title: Adherence to NICE guidelines on diabetes prevention in the UK: Effect on patient knowledge and perceived risk.
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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Nutrition and Dietetic Research Group, Imperial College London, Hammersmith Hospital, W12 0NN London, UK. Electronic address: n.guess10@imperial.ac.uk.
authors.forename: Nicola D
authors.initials: ND
authors.lastname: Guess
authors.affiliation: Nutrition and Dietetic Research Group, Imperial College London, Hammersmith Hospital, W12 0NN London, UK. Electronic address: natarin.caengprasath12@imperial.ac.uk.
authors.forename: Natarin
authors.initials: N
authors.lastname: Caengprasath
authors.affiliation: Division of Diabetes, Endocrinology and Metabolism, Imperial College, , NHS Trust, Du Cane Road, W12 0NN London, UK. Electronic address: a.dornhorst@imperial.ac.uk.
authors.forename: Anne
authors.initials: A
authors.lastname: Dornhorst
authors.affiliation: Nutrition and Dietetic Research Group, Imperial College London, Hammersmith Hospital, W12 0NN London, UK.
authors.forename: Gary S
authors.initials: GS
authors.lastname: Frost
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D004032:Diet / Q000009:adverse effects; D015444:Exercise; D058006:General Practice / Q000379:methods* / Q000592:standards; D005951:Glucose Tolerance Test; D019983:Guideline Adherence / Q000592:standards; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000592:standards; D010465:Perception; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D011237:Predictive Value of Tests; D011322:Primary Prevention / Q000379:methods* / Q000592:standards; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D057185:Sedentary Behavior; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
keywords: Prediabetes; Prevention; Risk perception; Screening; Type 2 diabetes