One could argue that there should already be a national screening programme specifically for T2DM as the prevalence is increasing, it contributes significantly to health inequalities within countries, and leads to significant morbidity and mortality which can be reduced by effective treatment. However, there is as yet no evidence that screening

and earlier interventions improve patient outcomes and reduce mortality; this is the subject of a large RCT.26 In Leicester, patients aged between 40 and 75, and 25–75 if GSI-IX nmr they are South Asian, from 28 practices have been systematically screened for diabetes using an oral glucose

tolerance test.27 Figure 3 shows the prevalence of impaired glucose regulation and T2DM. Follow up of 850 subjects selleck inhibitor with impaired glucose regulation has shown progression rates to T2DM in 12 months to be three-fold higher in South Asian compared to white European subjects.28 We have used the data collected in order to develop a simple and easy way in which to try to identify those at risk of T2DM. The end product is a simple questionnaire which includes seven questions. The score was derived by multiplying the coefficients by 10 and the scores are between 0 to 47. This score with a cut off of ≥16 has a sensitivity for detecting both diabetes and impaired glucose regulation of 80% and a specificity of 45%. This tool

can be used to identify those at high risk of impaired glucose regulation and T2DM.29 It is simple, non-invasive and inexpensive and we hope that it will increase the uptake to screening programmes; indeed, a web-based version is now available via the Diabetes UK website and has already been used by over 20 000 people within the first six weeks.30 I have come to the end of one odyssey here, but any experienced SDHB traveller knows that the end of one journey is only the beginning of another. In the process of this one, I have tried to show that, while some myths about diabetes do contain important truths, others need to be shown as the frauds that they are. Indeed, it is this process of continual myth making and myth breaking which creates a legacy of improved patient care and management of diabetes that is not just focused on biomedical outcomes but also addresses the beliefs and behaviours of patients and health care professionals.

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