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.

Jonathan Valabhji

Professor Jonathan Valabhji is National Clinical Lead for Multiple Long-Term Conditions at NHS England, having been National Clinical Director for Diabetes and Obesity between 2013 and September 2023. He is Clinical Chair in Medicine at Imperial College London and Honorary Consultant Diabetologist at Chelsea and Westminster Hospital NHS Foundation Trust.

As well as a practising clinician and researcher, over the last decade he established and led the NHS England diabetes and obesity programmes, with a broad portfolio of national workstreams focusing on lifestyle interventions, clinical care, and technological support for diabetes self-management. He has led rapid translation of high-quality research into national policy and practice and has established models for evaluation to assess translational impact.

He successfully made the case for, and led implementation of, the NHS Diabetes Prevention Programme, the NHS flagship prevention programme. By 2018 England became the first country to achieve universal population coverage with an evidence-based type 2 diabetes prevention programme, with over 1.3 million people now referred in, and latest evidence suggesting reduced type 2 diabetes incidence in both programme participants and at population level associated with programme implementation.

He qualified in 1990 from St Bartholomew’s Hospital Medical College, London, and in 2019 was awarded OBE in the Queen’s New Year Honours List for services to diabetes and obesity care.