What are the current trends in the epidemiology of diabetes in the UK, and how should they influence my screening practices?

Current trends in the epidemiology of diabetes in the UK show an increasing prevalence of type 2 diabetes, driven by factors such as rising obesity rates, aging population, and higher risk in certain ethnic groups including South Asian and Chinese descent populations. Type 2 diabetes is commonly associated with insulin insensitivity exacerbated by excess body weight, inactivity, and other comorbidities like hypertension and cardiovascular disease ².

Implications for screening practices include adopting a proactive, two-stage risk identification strategy: first offering validated risk assessments (computer-based or self-assessment questionnaires) to adults, especially those aged 40 and over, or younger adults from high-risk ethnic groups or with risk-enhancing conditions; second, offering blood tests to confirm diagnosis or risk level ¹.

Screening should not exclude older adults (including those aged 75 and over) as risk reduction is beneficial at all ages ¹. Screening opportunities should be extended beyond general practice to community venues such as pharmacies, workplaces, and faith centres, with clear pathways to ensure results are communicated back to GPs for follow-up ¹.

Regular reassessment is recommended based on risk level: low-risk individuals at least every 5 years, moderate risk every 3 years, and high-risk individuals annually with blood tests and lifestyle review ¹. Maintaining an up-to-date risk register and recall system supports continuity of care and timely intervention ¹.

Overall, these epidemiological trends necessitate a comprehensive, inclusive, and repeated screening approach tailored to local population needs and risk profiles to effectively identify and manage people at high risk of type 2 diabetes ¹,².