The flagship NHS diabetes prevention programme is so successful that patients could be reaping further health benefits when they take part, according to a new study.
As well as achieving the main goal of helping people reduce their blood sugar levels, the English programme also appears to help patients lose weight and reduce 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 are offered the chance to sign up to the programme, called Healthier You NHS Diabetes Prevention Programme.
The programme lasts for nine months and people are supported to manage their weight, eat healthier foods and be more physically active.
They can either sign up to face-to-face support or a digital service which includes the use of wearable technologies which monitor exercise, apps and digital support groups.
The new study, published in the journal Nature, examined the effectiveness of the programme by looking at GP records from patients across England.
During the study period, from January 2017 to June 2020, some two million patients had their blood sugar measured.
Of these, 26,513 were referred to the programme.
Among the patients referred to the programme, only 3.3% (882 people) were subsequently prescribed diabetes medication in the year after treatment.
The international team of experts, including academics from the University of Birmingham, found that blood sugar levels reduced on average by 1.26 millimoles per litre (mmol).
As well as reductions in blood sugar levels, the team also found improvements in other areas.
Our findings clearly demonstrate the huge benefits of intensive lifestyle counselling for improving the health of patients with prediabetes. The evidence also suggests a promising route for improving population health more broadly— Study co-author Professor Justine Davies
The average BMI score for each patient fell by more than one point while patients lost an average of nearly 3kg each.
They also found that the programme 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 huge benefits of intensive lifestyle counselling for improving the health of patients with prediabetes.
“The evidence also suggests a promising route for improving population health more broadly.
“The positive effects observed in the programme may also extend to other non-communicable diseases such as cancer, which is increasingly thought to be connected to unhealthy lifestyle habits and environments.”
This is important evidence for health systems and clinicians because it implies that counselling by itself can be effective, at least in the short to medium-term, if done intensively and in a structured programme— Senior study author Pascal Geldsetzer
Prof 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 larger BMI and actually, we found that this programme reduced BMI. It didn’t reduce BMI massively, but it did reduce BMI.
“It also had some effect on blood pressure.
“Whilst we haven’t tested it for its ability to reduce other non-communicable diseases like cancer, like osteoarthritis, it possibly does have an effect on those via its effect on BMI.”
She said that among medics working in the community there is a “bit of scepticism” about the programmes, adding: “What we’ve done is we’ve proven for certain that this works, which may lead to GPs accepting that it works and referring people to it, so it may help to improve the referral rates.
“It may also help to sustain the programme if it is a consideration for being cut.”
This important study provides further evidence that our world-leading NHS prevention programme is changing lives, supporting hundreds of thousands of people to make sustainable healthy lifestyle changes to reduce their risk of developing type 2 diabetes— Professor Partha Kar
Pascal Geldsetzer, assistant professor of medicine at Stanford University and the senior author of the study, added: “We found that intensive lifestyle counselling for prediabetes, when implemented at scale in routine care, has beneficial effects on health measures that we know are important for cardiometabolic health.
“This is important evidence for health systems and clinicians because it implies that counselling by itself can be effective, at least in the short to medium-term, if done intensively and in a structured programme.”
Commenting on the study, Professor Partha Kar, NHS England’s national specialty advisor for diabetes, said: “This important study provides further evidence that our world-leading NHS prevention programme is changing lives, supporting hundreds of thousands of people to make sustainable healthy lifestyle changes to reduce their risk of developing type 2 diabetes.
“Type 2 diabetes remains a growing problem that can cause long-term health issues including blindness, kidney failure, heart attack, stroke and many common types of cancer. If you’re concerned about your health, you can easily check your risk through the Diabetes UK ‘Know Your Risk’ tool and come forward for support.”
