This is a new guideline from SIGN on preventing Type 2 Diabetes. It was published in March 2025.
This guideline closely follows the NICE guideline on preventing type 2 diabetes, which came out in 2012 and was updated in 2017 but as I haven’t blogged in any detail on this before, I felt it worth covering.
What is new in this guideline for us?
- Prediabetes risks. There are increased risks associated with having prediabetes – which I had not appreciated before. I have outlined these below.
- HbA1c isn’t always going to be the best or most accurate test. I think we all know this, but when I looked again at the list of reasons it may be inaccurate, there were certainly conditions there that I hadn’t appreciated could be an issue.
- We should ‘consider’ annually recording weight for those with prediabetes. NICE is stronger on this and says we should offer an annual review of those with prediabetes – reinforcing advice on diet and physical activity.
- Gestational Diabetes. For those with a history of gestational diabetes, an HbA1c of 39 or more puts them at higher risk of developing T2DM. This isn’t new advice, but I had certainly forgotten it.
- If patients who have had, or currently have an eating disorder, and are at higher risk of T2DM, their eating disorder should be appropriately managed as the priority.
What are the risks associated with being prediabetic?
Prediabetes is associated with an increase in all cause mortality and cardiovascular disease. This applies both to people with established atherosclerotic disease and those without.
