NHS Diabetes Prevention Programme: What You Need to Know

Who is eligible?

Eligibility is clinical: adults (18+) with non‑diabetic hyperglycaemia (NDH), commonly called prediabetes. NDH is defined in UK guidance as an HbA1c between 42–47 mmol/mol (6.0–6.4%) or a fasting plasma glucose 5.5–6.9 mmol/L in people without a diagnosis of diabetes. NICE and NHS guidance use these thresholds to identify those most likely to benefit from the programme. People may be identified via routine blood tests at GP appointments, an NHS Health Check (available to eligible people aged 40–74) or targeted screening in higher risk groups. ([nice.org.uk](https://www.nice.org.uk/guidance/qs209/chapter/Quality-statement-1-Preventing-type-2-diabetes?utm_source=openai))

How referral and joining works

If your GP, nurse or pharmacist finds an HbA1c or fasting glucose in the NDH range they can offer a referral to the local NHS diabetes prevention programme. Referral pathways vary slightly by area but commonly include an invitation letter or direct referral to a local provider; many areas also provide a digital stream for people who prefer an online programme. Some practices run searches to identify people with recent NDH results and proactively invite them. NHS Digital and local NHS teams publish regional data on referrals and uptake. ([digital.nhs.uk](https://digital.nhs.uk/data-and-information/publications/statistical/national-diabetes-audit-ndh-dpp/ndh-dpp-2021-22-overview?utm_source=openai))

What the programme includes (face-to-face and digital)

The NHS diabetes prevention programme follows an evidence‑based structure focused on three core goals: achieving and maintaining a healthy weight where appropriate, meeting UK dietary recommendations, and meeting physical activity guidelines. The core components are:

• Structured behaviour-change sessions (group face‑to‑face or online) led by trained facilitators;
• Practical advice on diet — portion control, reductions in free sugars and saturated fat, and increasing fibre and vegetables;
• Gradual increases in physical activity up to the Chief Medical Officer recommendations (e.g. 150 minutes of moderate activity per week where possible);
• Goal setting, self-monitoring (weight, food diaries, activity) and relapse prevention; and
• Access to peer support and follow‑up contact to maintain changes after the core course ends. ([pmc.ncbi.nlm.nih.gov](https://pmc.ncbi.nlm.nih.gov/articles/PMC7158071/?utm_source=openai))

The digital stream offers interactive modules, remote coach support, activity trackers and online groups; evaluations show digital and face‑to‑face options can both be effective, and having a choice improves engagement. ([england.nhs.uk](https://www.england.nhs.uk/diabetes/digital-innovations-to-support-diabetes-outcomes/nhs-diabetes-prevention-programme-digital-stream/?utm_source=openai))

What the evidence says: effectiveness & outcomes

Large-scale national evaluations and research programmes (for example the DIPLOMA evaluation) indicate that the NHS diabetes prevention programme reduces progression to type 2 diabetes at population level when people engage and complete the recommended sessions. In routine practice the magnitude of benefit tends to be smaller than in tightly controlled trials, but at scale the public‑health impact is substantial because of the number of people reached. A matched cohort analysis found a small but significant reduction in conversion from NDH to type 2 diabetes among those referred. ([ncbi.nlm.nih.gov](https://www.ncbi.nlm.nih.gov/books/NBK614155/?utm_source=openai))

Typical intermediate outcomes reported include modest weight loss (often 3–5% body weight among completers) and small reductions in HbA1c within the NDH range. The benefit is greatest among people who complete the programme and sustain behaviour changes. National monitoring shows uptake and completion vary across providers and population groups — improving retention is a priority for maximising impact. ([ncbi.nlm.nih.gov](https://www.ncbi.nlm.nih.gov/books/NBK614155/?utm_source=openai))

Inequalities, barriers and who may be missed

National and academic reports highlight gaps. Younger adults, people living in more deprived areas and some minority groups are less likely to be identified, referred or to complete the programme. Local NHS teams are working to tailor services — for example offering out‑of‑hours sessions, translated materials, childcare‑friendly sessions and community‑based delivery — to reduce access barriers and improve equity. Monitoring and targeted outreach remain important. ([pmc.ncbi.nlm.nih.gov](https://pmc.ncbi.nlm.nih.gov/articles/PMC11316385/?utm_source=openai))

Practical tips: how to prepare and get the most from the programme

If you are referred or are offered the programme, here are practical steps to increase your chances of benefit:

