NHS diabetes programme works, and could become global template – study

The NHS’s Diabetes Prevention Programme could act as a template for other countries in their attempts to tackle the disease, as research has shown this type of nationwide intervention can make a difference.

The programme was launched in 2016 in England and referred adults with high risk of developing diabetes to lifestyle counselling for losing weight. It also encouraged people to take more physical activity and make other lifestyle improvements.

However, doubts remained as to whether it worked or not. Now, an international team of researchers from the UK, Germany, USA, and South Africa have analysed English health data from more than two million patients and found strong evidence that referral to the programme improved the factors that can lead to people developing Type 2 diabetes.

Published in the journal Nature, the research team used statistical methods to reveal how being referred to the programme resulted in improved glycaemic control, as well as reductions in body mass index (BMI), weight, high-density lipoprotein (HDL) cholesterol, and triglycerides.

Co-author Professor Justine Davies, professor of global health research at the University of Birmingham, said: “Our findings clearly demonstrate the huge benefits of intensive lifestyle counselling for improving the health of patients with prediabetes. The evidence also suggests a promising route for improving population health more broadly.

“The positive effects observed in the programme may also extend to other non-communicable diseases such as cancer, which is increasingly thought to be connected to unhealthy lifestyle habits and environments.”

The researchers highlighted that doctors’ scepticism about the effectiveness of lifestyle counselling for successful behaviour change could stem from GPs’ experience that brief counselling – often the only feasible approach in time-constrained consultations – may be of limited benefit.

Lead author Julia Lemp, a doctoral student from the University of Heidelberg in Germany, said: “There is an urgent need to implement population-based measures that prevent diabetes, enhance its early detection, and address cardiovascular risk factors to prevent or delay its progression to complications.

“Investment in structured, intensive behaviour change programmes may help prevent development of Type 2 diabetes whilst reducing the risk of complications from diabetes and cardiovascular events.

“Our results show beyond reasonable doubt that investments in programs such as this should continue. At the same time, there are many people at risk for diabetes who remain underserved by existing care pathways and for whom targeted prevention strategies should be further explored.”

Diabetes prevalence and related deaths continue to rise in most parts of the world. By 2030, the global number of adults with diabetes is expected to reach 578 million – 10% of the world’s adult population.

Earlier this year the charity Diabetes UK warned of an “escalating crisis”, as five million people in the UK were now living with the condition, which is linked to obesity and fast food.

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