Implementing a community-based diabetes prevention programme in Ireland

Abstract Summary: There is consensus in the literature that early detection, treatment and prevention is imperative for the wellbeing of society and the health care system (1). There is strong evidence which shows that T2D is preventable (2-5). Early identification of people at risk of T2D and lifestyle interventions has been shown to reduce progression to T2D. This abstract describes a diabetes prevention programme that has been set up in the community by a clinical nurse specialist and physiotherapist. An intervention was provided for those at medium to high risk. This comprised of a validated structured education programme and if the client was at high risk they were also provided with a one to one support for lifestyle change. Results from a retrospective audit of 273 in 2015, participants in the programme showed good outcomes with statistical improvement’s in weight loss, reductions in fasting glucose and reduction in blood pressure.Introduction: Type 2 diabetes (T2D) is a serious public health challenge. T2D is estimated to be the fifth leading cause of mortality globally. It is predicted that T2D will affect 552 million people worldwide by 2030, 90% will have or be diagnosed with T2D. It is estimated that between 33% and 65% adults with impaired fasting glucose or impaired glucose tolerance may progress to T2D within 6 years, versus 5% for those with normal blood glucose levels (6). T2D onset can occur up to twelve years before diagnosis of the disease. It is essential therefore to identify individuals at risk of T2D, as it enables opportunities for them to reduce their risks, preventing or delaying the development of T2D and T2D associated complications.Description of practice change implemented: Identifying clients at risk of diabetes can be through blood testing (fasting glucose, Hba1C or glucose tolerance test) or by using a risk score. It is a quick, easy and non-invasive way of identifying individuals at high risk of diabetes within the population. Risk tools are now recommended in guidance for diabetes prevention and have been used in many prevention programmes (7-10). The programme uses the validated Findrisc risk score. If the patient has a moderate risk for developing diabetes they are offered a single structured education programme called ‘Walk away from Diabetes’. This is a three hour, group based, structured education programme developed in the UK (11). If the client is at high risk they are also provided with one to one support for mak