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1. Who is at risk of type 2 diabetes?
Opportunistic testing in asymptomatic individuals at high risk of type 2 diabetes allows early identification and management of diabetes which is important in heading off complications. All symptomatic individuals (thirst, increased micturition, weight loss, recurrent bacterial and fungal infection, visual disturbance) should be tested for diabetes.
Nurses in primary care may well be asked about individual risk and Table 1 indicates factors that might prompt a test for diabetes.
The prevalence of type 2 diabetes is increasing with the demographic of an ageing population and rising rates of obesity.1 Studies show a two- to six-fold increased risk of type 2 diabetes for those with a positive family history versus those without.2
Ethnicity is an important factor for type 2 diabetes. Thus, in the UK, South Asians are several times more likely to develop type 2 diabetes than the general population.3
Gestational diabetes and polycystic ovarian syndrome are markers for insulin resistance and, as with prediabetes, annual HbA1c screening (or other method) should be instituted for the emergence of type 2 diabetes.4