Assessing the risk of diabetes

Rupal Shah, general practitioner partner11Bridge Lane Group Practice, London SW11 3AD, UKCorrespondence to: R Shah rupal.shah7atnhs.netAccepted 30 June 2015The bottom lineCheck for risk factors for diabetes, such as South Asian ethnicity, raised body mass index (BMI), and family history

Use a risk calculator (such as Qdiabetes and the diabetes risk score) to predict 10 year risk of developing type 2 diabetes

Consider testing for diabetes (using fasting blood glucose or HBA1c) in patients at high risk of diabetes. Consider the possibility of diabetes in South Asians over 25 years who are overweight or obese (BMI 23)

A 38 year old South Asian man comes to see you for a medication review. He takes bendroflumethiazide for hypertension, which is well controlled. His last recorded body mass index (BMI) was 29. As part of the review, you decide to discuss his risk of developing diabetes.

What you should coverThis man is at high risk of diabetes because of his ethnicity, his hypertension, and his BMI; in general, obesity accounts for 80-85% of the risk of developing type 2 diabetes. In adults over 40 years, the risk of diabetes is two to three healthcare public relations jobs times greater in South Asians than in age matched white people.