‘It’s about mind-set – not just numbers on the scales’ says specialist at Durham Type 2 diabetes prevention trailblazer site

A specialist from Durham’s trailblazing ‘Just Beat It scheme’ preventing hundreds of people from developing Type 2 Diabetes says ‘it’s about the mind-set not just numbers on the scales’.

The Just Beat It! Team sees up to 65 regular clients a week across Durham and the surrounding areas, delivering education around lifestyle intervention and exercise classes. They also do initial consultations for new clients who have been identified as being at risk of Developing Type 2 Diabetes and the newly diagnosed.

The scheme is one of seven demonstrator sites for the NHS Diabetes Prevention Programme which will roll out nationally next year.

Specialist Kayleigh Eckersley-Morris, a Health Improvement Practitioner from County Durham & Darlington NHS Foundation Trust which runs the scheme alongside Durham’s two Clinical Commissioning Groups (CCGs) and the Council, said results from the 201 people seen so far were ‘incredible’ including one man who lost 2 stone in 20 weeks and another recovering from a stroke who can now run.

She said: “It’s about the individual taking control of their life and what they can do for themselves. The sooner they realise that the sooner they can adapt to it for the future.

“It’s not just about food but about the whole mind-set of the individual. We need to change the way they think psychologically to get results.”

‘Just Beat It’ takes GP or self-referrals from people at a high risk of developing Type 2 diabetes and offers them a two year course of help and support.

The first six months is education and exercise including one education and two exercise classes a week plus 18 months follow-up and support.

Around 50,000 people in the Durham area are estimated to be at high risk or very high risk of developing diabetes and could benefit from the scheme.

In the first 8 months of the programme 201 people at high risk were referred from the NHS Health Check programme. So far 42 people have completed the first 6 months, and 110 are currently enrolled in groups of up to 12.

Kayleigh helps deliver both the education and exercise but says first they check they are mentally ready.

“Generally they turn up and go through the full programme,” she said. “But if not we offer them an alternative. If it’s the physical activity that’s not for them we offer them the education and once they see results from that we move them onto the next exercise cohort a few weeks later.”

In between times they fill in a food and exercise diary and are given a pedometer and encouraged to increase their walking.

The education session is once a week for an hour. It concentrates on a range of topics including: the Eat Well Plate, 5-a-day, portion control, the risks of diabetes, salt, fat and sugar, stress and eating behaviours, preventing relapse and ways to stay motivated.

“One of the most important sessions we do is about the health implications of Type 2 Diabetes. It’s the shock factor to make them realise the reality and the impact it can have on them. A lot of them do not realise the complications. It’s a shock,” Kayleigh added.

Kayleigh, one of a team of four, does an exercise session of 45 mins to an hour immediately after and another later in the week focusing on high intensity activity.

“We explain to people very early on that it’s their own high intensity no-one else’s. We don’t want it to be daunting. We explain to them how it’s done and it puts them at ease.”

The exercises are varied and functional based which include body weight exercises such as lunges, squats, press ups, shoulder press amongst others. As well as some cardio such as walking and running, depending on the ability of the individual.

“We have people with strokes and others who are very overweight and every person takes it at their own pace so there are ways to adapt each exercise. They find they really improve and the results we’ve seen have been absolutely fantastic. But we focus on the practical and for people to be able to bend over and pick things up by squatting or to climb the stairs more easily is a big step.

“People think if they have bad knees or are older then they can’t do the exercises but that’s not true. As long as people don’t have pre-existing conditions and take it gently they can do it. We are all trained to make sure people can push themselves a little bit further and we do that for each individual.”

The NHS DPP is a joint initiative between NHS England, Public Health England (PHE) and Diabetes UK, and aims to significantly reduce the four million people in England otherwise expected to have Type 2 diabetes by 2025.