A Healthier Future: type 2 Diabetes prevention, early detection and intervention: framework

What action will be taken at a National Level?

Success in making a difference to population health will require action at national, local and individual levels. Alongside actions taken by government at a national level this framework aims to provide guidance on how local health and social care partnerships can redesign and co-produce their services to best suit their local demographics.

Awareness campaigns

The Scottish Government will produce a public awareness campaign focused on positive messages around the actions and support available to individuals, which could enable them to reduce their risk of developing type 2 diabetes. This campaign will address misconceptions about the condition, promote healthy weight and aim to reduce stigma^[29]. The campaign will use digital marketing as well as posters and leaflets in various formats available in a variety of health and social care as well as community settings.

Targeted core messages

The development of core messages around healthy weight, type 2 diabetes and wider determinants on health can be very useful in ensuring that across a variety of organisations, settings and media, people are provided with consistent and accurate messages. 

Experts in obesity and diabetes through the prevention sub-committee of the SDG will coordinate a national approach to resources and guidance aligned with the pathways set out below. These core messages will be developed with those ‘at risk’ and diagnosed with of type 2 diabetes, so as to best design messaging and resources that are helpful to them and to ensure they are made available in the most suitable formats and locations.

Working effectively with individual people, families and communities is dependent on a having a well-informed workforce; including Community Planning Partners such as Education, Health, Social Care, Leisure Services and others. People need access to accurate information, the opportunity to learn about current intervention approaches and knowledge on local pathways and services. More information on training available for health and social care professionals can be found here.

Resources

The provision of resources alone will be of limited value. It is important that health professionals and others help to deliver the information to people. There should therefore be two kinds of resources:

• Professional-facing information intended to inform and support professionals to deliver health improvement.
• Public-facing information intended directly for members of the public.

Resources will be developed prior to national adoption of this framework and will be informed by on-going work in this area. The involvement of service and resource users will be important part of this development. This may involve advisory or working groups made up of service users, people at risk and professional stakeholders as well as commissioned pretesting or user testing through a specialist agency.

Resources should adopt some of the approved ‘Core Messages’ as discussed, to ensure consistency and accuracy. At a local or regional level they should also provide information on access to services such as weight management and lifestyle interventions

Resources should be made available in different languages and should be available in a range of mediums to ensure that information is delivered through the right channel for the audience – this may include print, online, face to face, or hard copy DVD.

The resources will be developed for three themes:

I. Awareness of risks associated with the development of type 2 diabetes

There will be a national public campaign to help increase people’s awareness of the risks associated with the development of type 2 diabetes. There will also be targeted awareness raising campaigns via a range of media will help reach those ‘at risk’ of developing type 2 diabetes.

‘At risk’ groups include those known to have an increased risk of type 2 diabetes due to weight, family history or age.

Keeping pathways and messages consistent and clear will improve communication to individuals and help healthcare professionals sign-post individuals to the resources and services they can access locally. This should include what the weight management and lifestyle interventions are, referral and entry  routes, what to expect and how they should indicate their intention to participate.

Resources could be made available in a variety of settings and we will work with people to understand where they would find it helpful to access resources and the format in which those resources would be helpful. This might include:

• All Healthcare premises including hospital clinics, antenatal clinics, secondary care diabetes clinics and other associate medical specialists, GP surgeries, health centres and health hubs
• Pharmacies
• Information packs from health visitors/ community midwives
• Opticians
• Respite centres
• Day-care centres
• Leisure venues
• Support groups
• Community hubs
• Libraries
• Faith centres
• Workplaces
• Homeless services
• Substance misuse services and facilities including recovery communities
• Mental health services and facilities

By working with people to help them become  aware of their risk, we can then offer advice on next steps including speaking to a healthcare professional or access online resources and tools, such as the Diabetes UK “Know your risk” leaflet^[30].

Separate resources would be required to raise awareness of complications associated with diabetes and the benefits of testing for those who are undiagnosed.

II. Information for those ‘at high risk’

Those ‘at high risk ’ include those who are clinically viewed as having pre-diabetes, Impaired Glucose Tolerance (IGT) or Impaired Fasting Hyperglycaemia (IFHG), those with current or previous gestational diabetes or polycystic ovary syndrome (PCOS).

• For patients diagnosed with pre-diabetes (IGT and IFHG) – a targeted leaflet for use by GPs and available online should set out the care pathway and weight management interventions designed for these individuals.
• For patients with gestational diabetes/ previous gestational diabetes – a targeted leaflet for use in antenatal clinics and for midwifes/health visitors to use with postnatal women would be appropriate.

III. Advice on healthy lifestyle, behaviour change, weight loss and maintenance and physical activity

At present these resources are generally locally developed and delivered within the weight management and physical activity programmes. Consolidating consistent messaging and facilitating sharing of resources through platforms such as NHS inform, Nutrition and Diet Resources (NDR UK)^[31], Diabetes UK and NHS Health Scotland including Weight Management Leads group will lead to improved outcomes and reduced variation. These resources should build upon existing resources such as the Physical Activity Pathway^[32].