Primary care nurses can target efforts to prevent type 2 diabetes by measuring patients’ waist circumference, according to a new definition of metabolic syndrome announced recently by the International Diabetes Federation. The definition focuses on excess abdominal fat – which results in people being ‘apple’ shaped – as a key contributor to the development of the dangerous mix of impaired glucose control, hypertension and hyperlipidaemia that sets people on the road to type 2 diabetes. Just looking at people’s body shape as they come into the surgery, measuring their waist size and taking steps to reduce it where indicated, can help in the ongoing fight against the disease.