Type 2 diabetes prevention is better than cure

Senior GP Neel Basudev explains how all healthcare professionals can play a role in preventing Type 2 Diabetes.

I have always believed the old adage that prevention is better than cure. My initial forays into the world of diabetes were based around type 2 diabetes prevention and I am still struck by how many people are at risk of developing type 2 diabetes – now at a record high of two million – and how it always feels like we are playing catch up with the disease.

Whatever figures you look at for type 2 diabetes, the numbers are simply staggering. Whether it is the prevalence, cost or complications, it is clear something needs to be done to prevent and slow down disease development.

That is why it is very encouraging to see early outcomes from the Healthier You: NHS Diabetes Prevention Programme published recently in the Diabetes Care journal.

In South London, we have been actively referring into the programme since its inception. It is a long programme, but it needs to be in order to help facilitate and sustain behaviour change and weight loss. For most people, this is a disease many years in the making and so the solution is not a quick fix.

We have a population of around 3.5 million people in South London which includes a population of about 275,000 people at risk of developing type 2 diabetes. Prevention is particularly important for South London as we have large pockets of deprivation and black and minority ethnic (BME) populations. BME populations are two to six times more likely to develop type 2 diabetes than their peers of European descent and at an earlier age.

We have a real opportunity to help people here and prevent type 2 diabetes. Some people live with type 2 diabetes for up to 10 years before being diagnosed and many more years being at risk of developing it. This only serves to increase risks of complications but also means we have a huge window of opportunity to make a difference which should be grasped with both hands.

Having the opportunity to provide this kind of long-term support to make general improvements to health is beneficial to both healthcare professionals and patients.

Having worked across several different transformational projects, it cannot be underestimated how challenging it is to get a large project like the Healthier You programme, with many different moving parts, off the ground. There is no other national programme in the world that has achieved total population coverage. That achievement should be applauded.

The volume of referrals over the two and a half years since programme inception is incredible. Latest figures show around half a million people have been referred so far, and the combined weight loss of the 90,000 people that have completed the programme so far equates to the same as 43 ambulances (or 185,000kgs).

We have done well to get a good amount of referrals from those who are most deprived and from BME populations but we need to get more people from both of these groups to complete the programme. People who are of older age are also more likely to complete the programme and so we also need to be mindful that younger age groups get good access to the Healthier You programme; which is being done with the roll out of a digital version of the programme.

In order to reach the NHS Long Term Plan target of 200,000 referrals per year into the programme, all healthcare professionals need to learn about Healthier You and promote it in their local communities. Luckily, it has never been easier to do just that with a free CPD-accredited e-learning module on the programme and a national Type 2 Diabetes Prevention Week campaign (20-26 April 2020) just around the corner with free materials that healthcare professionals can order to support.

Given type 2 diabetes prevalence and burden to healthcare systems it is in everyone’s interest to raise awareness of the Healthier You programme. I have just ordered my Type 2 Diabetes Prevention Week toolkit and I would encourage others to do so and to think creatively about ways to make type 2 diabetes prevention a sustainable part of routine clinical care.

Neel Basudev

Neel Basudev is Senior GP Partner at Springfield Medical Centre in Lambeth, Clinical Director Diabetes at Health Innovation Network (South London Academic Health Science Network) and Out of Hospital Lead.

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