NDH has the 2nd highest increase in prevalence year on year - from 6.09% in 2021/22 to 8.17% - and this trend is set to continue. In March 2022 there were more than 2.7 million people with NDH in England & Wales, a figure which is probably very under-reported.
In our QOF Prevalence Health Checks, we uncover a high number of patients who should be coded for inclusion on the NDH register who are not. It is essential when a patient has a HbA1c of 42-47 mmol/mol (or FPG of 5.5-6.9mmol/l) they are coded for inclusion on the register as these patients can then be monitored.
In our experience some practices prefer patients to have had 2 high HbA1c’s before they include them. This defeats the object of the register; the register ensures patients are invited for monitoring each year, not adding them to a register and relying on the patient coming back for a retest in a few months is risky - the patients often forget but when they do come back, you are retesting them prior to adding them to a register. This means you are doing the follow-up blood test without actually being paid for it in terms of prevalence.
The purpose of this register is to keep patients from developing type2 diabetes - patients 18 and over with a blood test demonstrating NDH can be referred to the NHS Diabetes Prevention Programme (NHS DPP). Patients on the register should be offered an annual blood test.