Detection of prediabetes and undiagnosed type 2 diabetes in underserved communities using community pharmacy point‐of‐care testing: A prospective feasibility study

Andrew Radley; Lewis J. Beer; Albert Farre; Petra Rauchhaus; George Thom; Calum Sutherland

doi:10.1111/dme.70368

Detection of prediabetes and undiagnosed type 2 diabetes in underserved communities using community pharmacy point‐of‐care testing: A prospective feasibility study

Andrew Radley (Lead / Corresponding author)
, Lewis J. Beer
, Albert Farre
, Petra Rauchhaus
, George Thom
, Calum Sutherland

Research output: Contribution to journal › Article › peer-review

13 Downloads (Pure)

Abstract

Aims
Early detection of type 2 diabetes (T2D) and prediabetes is critical to reduce disease burden, yet disadvantaged populations often remain undiagnosed. We assessed a pharmacy-based pathway using verified point-of-care HbA1c testing to identify prediabetes and enable engagement with a digital prevention programme and established the detection rates for undiagnosed T2D.

Methods
We conducted a prospective feasibility study across 16 community pharmacies in NHS Tayside, Scotland (Feb 2024–Jan 2025). Adults at high risk of T2D, identified using the Diabetes UK ‘Know Your Risk’ tool, were offered HbA1c testing. Participants with HbA1c 42–47 mmol/mol (6.0–6.4%) were referred directly to a digital diabetes prevention programme (DDP); those with HbA1c ≥48 mmol/mol (6.5%) were advised to attend their GP. Comparator data were drawn from GP patients identified for engagement with the same DPP.

Results
Of 499 pharmacy participants, 75 (15%) had prediabetes; 38 (51%) enrolled in DPP. Nineteen (4%) had HbA1c ≥48 mmol/mol (6.5%); 17 attended GP. Compared with GP-identified prediabetes (951 patients; 212 enrolled, 32%), pharmacy-based recruitment doubled DDP engagement (RR 2.08, 95% CI 1.61–2.67). Pharmacy recruited relatively younger participants from more deprived backgrounds (63% SIMD 1–2 vs. 33% in GP cohort).

Conclusion
Community pharmacies provided effective, equitable access to HbA1c testing and diabetes prevention, identifying individuals with prediabetes and undiagnosed T2D being missed by current pathways and doubling engagement of this underserved population with DPP. Pharmacy-based screening offers a scalable opportunity to reduce health inequalities and expand primary care capacity.

Original language	English
Article number	e70368
Number of pages	11
Journal	Diabetic Medicine
Volume	43
Issue number	7
Early online date	15 May 2026
DOIs	https://doi.org/10.1111/dme.70368
Publication status	Published - Jul 2026

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

community pharmacy
diabetes
missingness
point-of-care
prevention
primary care

ASJC Scopus subject areas

Internal Medicine
Endocrinology, Diabetes and Metabolism
Endocrinology

Access to Document

10.1111/dme.70368Licence: CC BY

Final Published VersionFinal published version, 841 KBLicence: CC BY

Cite this

@article{769846a15d3d4600a05ab11b22273206,

title = "Detection of prediabetes and undiagnosed type 2 diabetes in underserved communities using community pharmacy point‐of‐care testing: A prospective feasibility study",

abstract = "Aims Early detection of type 2 diabetes (T2D) and prediabetes is critical to reduce disease burden, yet disadvantaged populations often remain undiagnosed. We assessed a pharmacy-based pathway using verified point-of-care HbA1c testing to identify prediabetes and enable engagement with a digital prevention programme and established the detection rates for undiagnosed T2D. Methods We conducted a prospective feasibility study across 16 community pharmacies in NHS Tayside, Scotland (Feb 2024–Jan 2025). Adults at high risk of T2D, identified using the Diabetes UK {\textquoteleft}Know Your Risk{\textquoteright} tool, were offered HbA1c testing. Participants with HbA1c 42–47 mmol/mol (6.0–6.4\%) were referred directly to a digital diabetes prevention programme (DDP); those with HbA1c ≥48 mmol/mol (6.5\%) were advised to attend their GP. Comparator data were drawn from GP patients identified for engagement with the same DPP. Results Of 499 pharmacy participants, 75 (15\%) had prediabetes; 38 (51\%) enrolled in DPP. Nineteen (4\%) had HbA1c ≥48 mmol/mol (6.5\%); 17 attended GP. Compared with GP-identified prediabetes (951 patients; 212 enrolled, 32\%), pharmacy-based recruitment doubled DDP engagement (RR 2.08, 95\% CI 1.61–2.67). Pharmacy recruited relatively younger participants from more deprived backgrounds (63\% SIMD 1–2 vs. 33\% in GP cohort). Conclusion Community pharmacies provided effective, equitable access to HbA1c testing and diabetes prevention, identifying individuals with prediabetes and undiagnosed T2D being missed by current pathways and doubling engagement of this underserved population with DPP. Pharmacy-based screening offers a scalable opportunity to reduce health inequalities and expand primary care capacity.",

keywords = "community pharmacy, diabetes, missingness, point-of-care, prevention, primary care",

author = "Andrew Radley and Beer, \{Lewis J.\} and Albert Farre and Petra Rauchhaus and George Thom and Calum Sutherland",

