People at risk of diabetes reduce their weight and levels of bad cholesterol after undergoing “lifestyle counselling” in the NHS’s diabetes prevention programme, a major international study has found.
The health service launched the programme in 2016 to help prevent patients in England from developing diabetes through intensive weight loss, diet and exercise goals. Prediabetic patients referred to the scheme attend at least 13 group sessions over nine months. Latest figures from NHS England show that 1.3 million people have been referred to the scheme so far and 120,000 patients are due to take part this year.
It is the largest such project for prediabetic patients globally, and researchers from the UK, Germany, the US and South Africa found strong evidence that people with previously unhealthy lifestyles got “huge benefits” from the scheme.
Justine Davies, a professor of global health at the University of Birmingham and co-author of the study, said: “Our findings clearly demonstrate the huge benefits of intensive lifestyle counselling for improving the health of patients with prediabetes.”
The study analysed data from about 2 million people in England who had had their “diabetes risk” checked by their GP in 2017-18 by measuring their blood sugar. Of these, nearly 21,000 were referred to the diabetes prevention programme.
Those seen by the programme showed substantial reductions in blood glucose levels, BMI, weight, bad cholesterol and triglycerides. On average, patients’ BMI went down by 1.35 kg/m2, while their weight fell by nearly 3kg and their blood sugar also fell. Patients with blood sugar levels just below the threshold for referral to the scheme did not typically get the same improvements, the study found.
Previous research shows that even a small improvement in blood sugar, weight and other risk factors can have a big impact on wider health outcomes, reducing the likelihood of diabetes, kidney disease and cardiovascular disease.
“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,” Davies said.
The findings, published in Nature, offer causal evidence that behaviour change programmes are “a viable diabetes prevention strategy” and could also help other countries tackle their diabetes epidemics, the authors conclude.
“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,” said Julia Lemp from the University of Heidelberg in Germany, one of the lead authors of the research. “Our results show beyond reasonable doubt that investments in programmes such as this should continue.”
Responding to the findings, Partha Kar, NHS England’s national specialty adviser for diabetes, said: “This important study provides further evidence that our world-leading NHS prevention programme is changing lives, supporting hundreds of thousands of people to make sustainable healthy lifestyle changes to reduce their risk of developing type 2 diabetes.”
Type 2 diabetes remained a growing problem that could cause long-term health issues including blindness kidney failure, heart attack, stroke and many common types of cancer, he added. He said anyone concerned about their health should check their risk of diabetes and come forward for support.
Kamila Hawthorne, the chair of the Royal College of GPs, said the report was very encouraging.
She said: “Type 2 diabetes is an increasingly common condition in the UK and GPs, alongside specialists in secondary care, are a frequent port of call for many patients for their ongoing treatment. While it is a treatable and manageable condition, diabetes can have a significant impact on a patient’s quality of life and can increase their chances of developing more serious conditions. The fact that a prevention programme has shown promising results is therefore very welcome news for us and for our patients.
“With the rates of type 2 diabetes set to increase in the UK and globally in the coming years, prevention programmes will be a valuable tool in curbing what could develop into a serious challenge in public health – they deserve greater attention from policymakers.”
Dr Faye Riley, a research communications manager at Diabetes UK, said: “Diabetes is serious, it can be life-changing and diagnoses are on the rise. Without the right care and support, people with diabetes are at risk of serious complications.
“Every week diabetes leads to more than 184 amputations, 770 strokes, 590 heart attacks and more than 2,300 cases of heart failure.”
