Director of Public Health Annual Report 2012 [pdf] - Stoke-on-Trent ...

There is also evidence that through lifestyle changes some LTCs may be prevented or onset
may be delayed. An example is the prevention <strong>of</strong> type 2 diabetes in individuals with
impaired glucose tolerance (IGT) or high fasting glucose. Abnormal glucose control places
them at substantially increased risk <strong>of</strong> developing diabetes in the near future. Although
intensive treatment <strong>of</strong> diabetes helps to prevent complications, it does not usually restore
normal blood glucose or eliminate all the adverse events associated with diabetes. Often,
the diagnosis <strong>of</strong> type 2 diabetes is delayed until evidence <strong>of</strong> complications is already
present. However, prevention through lifestyle changes involving diet, weight management
and physical activity can revert IGT to normal levels 21 .
NHS health checks also have an important role in the prevention <strong>of</strong> LTCs for individuals
between 40 and 70 years, providing support and advice in the management <strong>of</strong> risk and
lifestyle interventions 22 .
The <strong>Health</strong> and Well Being Board needs to ensure that the proportion <strong>of</strong> expenditure
on prevention increases year on year compared with expenditure on reactive acute
care.
EVIDENCE: Prevalence modelling
It is self-evident that early diagnosis and treatment is important to help patients remain
independent, prevent complications and exacerbations, and improve quality <strong>of</strong> life.
Prevalence modelling is a way <strong>of</strong> finding undiagnosed patients and also ensuring correct
diagnoses. Statistical models estimate how many people would be expected to have LTCs in
individual GP practices. The practices will then use the information to help identify the
undiagnosed and record them on disease registers. Creating comprehensive register
facilitates many <strong>of</strong> the interventions described in figure 14 below, including secondary
prevention, optimal clinical care and personalisation. Good quality registers also allow for
targeting <strong>of</strong> vulnerable groups and reducing health inequalities.
Figure 14 Box plot showing range <strong>of</strong> PCT care process achievement in England
Source: National Diabetes Audit 2010-11 (<strong>2012</strong>) <strong>Report</strong> 1: Care Processes and Treatment Target
The National Diabetes Audit 23 <strong>of</strong> Primary Care Trusts identified variation in general practice
in the delivery <strong>of</strong> care and achieving the recommended targets for optimal management <strong>of</strong>
this condition.
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