Diagnosis resources
Here are links to evidence-based resources which provide further information on the diagnosis of diabetes and different types of diabetes. You may also want to refer to information about the national service frameworks and strategies across the UK.
Some of the resources on this page are in PDF format - see how to access PDF files.
Guidelines and guidance
British Medical Association Board of Science and Education (2004) Diabetes Mellitus: an update for healthcare professionals
This report, published by the British Medical Association, focuses on changes in understanding of the epidemiology, aetiology and clinical management of diabetes, placing emphasis on controversial issues and recent advances. It commences with a section on the classification and diagnostic criteria of diabetes and disorders of glucose homeostasis, and on causes of type 1 and type 2 diabetes.
Department of Health NSF: What is diabetes?
This section from the National Service Framework provides an overview of the different types of diabetes, their symptoms and diagnosis.
Department of Health NSF: Identification of people with type 2 diabetes
Standard 2 of the National Service Framework focuses on the development, implementation and monitoring of strategies to identify people who do not know they have diabetes.
Diabetes UK (2008) Position statement: Early identification of people with type 2 diabetes
This position statement outlines the arguments in favour of an active programme to identify people with type 2 diabetes early on. It presents a series of care recommendations and criteria relating to early identification of people with possible elevated blood glucose and includes an appendix on methods of screening.
International Diabetes Federation (IDF) (2005): Global guideline for type 2 Diabetes
This global guideline attempts to address some of the difficulties of providing optimal management of type 2 diabetes in an international context, given the complexities of diabetes care and taking into account different health care systems and resource levels. It does this by providing advice according to three levels of care - standard care, minimal care and comprehensive care.
Map of Medicine: Diabetes - suspected in adults
Describes the care pathway including prediabetes management, and points to key evidence supporting different stages of the pathway.
National Institute for Health and Clinical Excellence (NICE) (2004) Type 1 diabetes: diagnosis and management of type 1 diabetes in children, young people and adults
This clinical guideline presents recommendations on the diagnosis and treatment of type 1 diabetes and the care that should be available for children, young people and adults. A quick reference guide and information for the public are also available.
NICE (2009) Type 2 diabetes - the management of type 2 diabetes (CG66 and CG87)
Clinical guideline CG87 is a partial update of the NICE clinical guideline 66 published in 2008 and covers newer agents for blood glucose control in adults with type 2 diabetes. The documentation for CG87 includes the full guideline CG66 as well as the documents specific to CG87. The advice in the NICE guideline covers: the monitoring of glucose, lipid (blood cholesterol and fat) and blood pressure levels; diabetes education programmes; dietary advice; the use of medications to:- control blood glucose - prevent vascular (blood vessel) disease - reduce blood pressure and improve lipid levels; the detection and ongoing management of eye disease, kidney disease, nerve damage and nerve pain and depression.
NICE (2011) Diabetes in adults quality standard
NICE quality standards are “a set of specific, concise statements that act as markers of high-quality, cost-effective patient care, covering the treatment and prevention of different diseases and conditions”. They define clinical best practice within specific topic areas. Developed in collaboration with NHS and social care professionals and service users, the standards address three dimensions of quality: clinical effectiveness, patient safety and patient experience. This standard presents statements around key aspects of diabetes care for adults.
NHS Evidence - diabetes
There are sections within the library which bring together guidance and pathways, evidence, references, patient information and professional development resources on type 1 diabetes, type 2 diabetes, diabetes in pregnancy and other types of diabetes.
Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology(ESC) and the European Association for the Study of Diabetes (EASD) (2007) Guidelines on diabetes, pre-diabetes and cardiovascular diseases
Because of the inter-relation of diabetes and coronary heart disease (CHD), the European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD) formed a Taskforce to develop joint evidence-based guidelines for diabetes and cardiovascular diseases in sufficient detail to support both specialists in diabetes and in cardiology.
Scottish Intercollegiate Guidelines Network (SIGN) (2010) Management of diabetes (SIGN publication number 116)
This updates the guideline 55 published in 2001 incorporating all the new evidence published since then. The guideline includes recommendations for lifestyle interventions, for the management of cardiovascular, kidney and foot diseases and for the prevention of visual impairment. Specific advice for pregnant women with diabetes is provided. There are new sections on psychosocial issues and on glucose-lowering therapies in people with type 2 diabetes.
