Diagnosing Diabetes Mellitus

Primary Care Knowledge Boost

Doctors Lisa and Sara are joined by Diabetes Lead for Manchester CCG GP Dr Marlon Morais and Diabetes Support Lead and Diabetes Specialist Nurse Nicola Milne to discuss diagnosis of Diabetes Mellitus. We go through the types of Diabetes Mellitus, touching on MODY and LADA and get advice on avoiding common pitfalls in making a new diagnosis of Diabetes in General Practice. We talk about the prevalence and importance of this diagnosis, both for patients and the NHS and red flags to look out for. We then cover impaired fasting glucose and the current management options for this including the NHS Diabetes Prevention Programme. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources:

• Diabetes UK: types of Diabetes Mellitus explained: https://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes

• WHO Classification of Diabetes Mellitus (2019): https://www.who.int/publications/i/item/classification-of-diabetes-mellitus

• GP Notebook Clinical Classification of Diabetes Mellitus (2021): https://gpnotebook.com/en-gb/simplepage.cfm?ID=-26542064

• What is MODY Maturity-Onset Diabetes of the Young?: https://www.diabetesgenes.org/what-is-mody/

• NICE guidelines: When to suspect Type 2 Diabetes Mellitus (April 2022): https://cks.nice.org.uk/topics/diabetes-type-2/diagnosis/diagnosis-in-adults/

• NICE CKS Guidelines Type 1 Diabetes Mellitus (Nov 2020): https://cks.nice.org.uk/topics/diabetes-type-1/

• Language Matters in Diabetes: https://www.england.nhs.uk/publication/language-matters-language-and-diabetes/

• Diabetes UK Information Prescriptions: https://www.diabetes.org.uk/professionals/resources/resources-to-improve-your-clinical-practice/information-prescriptions-qa

• Finish Diabetes Prevention Study (2003): https://diabetesjournals.org/care/article/26/12/3230/21849/The-Finnish-Diabetes-Prevention-Study-DPS

• National Diabetes Prevention Programme: https://www.england.nhs.uk/diabetes/diabetes-prevention/

• Flatbush Diabetes information on GP Notebook: https://gpnotebook.com/en-gb/simplepage.cfm?ID=x20160928141517439169

• Effects of Diet and Exercise in Preventing NIDDM in People With Impaired Glucose Tolerance: The Da Qing IGT and Diabetes Study (Apr 1997): https://diabetesjournals.org/care/article/20/4/537/22408/Effects-of-Diet-and-Exercise-in-Preventing-NIDDM

• The Da Qing IGT and Diabetes Study 30 year follow up: Morbidity and mortality after lifestyle intervention for people with impaired glucose tolerance: 30-year results of the Da Qing Diabetes Prevention Outcome Study. Lancet Diabetes Endocrinol. Jun 2019: https://pubmed.ncbi.nlm.nih.gov/31036503/

• NHS Diabetes Prevention Programme: Know Your Risk Patient Calculator: https://preventing-diabetes.co.uk/know-your-risk-dtc/

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This podcast has been made with the support of Greater Manchester Health and Social Care Partnership, GP Excellence, Greater Manchester Training Hub and the GP Fellowship Programme, as well as Wigan Borough CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.