note = "Publisher Copyright: {\textcopyright} 2026 The Author(s). Diabetic Medicine published by John Wiley \& Sons Ltd on behalf of Diabetes UK.",

year = "2026",

month = jul,

doi = "10.1111/dme.70368",

language = "English",

volume = "43",

journal = "Diabetic Medicine",

issn = "0742-3071",

publisher = "Wiley-Blackwell",

number = "7",

}

Detection of prediabetes and undiagnosed type 2 diabetes in underserved communities using community pharmacy point‐of‐care testing: A prospective feasibility study. / Radley, Andrew (Lead / Corresponding author); Beer, Lewis J.; Farre, Albert et al.
In: Diabetic Medicine, Vol. 43, No. 7, e70368, 07.2026.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Detection of prediabetes and undiagnosed type 2 diabetes in underserved communities using community pharmacy point‐of‐care testing: A prospective feasibility study

AU - Radley, Andrew

AU - Beer, Lewis J.

AU - Farre, Albert

AU - Rauchhaus, Petra

AU - Thom, George

AU - Sutherland, Calum

PY - 2026/7

Y1 - 2026/7

N2 - Aims Early detection of type 2 diabetes (T2D) and prediabetes is critical to reduce disease burden, yet disadvantaged populations often remain undiagnosed. We assessed a pharmacy-based pathway using verified point-of-care HbA1c testing to identify prediabetes and enable engagement with a digital prevention programme and established the detection rates for undiagnosed T2D. Methods We conducted a prospective feasibility study across 16 community pharmacies in NHS Tayside, Scotland (Feb 2024–Jan 2025). Adults at high risk of T2D, identified using the Diabetes UK ‘Know Your Risk’ tool, were offered HbA1c testing. Participants with HbA1c 42–47 mmol/mol (6.0–6.4%) were referred directly to a digital diabetes prevention programme (DDP); those with HbA1c ≥48 mmol/mol (6.5%) were advised to attend their GP. Comparator data were drawn from GP patients identified for engagement with the same DPP. Results Of 499 pharmacy participants, 75 (15%) had prediabetes; 38 (51%) enrolled in DPP. Nineteen (4%) had HbA1c ≥48 mmol/mol (6.5%); 17 attended GP. Compared with GP-identified prediabetes (951 patients; 212 enrolled, 32%), pharmacy-based recruitment doubled DDP engagement (RR 2.08, 95% CI 1.61–2.67). Pharmacy recruited relatively younger participants from more deprived backgrounds (63% SIMD 1–2 vs. 33% in GP cohort). Conclusion Community pharmacies provided effective, equitable access to HbA1c testing and diabetes prevention, identifying individuals with prediabetes and undiagnosed T2D being missed by current pathways and doubling engagement of this underserved population with DPP. Pharmacy-based screening offers a scalable opportunity to reduce health inequalities and expand primary care capacity.

AB - Aims Early detection of type 2 diabetes (T2D) and prediabetes is critical to reduce disease burden, yet disadvantaged populations often remain undiagnosed. We assessed a pharmacy-based pathway using verified point-of-care HbA1c testing to identify prediabetes and enable engagement with a digital prevention programme and established the detection rates for undiagnosed T2D. Methods We conducted a prospective feasibility study across 16 community pharmacies in NHS Tayside, Scotland (Feb 2024–Jan 2025). Adults at high risk of T2D, identified using the Diabetes UK ‘Know Your Risk’ tool, were offered HbA1c testing. Participants with HbA1c 42–47 mmol/mol (6.0–6.4%) were referred directly to a digital diabetes prevention programme (DDP); those with HbA1c ≥48 mmol/mol (6.5%) were advised to attend their GP. Comparator data were drawn from GP patients identified for engagement with the same DPP. Results Of 499 pharmacy participants, 75 (15%) had prediabetes; 38 (51%) enrolled in DPP. Nineteen (4%) had HbA1c ≥48 mmol/mol (6.5%); 17 attended GP. Compared with GP-identified prediabetes (951 patients; 212 enrolled, 32%), pharmacy-based recruitment doubled DDP engagement (RR 2.08, 95% CI 1.61–2.67). Pharmacy recruited relatively younger participants from more deprived backgrounds (63% SIMD 1–2 vs. 33% in GP cohort). Conclusion Community pharmacies provided effective, equitable access to HbA1c testing and diabetes prevention, identifying individuals with prediabetes and undiagnosed T2D being missed by current pathways and doubling engagement of this underserved population with DPP. Pharmacy-based screening offers a scalable opportunity to reduce health inequalities and expand primary care capacity.

KW - community pharmacy

KW - diabetes

KW - missingness

KW - point-of-care

KW - prevention

KW - primary care

U2 - 10.1111/dme.70368

DO - 10.1111/dme.70368

M3 - Article

SN - 0742-3071

VL - 43

JO - Diabetic Medicine

JF - Diabetic Medicine

IS - 7

M1 - e70368

ER -

Detection of prediabetes and undiagnosed type 2 diabetes in underserved communities using community pharmacy point‐of‐care testing: A prospective feasibility study

Abstract

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

Fingerprint

Cite this