World Health Organization (2011) Factsheet 312: Diabetes
This factsheet presents key information on what diabetes is, its consequences, and the activities of WHO in preventing and controlling diabetes. Links are also provided to other WHO diabetes related resources.
World Health Organization (2006) Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia: report of a WHO/IDF consultation (PDF 1.61MB)
This document which updates the 1999 'Definition, diagnosis and classification of diabetes mellitus and its complications', resulted from a review of the diagnostic criteria for diabetes, impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) undertaken because of changes made in recommendations from the American Diabetes Association (ADA).
Systematic reviews and evidence summaries
Bandolier: Diabetes risk
Looks briefly at the chance of developing diabetes and the chance of dying with diabetes.
Bandolier: Impaired fasting glycaemia
This looks at a number of studies which consider the risk of progressing to diabetes from impaired fasting glycaemia, what the risk factors are, and interventions for preventing or delaying progression.
Cochrane Review: Alpha-glucosidase inhibitors for people with impaired glucose tolerance or impaired fasting blood glucose
Alpha-glucosidase inhibitors reduce blood glucose levels and this review assesses their effect in patients with impaired glucose tolerance (IGT) or impaired fasting blood glucose (IFBG), or both.
NHS Evidence – diabetes: 2010 Annual Evidence Update on diabetes
This identifies new systematic reviews on diabetes published since the last update in September 2009. It includes a section on prediabetic state and there are links to the previous Annual Evidence Updates.
Other resources
BBC Health: Diabetes
The BBC, as part of their pages on health has put together information under headings such as 'about diabetes', 'living with diabetes', 'treating diabetes', and 'research into diabetes'. Useful contacts and a range of personal stories are also included.
Better testing
This website aims to be an information source on tests for health care professionals, particularly those working in primary care, and assumes knowledge of the context in which the tests are used. Information in each topic area is presented around a series of questions and answers based on evidence that exists particularly in the form of best practice reviews and consensus statements. This is the diabetes topic area.
Diabetes UK: Introduction to diabetes
This part of the Diabetes UK website offers descriptions of the different types of diabetes and discusses causes and risk factors with links to related resources.
Diabetes UK: Diabetes and the body: 'Explaining diabetes' animation
The animation shows how the body works in three contexts - unaffected by diabetes, with type 1 diabetes and with type 2 diabetes.
Diabetes UK: Diabetes Risk Score Assessment Tool
This new assessment tool aims to identify individuals with impaired glucose regulation (IGR) and is designed to predict an individual’s risk of developing type 2 diabetes within the next 10 years. It was developed in collaboration with University of Leicester and University Hospitals of Leicester NHS Trust. Diabetes UK would like to see the Diabetes Risk Score more widely used in preference to the finger prick test as it takes into consideration the risk factors for diabetes. Using a points system which identifies if a person is at low, moderate or high risk appropriate advice is provided in the form of lifestyle changes or a GP referral. To take the test see Diabetes Risk Score.
EQUIP - Electronic Quality Information for Patients: Diabetes
EQUIP is a gateway to quality information focussing on websites that have appropriate information for UK patients and families and that fulfil the quality criteria which are described on the website. Much of the information is generally applicable but some is orientated to people in the West Midlands where the website was developed.
National Diabetes Information Clearinghouse (NDIC). Diabetes dictionary
The NDIC is an information dissemination service of the National Institute of Diabetes and Digestive and Kidney Diseases (NDDK) in the USA. The dictionary aims to provide definitions for words commonly used when people talk or write about diabetes.
Merck Manuals Online Medical Library
Merck & Co, Inc. is a pharmaceutical company and the Merck Manuals are a series of healthcare books for professionals and consumers. The online version is freely available with additional photographs, audio and video material not available in the printed form.
NHS Education for Scotland (NES) The Knowledge Service: Diabetes portal
This is one of the specialist portals provided by the Knowledge Service in Scotland bringing together key resources which can be accessed via topic headings or a search facility. Other parts of the service which includes full text journals and databases are for NHS staff in Scotland and require an Athens password.
NHS Evidence - diabetes: Statistics section
These are resources with significant statistical content.
Yorkshire and Humber Public Health Observatory (YHPHO)(2006) Diabetes key facts
This publication provides key facts on the prevalence and cost of diabetes and its complications, risk factors, what can be done to prevent complications and cost-effectiveness of interventions.