(C317. in EMIS or XaaeP in SystmOne)

• Code Diabetes type if possible
• Refer if suspected Type 1 or Pregnant or MODY
• Refer structured education
• Refer retinal screening
• Arrange regular follow up
• Refer to Remission programme if eligible
• Carry out mental health screening (PHQ4 in primary and community care OR DDS2 in secondary care) and consider referral to IAPT or other relevant part of local pathway if positive

● Progression to insulin within 3 years
● BMI (< 25 for sens/spec*)
● Age at diagnosis (< 30 for sens/spec* other guidelines < 35)
● Weight loss
● Diagnosis HbA1c (>115 mmol/mol) or Glucose (>20mmol/L)
● Lack of FH diabetes
● Osmotic symptoms 
● DKA
● Other autoimmune disease

● BMI at diagnosis > 25
● Absence of weight loss
● Absence of Ketoacidosis
● Less marked hyperglycaemia
● Weak discriminators - Non-white ethnicity  

● Age < 35 
● HbA1c < 58 mmol/mol at diagnosis
● Parent with Diabetes
● Features of a specific monogenic cause (e.g., 
      renal cysts, 
      partial lipodystrophy, 
      maternally inherited deafness, and 
      severe insulin resistance in the absence of obesity)
● Monogenic diabetes prediction model probability >5%

● Progression to insulin within 3 years
● BMI (< 25 for sens/spec*)
● Age at diagnosis (< 30 for sens/spec* other guidelines < 35)
● Weight loss
● Diagnosis HbA1c (>115 mmol/mol) or Glucose (>20mmol/L)
● Lack of FH diabetes
● Osmotic symptoms 
● DKA
● Other autoimmune disease

● BMI at diagnosis > 25
● Absence of weight loss
● Absence of Ketoacidosis
● Less marked hyperglycaemia
● Weak discriminators - Non-white ethnicity  

● Age < 35 
● HbA1c < 58 mmol/mol at diagnosis
● Parent with Diabetes
● Features of a specific monogenic cause (e.g., 
      renal cysts, 
      partial lipodystrophy, 
      maternally inherited deafness, and 
      severe insulin resistance in the absence of obesity)
● Monogenic diabetes prediction model probability >5%

• ● Severe osmotic symptoms (nocturia x 3-4)
• ● Short history (weeks)
• ● Marked weight loss (irrespective of absolute weight)
• ● A first degree relative with Type 1 Diabetes
• ● A personal history of autoimmune disease