TY - JOUR T1 - Reducing the rise in type 2 diabetes JF - British Journal of General Practice JO - Br J Gen Pract SP - 533 LP - 534 DO - 10.3399/bjgp08X319693 VL - 58 IS - 553 AU - Norman Waugh Y1 - 2008/08/01 UR - http://bjgp.org/content/58/553/533.abstract N2 - The York and Humber Public Health Observatory1 reports that 4.7% of the population now have diabetes, of which 92% (4.3% of the population) have type 2 diabetes. The diagnosed prevalence has doubled between 1994 and 2003. The increasing number of people with type 2 diabetes reflects several factors: an ageing population; a true increase in prevalence, related to increased prevalence of overweight and obesity; decreasing physical activity; better survival of those with diabetes due to improved control of blood glucose, blood pressure, and lipids; and earlier diagnosis, partly from informal screening. (A recent study using British general practice data found that one-third of people aged over 40 years [excluding those known to have diabetes] underwent blood glucose measurement in the previous 2 years.2)The debate on whether there should be organised screening has shifted towards a broad-based approach of cardiovascular risk reduction. This is logical, as the main risk for those with undiagnosed type 2 diabetes is vascular disease. The arguments for screening are that:Many people with type 2 diabetes, perhaps 20% although some estimates are higher, are undiagnosed.People can develop complications such as eye disease, before they develop symptoms and have their diabetes diagnosed.The risk of heart disease is increased, and the first symptom of heart disease may be a heart attack which is often fatal.People with impaired glucose tolerance (IGT) are also at higher risk of heart disease than those with normal glucose levels.3Progression to diabetes can be reduced or delayed by lifestyle measures (and by drug therapy, such as metformin).So the aim of screening would be to treat hyperglycaemia … ER -