The Healthier You Programme is an evidence-based behaviour change programme that supports people identified as being at high risk of developing type 2 diabetes. It is proven to be effective in reducing the risk of developing type 2 diabetes. Over 9 months, individuals receive personalised support with healthy eating and lifestyle, increasing physical activity and managing their weight. There is no cost to participants.

People aged 18 to 79 with a history of GDM can self-refer. They can do so at any point after they have been diagnosed with GDM; there is no time limit.

People without a history of GDM who are eligible for the programme due to non-diabetic hyperglycaemia cannot self-refer and must be referred by their GP practice with an appropriate blood test result.

The exclusion criteria are the same whether a person is referred or self-refers. These are:

• individuals who have ever been diagnosed with type 2 diabetes
• individuals with an active eating disorder
• individuals with severe/moderate frailty
• individuals who have undergone bariatric surgery in the last 2 years.

Previously, the programme required all individuals with a history of GDM to be referred through general practice (using a referral form) and to have had a blood test result within the previous 12 months (to show that they did not have type 2 diabetes).

Since February 2024, anyone with a history of GDM can either self-refer or be referred to the Healthier You Programme without a blood test result. This includes those who have current GDM (ie are currently pregnant), although they can only start the programme post-pregnancy.

As the GDM self-referral route does not require a blood test result, individuals should be advised of the importance of having blood tests postnatally and annually thereafter, in line with NICE guidance NG3.

General practice may refer using locally agreed referral forms, which include a section to indicate whether the person referred has a history of GDM. If this history is indicated on the referral form, the referral will be accepted without a blood test result, although practices should continue to offer yearly HbA1c testing for people with a history of GDM, in line with NICE guidance.

In addition, practices may direct appropriate patients with a history of GDM to self-refer. This could be facilitated through clinical system searches and appropriate bulk messaging.

By accessing www.england.nhs.uk/healthier-you/gdm-self-referral, individuals can contact their local Healthier You Programme provider by completing a short form or by email or telephone.

Healthcare professionals may signpost people with a history or current GDM diagnosis to the self-referral route by directing them to www.england.nhs.uk/healthier-you/gdm-self-referral and/or sharing the leaflet.

If an individual is found to have type 2 diabetes before starting the programme, they should speak to their GP practice to seek appropriate clinical support and cannot start the programme.

If someone is found to have previously undetected type 2 diabetes after starting the programme, they will be given the option to continue on the Healthier You Programme as they may still benefit from the support to improve nutrition, increase physical activity and achieve a healthy weight. They should also access appropriate clinical support from their GP practice.

The Healthier You Programme provider will notify the GP practice of the self-referral, as long as the individual has given consent to this.