Risk assessment

Prevention and remission of type 2 diabetes (SIGN)
Healthcare Improvement Scotland
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Risk assessment, alongside clinical judgement, can identify people who are at high risk of developing type 2 diabetes. The assessment may consider risk factors such as age, body mass index (BMI), waist circumference, ethnicity, previous gestational diabetes and steroid or antipsychotic drug treatment. Validated computer-based self-assessment tools, like QDIABETES-18 or Diabetes UK’s Know Your Risk, allow people to estimate risk without a blood test. These specific risk-assessment tools can be highlighted primarily by general practitioners  and primary care nurses but also by a range of healthcare professionals in a variety of settings, including pharmacists, optometrists, occupational health nurses, and staff involved in the care of vulnerable groups.

People should not be excluded from any risk assessment on the basis of age alone.

The principle of informed consent requires healthcare professionals to fully inform patients of the consequences of any assessment or test.

Information on the implications of being at high risk and the consequences of developing the condition can be found on the Diabetes UK website. People at any level of risk can be signposted towards reliable trusted sources of support (see Sources of further information).

 

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Primary care healthcare professionals should implement a two-stage strategy to identify people at high risk of type 2 diabetes (and those with undiagnosed type 2 diabetes).

  • Firstly, a risk assessment should be offered.
  • Secondly, for those with high risk scores, a blood test should be offered to investigate if they have type 2 diabetes or prediabetes.

 

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Encourage people in the following groups to have a risk assessment:

  • all eligible adults aged 40 and above
  • people aged 25 and above of South Asian, Chinese, African-Caribbean, Black African and other high-risk Black and minority ethnic groups
  • adults with conditions that increase the risk of type 2 diabetes.

 

When raising the issue of risk with individuals, adopt a person-centred conversation approach underpinned by professional education and support.

  

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Where risk assessment is conducted by health professionals in NHS settings outside general practice (for example, in community pharmacies) and the person is scored as high risk, the professionals involved should work to ensure the results are shared with the person and their GP practice (with permission).

 

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Primary care providers should record risk assessments that score as high risk to ensure appropriate follow up and continuity of care, with consent from the individual.

 

Robust approaches to follow up and recording (with permission) should be applied in point-of-care pharmacy testing and home blood testing.