World's First Nationwide Diabetes Prevention Program to Run in UK

March 23, 2016

The world's first nationwide program to attempt to prevent at-risk individuals from developing type 2 diabetes is due to begin rolling out in England.

Healthier You: The National Health Service Diabetes Prevention Programme (NHS DPP) will start this year with a first wave of 27 areas covering 26 million people, half of the population, and making up to 20,000 places available.

The NHS DPP was initially launched in March 2015, in seven "demonstrator" sites, which have been conducting trials of different models of finding people known to be at high risk and helping them change their lifestyles, stressing that type 2 diabetes is a serious but often preventable health condition.

Information from these pilot sites is being used to inform the new program, with the plan being that this will roll out to the whole country by 2020, with an expected 100,000 referrals available each year after.

Simon Heller, professor of clinical diabetes, University of Sheffield, United Kingdom, told Medscape Medical News: "This is a challenging and ambitious aim and is to my knowledge the first time that a prevention initiative of this type has been attempted on such a large scale."

Expanding upon this, he added, "There are reasons why this initiative might not be as successful as the original [Diabetes Prevention Program (DPP)] trials — ie, people who volunteer for trials are clearly minded to engage, while in real life those who struggle are likely to be more resistant."

Hence, he says it is important that this new initiative is beginning "where there has been piloting and that there will be strong evaluation policies."

While this new British initiative is believed to be the first truly nationwide program, the Centers for Disease Control and Prevention (CDC) in the US has a number of Diabetes Prevention Program sites across the country.

A new advertising campaign aimed at raising public awareness about prediabetes was recently launched there, with resources made available for clinicians to try to help engage patients in diabetes prevention.

GPs Will Refer Patients to Personalized and Tailored Programs

There are currently 2.6 million people with type 2 diabetes in England, with around 200,000 new diagnoses every year, meaning that 500 people find out they have type 2 diabetes every day.

Individuals found to be at high risk of type 2 diabetes confirmed with an HbA1c test in the past 12 months will be referred to the scheme by their general practitioner.

Over 9 months, they will be offered at least 13 education and exercise sessions of 1 to 2 hours per session, with at least 16 hours face-to-face or one-to-one in total.

The scheme is being run by NHS England, Public Health England, and the charity Diabetes UK, with health officials stating they believe it will save money in the long term.

"This personalized, tailored program for people at risk will offer support on improving their lifestyle habits, including getting more exercise, a better balanced diet, and losing and keeping off excess weight — helping people to take more control of their health and ultimately prevent them developing what is potentially a life-threatening condition," notes Duncan Selbie, chief executive of Public Health England, in a statement.

"By offering targeted support for at-risk individuals, the NHS is now playing our part in the wider campaign against obesity — which is already costing the country more than we spend on the police and fire service combined," comments Simon Stevens, NHS England's CEO.

"The benefits for patients will show up as hospitalizations prevented, strokes avoided, and amputations averted," he added.

A Step in the Right Direction, but Much More Work Needed

Chris Askew, Diabetes UK chief executive, says the fact that people in England identified at high risk of developing type 2 diabetes will be offered personalized support to help them to eat well, become more active, and maintain a healthy weight is "a significant step in the right direction."

"This will provide them with the best possible chance of reducing their risk of developing type 2 diabetes and living a long full healthier life."

And while Dr Heller doesn't disagree, he stresses this program alone "will not be enough."

"We need to start influencing the culture, which must happen in schools…so sugar taxes may also help."

And education is vital "about how nasty type 2 diabetes is," along with strategies to counteract the "worrying tendency to take a moral view on those who develop type 2 diabetes, which is both unhelpful and not justified," he observes.

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