Type 2 diabetes prevention: population and community-level interventions

Body mass index

Body mass index (BMI) is commonly used to measure whether or not adults are a healthy weight or underweight, overweight or obese. It is defined as the weight in kilograms divided by the square of the height in metres (kg/m²).

Community

A group of people who have common characteristics. Communities can be defined by location, race, ethnicity, age, occupation, a shared interest (such as using the same service), a shared belief (such as religion or faith) or other common bonds. A community can also be defined as a group of individuals living within the same geographical location (such as a hostel, a street, a ward, town or region).

Community champions

Community champions are inspirational figures, community entrepreneurs, mentors or leaders who 'champion' the priorities and needs of their communities and help them build on their existing skills. They drive forward community activities and pass on their expertise to others. They also provide support, for example, through mentoring, helping people to get appropriate training and by helping to manage small projects.

Diabetes

Diabetes is caused when there is too much glucose in the blood and the body cannot use it as 'fuel' because the pancreas does not produce any or sufficient insulin to help it to enter the body's cells. Alternatively, the problems may be caused because the insulin produced may not work properly ('insulin resistance'). Also see 'glucose' and 'insulin'.

Fasting glucose sample

Glucose sample taken after a person has refrained from eating or drinking any liquids other than water for 8 hours.

Glucose

Glucose comes from digesting carbohydrate and is also produced by the liver. Carbohydrate comes from many different kinds of food and drink, including starchy foods such as bread, potatoes and chapatis; fruit; some dairy products; sugar and other sweet foods (Diabetes UK 2010).

HbA1c

Glycated haemoglobin (HbA1c) forms when red cells are exposed to glucose in the plasma. The HbA1c test reflects average plasma glucose over the previous eight to 12 weeks. Unlike the oral glucose tolerance test, an HbA1c test can be performed at any time of the day and does not require any special preparation such as fasting.

HbA1c is a continuous risk factor for type 2 diabetes. This means there is no fixed point when people are or are not at risk. The World Health Organization recommends a level of 6.5% (48 mmol/mol) for HbA1c as the cut-off point for diagnosing type 2 diabetes in non-pregnant adults.

Impaired glucose tolerance

See definition below of 'pre-diabetes'.

Insulin

Insulin is the hormone produced by the pancreas that allows glucose to enter the body's cells, where it is used as fuel for energy. It is vital for life (Diabetes UK 2010).

Lay or community workers

People recruited from the local community or subgroup of the population to assist in the delivery of an intervention to a group of people who they identify with and are knowledgeable about. They might be peers or from the wider community but they are not professional health or public health workers.

Oral glucose tolerance test

An oral glucose tolerance test involves measuring the blood glucose level after fasting, and then 2 hours after drinking a standard 75 g glucose drink. Fasting is defined as no calorie intake for at least 8 hours. More than one test on separate days is required for diagnosis in the absence of hyperglycaemic symptoms.

Physical activity

The full range of human movement, from competitive sport and exercise to active hobbies, walking, cycling and the other physical activities involved in daily living.

Pre-diabetes

Where used in this guidance, the term pre-diabetes refers to raised (but not diabetic) blood glucose levels (also known as non-diabetic hyperglycaemia, impaired glucose regulation). It indicates the presence of impaired fasting glucose and/or impaired glucose tolerance. People with pre-diabetes are at increased risk of getting type 2 diabetes. They are also at increased risk of a range of other conditions including cardiovascular disease.

Socioeconomic group

A person's socioeconomic group is defined by a combination of their occupation, income level and education level. There is a strong relationship between socioeconomic group and health, with people from lower socioeconomic groups generally experiencing poorer health than those from higher socioeconomic groups.

Type 2 diabetes

Type 2 diabetes (previously termed non-insulin dependent diabetes) results from reduced tissue sensitivity to insulin (insulin resistance) and/or reduced insulin production.