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World Diabetes Day 2018 – An update from the NHS Diabetes Programme team

It’s been a busy year for the NHS Diabetes Programme. This Summer, and coinciding with the NHS’s 70th Birthday, England became the first country in the world to achieve full national coverage with a Type 2 diabetes prevention programme. From launch in June 2016, the Healthier You: NHS Diabetes Prevention Programme (NHS DPP) has seen over a quarter of a million people referred in.

The results of early analyses show that both numbers of referrals and the proportion of those referred that attend, are higher than anticipated.  Men are at slightly higher risk than women, and nearly half – 45% – of those who attended an initial assessment are men, whereas experience of attendance at weight loss programmes has tended to see the proportion of men at only 10-20%. With good initial attendance amongst those from the most deprived areas and amongst those of non-white ethnicity, groups who are at significantly greater risk of developing Type 2 diabetes, the programme appears to be reaching those who are both at greater risk and who typically access healthcare less effectively.

This time last year we announced the launch of the digital stream of the NHS DPP. We hoped to reach 5,000 people during the pilot and the good news is that we have already seen over 6,000 people referred in, with almost 4,000 people now registered with the interventions to receive support for lifestyle change.

We are currently going through a re-procurement for the NHS DPP and plan to offer greater opportunity to access digital interventions as part of the NHS DPP for those that are unable to attend in person.

Not only is our prevention programme exceeding the initial expectations for referrals and equity of access, we’ve also seen the first set of encouraging weight loss results this year too. So far, over 50% of people who start, complete the programme; attending at least eight support sessions over a nine month period, and these individuals have lost an average of 3.3kgs, around 1kg more than originally forecast by our evidence review.

We know that obesity and Type 2 diabetes are strongly linked and we’ve been making progress in NHS England’s push to curb the rising obesity crisis too; with a focus on NHS hospitals. Every NHS hospital in England has now agreed to cut sugary drinks on their premises. Nearly 30 million teaspoons of sugar have now been removed from NHS canteens, shops and vending machines as a result.

As well as expanding our Type 2 diabetes prevention work, we have continued to improve services for people living with Type 1 and Type 2 diabetes. We have invested £80million over this year and last in the areas of: access to structured education; care delivery aiming to achieve better glucose, blood pressure and cholesterol levels, which will help avoid the long term complications; better access to multidisciplinary foot teams when necessary; and better access to diabetes specialist nurse support when in hospital.

Earlier this year we launched an online resource for people with Type 1 diabetes; the resource is a simple and effective way for those with Type 1 diabetes to learn more about the disease and to understand how to manage it most effectively.

We also plan to make available nationally a similar web-based tool that delivers education for people with Type 2 diabetes next year.

Last month, we also announced that three out of seven new NHS Test Bed programme sites will focus on diabetes. The NHS Test Beds Programme is a joint programme between NHS England and government. It sees the NHS working with innovators using technology to address some of the biggest challenges in health and care.

The diabetes sites will test out digital platforms and technologies designed to help people self-manage their condition more effectively and digital solutions within existing diabetes pathways to provide structured, ongoing self-management support for lifestyle change.

This process will allow us to discover what really works for patients and these findings will play a crucial role in accelerating the use of world leading interventions as part of the future of the programme.

Today, to mark World Diabetes Day, we have announced action to end the current variation in access to the Freestyle Libre device for people with Type 1 diabetes. The wearable sensor does away with the need for inconvenient and sometimes painful finger prick blood tests by relaying glucose levels to a smart phone or e-reader.

Looking forward, as we develop a long term plan for the NHS Diabetes Programme, we are examining other ways we can harness digital technologies to improve patient care and aid prevention. We are also looking at where other high-quality research can add to the treatments we offer. For example, following on from the results of the DiRECT trial, we have recently started work on exploring the potential within the NHS for very low calorie diets to achieve remission of Type 2 diabetes. We are also looking at how we can contribute to wider health issues in those with diabetes, such as mental health.

World Diabetes Day is a good point to step back and reflect on the work we’ve been doing and what we have achieved so far. I look forward to all the progress we can share with you next year.

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.

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  1. Smitha says:

    Great initiative and wish and hopefully our GP’s and healthcare team will be more proactive on this issue as it will help those who are either type 2 or who has more chances to get one. Eventhough I knew I was Prediabetic, little I bothered to research or did anyone warn me of how it could have ended up and later was diagnosed with Type 2 and within few months, I have successfully put it into remission with strict lifestyle changes and exercise apart from losing more than 12 % body weight. If I can do it , then anybody can. Would be great to know more new and research on remission as it will help people like me more focused for the long term. Cheers.