Tackling diabetes is one of the biggest healthcare challenges of our time

To mark Diabetes Week, NHS England’s National National Clinical Director for Obesity and Diabetes, Professor Jonathan Valabhji offers an insight into the thinking behind the Healthier You NHS Diabetes Prevention Programme.

Tackling diabetes is one of the biggest healthcare challenges of our time, as the number of people with Type 2 diabetes continues to rise. The facts speak for themselves – it’s currently estimated that 3.4 million have Type 2, while a further five million are currently at risk of developing it. In addition, the cost of treating Type 2 diabetes is thought to be roughly £8.8 billion every year and it is a leading cause of sight loss and lower limb amputation, and can contribute to kidney failure, heart attack, and stroke

It is therefore crucial that we have a joined approach to tackling not just the prevention of Type 2 diabetes but also the successful management of all forms of diabetes and essential that we support the spread of evidence based interventions to help reduce the harm that diabetes can cause.

It has been proven that Type 2 diabetes can be delayed or prevented in those known to be at high risk through lifestyle interventions that promote better nutrition, weight loss, and increased physical activity. The Healthier You NHS Diabetes Prevention Programme is part of a wider package of measures to support people with diabetes and those on the cusp of it, to stay fit, well and prevent further deterioration.

The programme, which is run collaboratively by NHS England, Public Health England and Diabetes UK, was officially launched last year. As set out in the recently published Next steps on the NHS Five Year Forward View, the ambition is for the programme to eventually cover the whole of the country and figures could rise to as many as 200,000 referrals of people at high risk of Type 2 diabetes and more than 80,000 people on programmes by 2018/19.

Those referred on to the programme will get tailored, personalised help to reduce risk. This will include education on healthy eating and lifestyle choices, reducing weight through bespoke physical exercise programmes and portion control, which together have been proven to reduce the risk of developing Type 2 diabetes.

The evidence from implementation of diabetes prevention programmes internationally suggest that Healthier You: the NHS Diabetes Prevention programme is likely to be highly effective in those who accept the invitation, and commit to the programme. But behaviour change is challenging to individuals, as is achieving it on a population scale. We know we have to do more than make the intervention available, and we need others to support us in getting the maximum uptake – primary care professionals can endorse the programme and encourage their patients to participate; communities can support those that are seeking opportunities to improve their diet and physical activity levels; individuals starting out on the challenge need support from their own social networks.

We cannot just sit back – we have to take action on prevention and public health and this programme can be an effective part of the solution.

Professor Jonathan Valabhji

Professor Jonathan Valabhji is National Clinical Director for Obesity and Diabetes at NHS England.

He is a Consultant Diabetologist at St Mary’s Hospital, Imperial College Healthcare NHS Trust in West London and so remains highly active at the clinical coalface. The published clinical outcomes from his Multidisciplinary Diabetic Foot Service at the Trust are comparable to the best centres internationally. He is Adjunct Professor at Imperial College London, with a current research focus on diabetic foot disease as well as on diabetes population level health, and past publications on cardiovascular disease in diabetes. He is a committee member of the Association of British Clinical Diabetologists.

As National Clinical Director, he is currently providing clinical leadership around a number of national initiatives, including the NHS Diabetes Prevention Programme, a collaboration between NHS England, Public Health England and Diabetes UK that aims to cause England to be the first country to implement at scale a national evidence-based Type 2 diabetes prevention programme.