drinkers.  In keeping with previous studies, death rates were slightly lower in coffee drinkers than in non-coffee drinkers.

“The studies were well conducted and have the advantage of having observed thousands of people from many different countries and ethnic backgrounds, and the association between coffee drinking and mortality seems to be the same across all these populations.

“The authors of both studies are commendably cautious about whether or not coffee drinking is the cause of the reduced mortality in coffee drinkers, or whether there are other unknown differences between coffee drinkers and non-coffee drinkers that are the real cause for the differences observed.  Neither study seems to take into account the income of the people involved (although they do adjust for educational level) and since coffee isn’t cheap it is possible that non-coffee drinkers are less well off, which would be a potential explanation for some of the differences seen.

“What can we conclude from these studies?  The authors of both papers sensibly go no further than concluding that their results show that coffee drinking is not harmful.  I’m occasionally asked by patients whether they should drink coffee and these studies will help in advising them that coffee drinking is safe.

“The only way to be certain whether or not coffee might make people live longer is to force many thousands of people to drink it regularly, while preventing many thousands of otherwise similar people to never drink coffee.  A study like this is never going to take place, so we may never know the answer to this question.

“I don’t think this study should lead anyone to drink more coffee in search of a health benefit that might not actually exist.  It is useful to compare this to the proven benefits of physical activity.  A 20-min walk to a local coffee shop will definitely provide many health benefits, even if you don’t actually go in and buy anything.”

Why gluten-free food is not the healthy option and could increase your risk of diabetes

New research from Harvard University has found a link between gluten-free diets and an increased risk of developing type 2 diabetes | Brown, J. for The Conversation

Image source: Whatsername? – Flickr // CC BY-SA 2.0

There is evidence that the popularity of gluten-free diets has surged, even though the incidence of coeliac disease has remained stable. This is potentially due to increasing numbers of people with non-coeliac gluten sensitivity. In these cases, people exhibit some of the symptoms of coelaic disease but without having an immune response. In either case, avoiding gluten in foods is the only reliable way to control symptoms, which may include diarrhoea, abdominal pain and bloating.

Without any evidence for beneficial effects, many people without coeliac disease or gluten sensitivity are now turning to gluten-free diets as a “healthy” alternative to a normal diet. Supermarkets have reacted to meet this need by stocking ever growing “free from” ranges. The findings of this recent study, however, suggest that there could be a significant drawback to adopting a gluten-free diet that was not previously known.

Read the full blog post here

Read the original research abstract here

National Diabetes inpatient audit

The Healthcare Quality Improvement Partnership has published National Diabetes Inpatient Audit, England and Wales 2016.

The report finds that the prevalence of all hypoglycaemic episodes in hospital, both mild and severe, has decreased from 26 per cent in 2011 to 20 per cent in 2016. It also highlights that there has been an overall reduction in the prevalence of the most severe, life-threatening hypoglycaemia which requires injectable rescue treatment for inpatients with diabetes. This has fallen from 2.2 per cent in 2011 to 1.7 per cent in 2016.

Full report and findings available here