Summary

Pre-diabetes (aka non-diabetic hyperglycaemia) is a condition where a patients blood glucose is higher than what is considered ‘normal’. However, it’s not high enough for a diabetes diagnosis. Pre-diabetes does not typically have any symptoms, but it does increase risk of developing type 2 diabetes.

Care pathways

This pathway is designed to detect high risk of diabetes, so that disease prevention strategies can be initiated early.

1️⃣ Book the appointment

1. We are using a combination of platforms / tools / teams to book patients in correctly with minimal manual effort. If @Louis Williams hasn’t already been in touch, check out the page to find our Monthly Summary plans or reach out to him to find out what you should be doing:
• If we’re using Hippo Labs, log into app.hippolabs.co.uk to find patient lists (see for more information)
• If we’re using Hero Health or AccuRX, @Louis Williams will send your team manual excel recall lists

2. Call the patient to book an appointment with an HCA or Nursing Associate F2F

You can book an appointment with any member of the nursing team, depending on availability and level of expertise of the nursing staff at your surgery

Explain what the appointment is for, and advise them that they’ll have a blood test on the day

2️⃣ Patient arrives for appointment

1. Record that the patient has arrived in the appointment book
2. Allow the patient a moment to relax before asking to capture data on height, weight, blood pressure, smoking status, and alcohol status (if possible) and add to patient’s EMIS record
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How-to guides

3️⃣ Carry out review

1. Open the clinical template: ‘Penrose Health - Pre-Diabetes’ on EMIS
2. Draw bloods (for HbA1c, renal and cholesterol test) and complete the template
3. Make appropriate referrals as below
• For lifestyle advice for the prevention of type 2 diabetes, refer to 🍎Healthier You
• For BMI, refer to 🍎The Lambeth Healthy Weight Hub, 🍎Up! Up! Lewisham (Tier 2 Weight Management), 🍎NHS Tier 2 Weight Management Service or 🍎NHS Tier 3 Healthy Weight Programme as appropriate
• For smoking cessation, refer to 🚭Southwark Stop Smoking Service, 🚭Lewisham Stop Smoking Service or 🚭Lambeth Stop Smoking Service

4️⃣ Check & triage results

1. Review pathology results, and action as per the 🧊HbA1c and Glucose page

5️⃣ Follow-up appointment for high risk patients

1. If results warrant a new diabetes diagnosis, discuss with the patient and treat as described in step 5 of our 🍎Diabetes page
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How to diagnose diabetes
2. For all newly diagnosed diabetic patients, provide lifestyle advice and encourage signing up to 🍎Diabetes Book & Learn