Promoting health and preventing premature mortality in black, Asian and other minority ethnic groups

Structure

Evidence of local arrangements for identifying and referring people from Black, Asian and other minority ethnic groups at high risk of type 2 diabetes.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, GP contracts.

Process

a) Proportion of people from Black, Asian and other minority ethnic groups identified as being at high risk of type 2 diabetes who are referred to an intensive lifestyle change programme.

Numerator – the number in the denominator who are referred to an intensive lifestyle change programme.

Denominator – the number of people from Black, Asian and other minority ethnic groups who are identified as being at high risk of type 2 diabetes.

Data source: The Diabetes UK and NHS Digital's National Diabetes Audit and local data collection, for example, GP patient records or data providers such as commissioning support units (CSUs).

b) Proportion of people from Black, Asian and other minority ethnic groups referred to an intensive lifestyle change programme who attended the programme.

Numerator – the number in the denominator who attended an intensive lifestyle change programme.

Denominator – the number of people from Black, Asian and other minority ethnic groups who are at high risk of type 2 diabetes referred to an intensive lifestyle change programme.

Data source: The Diabetes UK and NHS Digital's National Diabetes Audit and local data collection, for example, GP patient records or data providers such as CSUs.

c) Proportion of people from Black, Asian and other minority ethnic groups referred to an intensive lifestyle change programme who completed the programme.

Numerator – the number in the denominator who completed an intensive lifestyle change programme.

Denominator – the number of people from Black, Asian and other minority ethnic groups who are at high risk of type 2 diabetes referred to an intensive lifestyle change programme.

Data source: The Diabetes UK and NHS Digital's National Diabetes Audit and local data collection, for example, GP patient records or data providers such as CSUs.

Outcome

a) Change in BMI among people from Black, Asian and other minority ethnic groups completing intensive lifestyle change programmes.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, GP patient records.

b) Change in blood pressure among people from Black, Asian and other minority ethnic groups completing intensive lifestyle change programmes.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, GP patient records.

c) Change in HbA1c among people from Black, Asian and other minority ethnic groups completing intensive lifestyle change programmes.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, GP patient records.

d) Prevalence of type 2 diabetes among people from Black, Asian and other minority groups.

Data source: The Diabetes UK and NHS Digital's National Diabetes Audit and Public Health England's diabetes prevalence estimates for local populations.

Intensive lifestyle change programme

A structured and coordinated range of interventions provided in different venues for people identified as being at high risk of developing type 2 diabetes. It should be local, evidence-based and quality-assured. The aim is to help people to become more physically active and improve their diet. If the person is overweight or obese, the programme should result in weight loss. Programmes may be delivered to individuals or groups (or involve a mix of both) depending on the resources available. They can be provided by primary care teams and public, private or community organisations with expertise in dietary advice, weight management and physical activity. [NICE's guideline on preventing type 2 diabetes in people at high risk, glossary]

High risk of type 2 diabetes

High risk is defined as a fasting plasma glucose level of 5.5 to 6.9 mmol/litre or an HbA1c level of 42 to 47 mmol/mol (6.0% to 6.4%). These terms are used instead of specific numerical scores because risk assessment tools have different scoring systems. Examples of risk assessment tools include: Diabetes risk score assessment tool, QDiabetes risk calculator and Leicester practice risk score. Risk can also be assessed using the NHS Health Check. [NICE's guideline on type 2 diabetes: prevention in people at high risk, glossary]

Lower thresholds (23 kg/m² to indicate increased risk and 27.5 kg/m² to indicate high risk) should be used for BMI to trigger action to prevent type 2 diabetes among people with a South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean family background compared to those used for the general population. [NICE's guideline on obesity: identification, assessment and management, recommendation 1.2.8]