Type 2 diabetes and the importance of prevention

The increasing number of people with Type 2 diabetes challenges the NHS and all healthcare systems across the world. Professor Jonathan Valabhji, National Clinical Director for Obesity and Diabetes at NHS England marks the start of Diabetes Prevention Week by providing an insight into the ongoing work to reach people who are at risk in England.

The facts speak for themselves. Around 3.5 million people in England now have Type 2 diabetes. It can cause personal suffering through its complications – it is a leading cause of sight loss and lower limb amputation, and can contribute to kidney failure, heart attack and stroke. Diabetes and its complications cost over £6 billion every year to treat and one in six patients in hospital now has diabetes.

Around nine out of 10 people with diabetes have Type 2 diabetes and there is strong evidence that its onset can be prevented or delayed in those at high risk, through improved quality of diet, through increase in physical activity, and through successful weight loss.

Wherever possible, prevention is preferable to cure and as a result, NHS England has been investing significant effort into reaching people who are at risk of developing Type 2 diabetes. During the last two years, we have been rolling out The Healthier You NHS Diabetes Prevention Programme to help people at high risk of developing Type 2 diabetes reduce that risk and potentially avoid diabetes by getting face to face support.

So far there there has been huge enthusiasm from primary care with over 167,000 people referred and over 71,000 taking up the programme to date – reflecting acceptability by both members of the public and the healthcare professionals involved in the referral process. Three quarters of England already has coverage and with Wave 3 of the programme live from this month, it means we are about to achieve our goal and reach full national coverage – that is an achievement we should be proud of.

Early analyses has been positive and confirmed that just under half of those taking up the programme are men – a much higher proportion than typically attend weight loss programmes, while roughly a quarter are from black, Asian and minority ethnic communities, groups that are at significantly greater risk of developing Type 2 diabetes.

Not only is our prevention programme exceeding the initial targets set for referrals and equity of access, what we are now starting to see is the first set of encouraging weight loss results too. So far well over 50% of people have completed the flagship scheme in terms of attending at least eight support sessions over a nine month period – losing an average of 3.3 kgs. However, when excluding those who already had normal weight and BMI but on the programme due to other health and lifestyle risks associated with developing Type 2 diabetes, this average weight loss figure is 3.7kg, 1kg higher than we had predicted at the outset. If those on our programme continue to lose weight, as this snapshot suggests, then it is a step in the right direction and this programme can be an effective part of the solution.

We also launched a digital stream of the NHS DPP in November 2017 – with services implemented in eight areas as part of a major evaluation. In the first two months of the programme nearly 1,400 people have been referred onto the programme with more than 820 logging on and accessing diabetes and obesity prevention services through the touch of a button. We aim to have recruited 5,000 people onto these services during 2017/18.

Behaviour and lifestyle change is a challenge for us all but for those with diabetes and at risk of Type 2 diabetes it takes on an even greater focus – by putting people in control of their health the programme is helping improve the outlook of thousands of people and hopefully next year this will add up to many more thousands as the gift of technology extends our horizons.

Diabetes Prevention Week takes place from 16-22 April 2018. Free toolkits were made available in advance of the week for local areas to run their own prevention events; an estimated 5,000 events are taking place across England. A number of printable and online resources are also available from the Public Health England Campaign Resource Centre and you can find out what’s going on and join in the conversation on social media by following the hashtag #PreventingType2.

Find out more about the NHS Diabetes Prevention Programme.

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.


  1. syamsul says:

    Diabetes or Diabetes Mellitus (DM) is a disease in which the body is unable to control the concentration of blood sugar in the body. In general DM is divided into two types. Type 1 is a type of diabet that occurs in children or young adults (less than 40 years).

    This disorder is caused due to congenital abnormalities regarding chromosomal factors. In this type of pancreatic cells fail to produce the hormone insulin (blood sugar regulating hormone)…

  2. Rajeev Samuel says:

    Carbohydrates cause diabetes, cancer, obesity, liver disease and heart disease. All carbohydrates break down into glucose, fructose and (alcohol), all of which cause insulin resistance.