• Choose the format you can stick to: if travel or work shifts make groups hard, consider the digital stream. Research and user surveys show choice increases engagement. ([diabetes.org.uk](https://www.diabetes.org.uk/professionals/resources/shared-practice/nhs-diabetes-prevention-programme/discovery?utm_source=openai))
• Set small, specific goals (for example: lose 2–3% of body weight in 3 months; walk 15 minutes extra each day). Evidence supports goal setting and self-monitoring. ([ncbi.nlm.nih.gov](https://www.ncbi.nlm.nih.gov/books/NBK614155/?utm_source=openai))
• Use simple tools: weigh weekly, use a smartphone for step counts or activity, keep a short food diary to spot high‑calorie habits.
• Ask for reasonable adjustments if you have a disability, caring responsibilities, or English isn’t your first language — providers should accommodate these needs. ([nice.org.uk](https://www.nice.org.uk/guidance/qs209/chapter/Quality-statement-1-Preventing-type-2-diabetes?utm_source=openai))
• If you’re on medications, discuss with your GP or pharmacist how weight loss or dietary changes may affect doses (for example blood pressure or diabetes medications). Keep the team informed if you experience dizziness, fainting or symptoms of low blood sugar.

When to contact your GP or pharmacist

Contact your GP, practice nurse or community pharmacist if you have any of the following:

• Your blood tests show HbA1c 42–47 mmol/mol or fasting glucose 5.5–6.9 mmol/L and you haven’t been offered referral to the NHS diabetes prevention programme;
• You experience symptoms suggestive of diabetes (increased thirst, frequent urination, unexplained weight loss) — these require prompt assessment and may indicate established diabetes rather than NDH;
• You’re on medication that may change with weight loss or changes in diet and activity; or
• You would like an NHS Health Check (available to people aged 40–74) to assess cardiovascular and diabetes risk. ([england.nhs.uk](https://www.england.nhs.uk/diabetes/diabetes-prevention/?utm_source=openai))

Key scientific references and resources

1. NHS England — Healthier You: NHS Diabetes Prevention Programme (programme overview). ([england.nhs.uk](https://www.england.nhs.uk/diabetes/diabetes-prevention/?utm_source=openai))
2. National Institute for Health and Care Excellence (NICE) — PH38 / quality statements: definitions of non‑diabetic hyperglycaemia (HbA1c 42–47 mmol/mol; FPG 5.5–6.9 mmol/L). ([nice.org.uk](https://www.nice.org.uk/guidance/qs209/chapter/Quality-statement-1-Preventing-type-2-diabetes?utm_source=openai))
3. Diabetes Prevention — Long‑term Multimethod Assessment (DIPLOMA) evaluation — comprehensive assessment of the NHS DPP (NCBI Bookshelf). ([ncbi.nlm.nih.gov](https://www.ncbi.nlm.nih.gov/books/NBK614155/?utm_source=openai))
4. National Diabetes Audit / NHS Digital — NDH and DPP reports (programme data and monitoring). ([digital.nhs.uk](https://digital.nhs.uk/data-and-information/publications/statistical/national-diabetes-audit-ndh-dpp/ndh-dpp-2021-22-overview?utm_source=openai))
5. BMJ Open — formative evaluation of the NHS DPP early implementation. ([bmjopen.bmj.com](https://bmjopen.bmj.com/content/8/2/e019467?utm_source=openai))
6. BMJ Diabetes Research & Care — observational study on point‑of‑care HbA1c testing within the DPP. ([drc.bmj.com](https://drc.bmj.com/content/bmjdrc/8/2/e001703.full.pdf?utm_source=openai))
7. Diabetes UK — partnership resources and participant surveys (patient choice and experience). ([diabetes.org.uk](https://www.diabetes.org.uk/professionals/resources/shared-practice/nhs-diabetes-prevention-programme/discovery?utm_source=openai))
8. GOV.UK — Diabetes profile statistical commentary (April 2026 update) discussing NDH definitions and population prevalence. ([gov.uk](https://www.gov.uk/government/statistics/diabetes-profile-update-april-2026/diabetes-profile-statistical-commentary-april-2026?utm_source=openai))
9. British Heart Foundation — facts about diabetes prevalence and links to cardiovascular risk in the UK. ([bhf.org.uk](https://www.bhf.org.uk/diabetes?utm_source=openai))