African Region Tops World in Undiagnosed Diabetes - WHO Analysis (2)

19 November, 2022

Neil,

The wording is a little unclear here. I believe the wording should be "only 46% of people in the African region who have the diabetes criteria of diabetes have been diagnosed".

The UK NICE organization has easy to read guidelines on diagnosing diabetes. Unfortunately, unlike obesity, physical inactivity and raised blood pressure, diabetes cannot easily be self diagnosed without external professional help. However general education within curricula of bodies such as PSHE might help? (the national body for personal, social, health and economic education.

NICE guidance Diagnosis in adults | Diagnosis | Diabetes - type 2 | CKS | NICE

https://cks.nice.org.uk/topics/diabetes-type-2/diagnosis/diagnosis-in-ad...

'Suspect a diagnosis of type 2 diabetes if an adult presents with persistent hyperglycaemia that may be accompanied by clinical features.

'Possible clinical features of type 2 diabetes include:

Symptoms such as polydipsia, polyuria, blurred vision, unexplained weight loss, recurrent infections, and tiredness. Note: these may be mild or absent.

Signs such as acanthosis nigricans (a skin condition causing dark pigmentation of skin folds, typically the axillae, groin, and neck), which suggests insulin resistance.

The presence of risk factors.

Persistent hyperglycaemia is defined as:

HbA1c of 48 mmol/mol (6.5%) or more.

Fasting plasma glucose level of 7.0 mmol/L or more.

Random plasma glucose of 11.1 mmol/L or more in the presence of symptoms or signs of diabetes.

If the person is symptomatic, a single abnormal HbA1c or fasting plasma glucose level can be used, although repeat testing is sensible to confirm the diagnosis.

If the person is asymptomatic, do not diagnose diabetes on the basis of a single abnormal HbA1c or plasma glucose result. Arrange repeat testing, preferably with the same test, to confirm the diagnosis. If the repeat test result is normal, arrange to monitor the person for the development of diabetes, the frequency depending on clinical judgement.

Note: be aware that severe hyperglycaemia in people with acute infection, trauma, circulatory or other stress may be transitory and is not diagnostic of diabetes.'

HIFA profile: Richard Fitton is a retired family doctor - GP. Professional interests: Health literacy, patient partnership of trust and implementation of healthcare with professionals, family and public involvement in the prevention of modern lifestyle diseases, patients using access to professional records to overcome confidentiality barriers to care, patients as part of the policing of the use of their patient data

Email address: richardpeterfitton7 AT gmail.com