- Design
- Cross-sectional and cohort study of national primary care records
- Population
- 2,326,400 adults at high risk of type 2 diabetes, England
- Primary outcome
- Social prescribing referral and incident type 2 diabetes
- Effect
- aHR 1.09 (1.04–1.15) at 0–2 years; 0.88 (0.80–0.97) at ≥3 years
A BJGP study used Oxford-RCGP records from more than 1,800 English practices to follow 2.3 million adults at high risk of type 2 diabetes from 2019 to 2023.
Social prescribing referrals rose from 0.3% to 2.5% of this group. They were more common in women, people in deprived areas, smokers, people with obesity, depression or anxiety, or multimorbidity. Referral was associated with a slightly higher diabetes risk in the first two years (aHR 1.09) but a lower risk from three years (aHR 0.88), and the association turned protective as services matured after the pandemic.
The reach is encouraging: the people referred are those whom traditional prevention programmes often miss. The outcome data are harder to read. Early higher risk may reflect who gets referred, and later benefit may reflect engagement, which was not recorded.
Social prescribing is a reasonable addition for high-risk patients with social needs, but these data do not prove it prevents diabetes.
- Consider social prescribing for high-risk patients whose social circumstances limit lifestyle change
- Keep offering structured diabetes prevention programmes; social prescribing adds to them
- Recheck HbA1c in referred patients as usual; early risk was not lower
- Ask what the patient actually took up, as activity data were not available here
Why it matters
It is reaching the people prevention usually misses, which is half the problem.
Don't overread it
This was observational, with no data on what patients did; it cannot show that social prescribing prevents diabetes.
The statistics, in plain English
An aHR of 0.88 after three years means 12% lower risk, but a reversal from early harm to later benefit is a pattern that confounding can produce.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for family medicine, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free