Two years (average) before Type 2 diagnosis

People living with Type 2 diabetes are on average waiting more than two years before receiving a diagnosis. There are around 4.8m people living with diabetes in the UK – including, it is estimated, the ‘missing million’, of around 1m who have undiagnosed Type 2 diabetes.

The team of researchers, led by Dr Katie Young at the University of Exeter, analysed data from 200,000 participants of the UK Biobank who did not have a clinical diagnosis of Type 2 diabetes. When participants enter the UK Biobank study – one of the largest health studies in the world – blood samples are taken and their health is monitored over time.

Among the 200,000 people identified, 1% (2,022) had a reported HbA1c (a measure of average blood glucose levels for the last two to three months) of 48mmol/mol (6.5%) or over. This is the threshold at which – when combined with additional measures – Type 2 diabetes is diagnosed.

The researchers linked the Biobank data with the individuals’ GP records and found it took an average of 2.3 years following the elevated HbA1c test to receive a clinical diagnosis of Type 2 diabetes. Almost a quarter of people (23%) had still not received a diagnosis after five years of having elevated blood glucose levels.

The team examined factors associated with an increased delay in receiving a diagnosis and found that women were likely to wait longer for a diagnosis. They also found that having a lower HbA1c within the Type 2 diabetes range, and/or lower BMI, was associated with a delayed diagnosis. The researchers suggest that this was because these people may be less likely to experience symptoms or may be less likely to be given a test to confirm Type 2 diabetes.

The findings build on preliminary data that suggested screening those aged 40–70 years would ensure a timely diagnosis of Type 2 diabetes, allowing people to get the treatment they need to live well and avoid serious, potentially life-altering diabetes complications. They also emphasise the need for increased awareness among healthcare professionals of the importance of Type 2 diabetes checks in women and people of a lower bodyweight.

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