The presence of even mild diabetic complications has a significant impact on patients' quality of life. Early diagnosis and treatment is essential to help prevent deterioration of HRQOL in these patients.

Type II (non-insulin-dependent) diabetes mellitus is a common chronic illness with a prevalence as high as 8 % in many countries [1]. In Europe approximately 27 million people suffer from diabetes, 80±90 % of whom have Type II diabetes [2]. Due to increased life expectancy, increased frequency of diagnosis and lifestyle changes, the prevalence of this disease in Europe is expected to increase by 50 % over the next 15 years. Approximately 50 % of people with Type II diabetes are thought to be undiagnosed [3] because its onset is gradual and could precede diagnosis by up to 7 years [4].Diabetes imposes a substantial burden on both individuals [5] and health-care budgets. In the UK, annual diabetes costs were estimated at £ 547 million in 1995, with 64 % of these costs resulting from hospital in-patient care [6]. This large hospital care burden is a result of the treatment of retinal, renal, neuropath-

In the next 30 years Type 2 diabetes will present a serious clinical and financial challenge to the UK NHS.

The Framingham risk equations can be unreliable when applied to the diabetic population, tending to underestimate an individual's probability of progressing to CHD; the equations perform marginally better in women than in men. The use of imputed mean HDL-cholesterol values improved the reliability of the estimates of risk.