What's the risk

Pulse reveals that there is pressure from DH for NICE to recommend lowering the threshold for diabetes testing for adults. Draft guidance on prevention of type 2 diabetes, published last year, proved unpopular when it recommended a case finding approach, whereby GPs would be expected to assess risk of patients and offer lifestyle advice and testing to high risk patients. At this stage, the threshold was set at HbA1c levels of 6.0- 6.4%; according to Pulse, the new proposals suggest a level below 6.0% for high risk patients. A modelling study has recently suggested that using this lower threshold would prevent more cases but with a "disproportionately higher workload". Much reported was the study on variation in incidence of lower limb amputation in England, which suggested that multidisciplinary teams could be a better way of dealing with the issue.