Complete guide to NHS diabetes care in the UK — National Diabetes Audit (NDA), continuous glucose monitoring (CGM), structured education, NHS Diabetes Prevention Programme, and diabetes software.
4.7 million people in the UK have diabetes, costing the NHS £10 billion annually — 10% of the NHS budget. The NHS Diabetes Programme is the largest in the world. This guide covers diabetes care, audit, and technology.
NHS Diabetes Care Components
| Component | Description | Target |
|---|---|---|
| Annual review | 8 care processes for all diabetics | 100% completion |
| HbA1c check | Every 3-6 months | 100% annually |
| Retinal screening | Annual diabetic eye screening | 100% annually |
| Foot check | Annual foot risk assessment | 100% annually |
| Structured education | DESMOND (T2), DAFNE (T1) within 1 year | 75%+ attendance |
| CGM (Type 1) | Continuous glucose monitoring | 100% of T1 |
| Flash GM (Type 2) | FreeStyle Libre for eligible T2 | 50%+ of insulin T2 |
| Prevention programme | NHS DPP for pre-diabetes | 200K referrals/year |
NDA Care Processes & Treatment Targets
- Care process 1: HbA1c measurement (target: 100% annually)
- Care process 2: Blood pressure measurement
- Care process 3: Cholesterol measurement
- Care process 4: Foot risk assessment
- Care process 5: Retinal screening
- Care process 6: Urine albumin (kidney function)
- Care process 7: BMI measurement
- Care process 8: Smoking status
- Treatment target 1: HbA1c < 58 mmol/mol
- Treatment target 2: BP < 140/80
- Treatment target 3: Cholesterol < 5 mmol/L
NHS Diabetes Prevention Programme (DPP)
- Identification: NHS DPP identifies pre-diabetic patients (HbA1c 42-47)
- Referral: GP refers to 9-month lifestyle change programme
- Programme: 13 sessions covering nutrition, exercise, behaviour change
- Digital option: Digital DPP via apps (Oviva, Second Nature)
- Impact: Reduces Type 2 progression by 20-40%
- Scale: 200,000 referrals per year — largest prevention programme globally
Frequently Asked Questions
- How many people have diabetes in the UK?
- 4.7 million people in the UK have diabetes (90% Type 2, 8% Type 1, 2% other). 13.6 million have increased risk of Type 2. Diabetes costs the NHS £10 billion annually — 10% of the NHS budget. Every week diabetes causes 160 amputations, 770 strokes, and 590 heart attacks.
- What is the National Diabetes Audit (NDA)?
- The NDA is the national clinical audit for diabetes. It measures: 1) Care processes (HbA1c, BP, cholesterol, foot check, eye check, urine test), 2) Treatment targets (HbA1c < 58, BP < 140/80, cholesterol < 5), 3) Structured education attendance, 4) CGM uptake. All NHS trusts and GP practices must submit NDA data.
- Who gets CGM on the NHS?
- NHS England provides CGM (continuous glucose monitoring) to: 1) All Type 1 diabetes patients (target 100%), 2) Type 2 patients on insulin (target 50%+), 3) Type 2 patients with hypoglycaemia risk. Flash glucose monitoring (FreeStyle Libre) is available to all Type 1 and eligible Type 2 patients. CGM reduces HbA1c by 0.5-1%.