Type 2 diabetes prevention program ‘gets other benefits’ – study

The NHS's flagship diabetes prevention program is so successful that patients could reap further health benefits when they take part, a new study has found.

In addition to achieving the main goal of helping people lower their blood sugar levels, the English program also appears to help patients lose weight and lower blood pressure.

While type 1 diabetes cannot be prevented, type 2 is largely preventable through lifestyle changes.

People at risk of developing type 2 diabetes have the opportunity to sign up to the scheme, called the NHS Healthy You Diabetes Prevention Programme.

The program lasts nine months and people are supported to manage their weight, eat healthier foods and be more physically active.

They can either sign up for face-to-face support or a digital service that includes the use of wearable technologies that track exercise, apps and digital support groups.

The new study, published in the journal Nature, examined the effectiveness of the scheme by looking at GP records from patients across England.

During the study period, from January 2017 to June 2020, approximately two million patients had their blood sugar measured.

Of these, 26,513 were referred to the program.

Among patients referred to the program, only 3.3% (882 subjects) subsequently received diabetes medication in the year after treatment.

The international team of experts, including academics from the University of Birmingham, found that blood sugar levels fell by an average of 1.26 millimoles per liter (mmol).

In addition to reductions in blood sugar levels, the team found improvements in other areas as well.

Our findings clearly demonstrate the enormous benefits of intensive lifestyle counseling in improving the health of patients with prediabetes. The evidence also suggests a promising avenue for improving population health more broadly

Study co-author Professor Justine Davies

The average BMI score for each patient decreased by more than one point while the patients lost an average of almost 3 kg each.

They also found that the program appeared to have a positive effect on cholesterol and blood pressure.

Study co-author Professor Justine Davies, from the University of Birmingham, said: “Our findings clearly demonstrate the enormous benefits of intensive lifestyle counseling in improving the health of patients with prediabetes.

“The evidence also suggests a promising route to improving population health more broadly.

“The positive effects seen in the program may also extend to other non-communicable diseases such as cancer, which are increasingly thought to be linked to unhealthy lifestyle habits and environments.”

This is important for health systems and clinicians because it implies that counseling alone can be effective, at least in the short to medium term, if done intensively and in a structured program

Senior study author Pascal Geldsetzer

Professor Davies told the PA news agency: “With other non-communicable diseases – cancer, mobility diseases, especially osteoarthritis – often, the risk is massively increased in people who have a higher BMI and in fact, we found that this program reduced BMI. It didn't lower BMI massively, but it did lower BMI.

“It also had some effect on blood pressure.

“While we have not tested it for its ability to reduce other non-communicable diseases such as cancer, such as osteoarthritis, it may have an effect on them through its effect on BMI.”

He said there was “a bit of skepticism” about the schemes among GPs working in the community, adding: “What we've done is we've shown for sure that it works, which can lead to GPs accepting that it works and referring people in it, so it can help improve referral rates.

“It can also help preserve the program if there is a cut.”

This important study provides further evidence that the world's leading NHS prevention program is changing lives, supporting hundreds of thousands of people to make sustainable healthy lifestyle changes to reduce their risk of type 2 diabetes

Professor Partha Kar

Pascal Geldsetzer, assistant professor of medicine at Stanford University and the study's senior author, added: “We found that intensive lifestyle counseling for prediabetes, when implemented at scale in usual care, has beneficial effects on health measures we know to are important for cardiometabolic health.

“This is important for health systems and clinicians because it suggests that counseling alone can be effective, at least in the short to medium term, if done intensively and in a structured program.”

Commenting on the study, Professor Partha Kar, NHS England's national specialist adviser on diabetes, said: “This important study provides further evidence that the world-leading NHS prevention program is changing lives, supporting hundreds of thousands of people to make sustainable changes to their health lifestyle to reduce the risk of developing type 2 diabetes.

“Type 2 diabetes remains a growing problem that can cause long-term health problems such as blindness, kidney failure, heart attack, stroke and many common types of cancer. If you're worried about your health, you can easily check your risk with Diabetes UK's ‘Know Your Risk' tool and come forward for support.'