Soup and Shake NHS Diet Rolled Out to Thousands

Peter Russell

September 01, 2020

Thousands of people with type 2 diabetes are to be encouraged to take up the offer of a 'soup and shake' weight loss plan in an NHS effort to help people tackle the condition.

The very-low-calorie diet will be tested in 10 areas of England to see whether results in the 'real world' match a trial in which more than a third of people with type 2 diabetes maintained remission after 2 years.

Diabetes is estimated to cost the NHS £10 billion a year, while almost 1 in 20 prescriptions written by GPs is for diabetes treatment.

A review of international evidence earlier this year by Public Health England found a higher risk of dying from COVID-19 for people who were obese or excessively overweight.

A further study published last week by the University of North Carolina found that people who were obese were 113% more likely to require hospitalisation with COVID-19 and 74% more likely to be admitted to intensive care.

Low Calorie Liquid Diet and Support Sessions

Professor Jonathan Valabhji, NHS national clinical director for diabetes and obesity said: "There has never been a more important time to lose weight and put their type 2 diabetes into remission, so it's good news for thousands of people across the country that practical measures like this are increasingly available on the NHS."

The weight loss plan will be available to 5000 more patients who have been diagnosed with type 2 diabetes in the last 6 years and who meet other eligibility criteria.

The intervention will involve low-calorie total diet replacement products alongside virtual one-to-ones, group sessions, and digital support.

Programme Builds on DiRECT Trial

Evidence from the 12-month treatment course will be gathered to test how closely it matches results from the original trial.

Results from the DiRECT Trial showed that 36% of people with type 2 diabetes who took part in a weight management programme delivered in NHS primary care were in remission after 2 years.

The intervention programme comprised total diet replacement (825–853 kcal/day formula diet) for 3–5 months, stepped food reintroduction in weeks 6 to 8, followed by structured support for weight loss maintenance.

Participants were defined as in remission if they had long-term HbA1c levels of less than 48mmol/mol without needing diabetes medications.

The research, published in The Lancet Diabetes and Endocrinology , found that sustained remission "was linked to the extent of sustained weight loss".

Sites rolling out the low-calorie diet programme will be:

  • North East and Yorkshire: South Yorkshire & Bassetlaw ICS, and Humber Coast & Vale STP

  • North West: Greater Manchester Health and Social Care Partnership

  • South East: Frimley Health and Care STP

  • South West: Gloucestershire STP

  • Midlands (West and East): Derbyshire STP, and Birmingham and Solihull STP

  • East of England: Bedfordshire, Luton and Milton Keynes (BLMK) ICS

  • London: North East London, and North Central London

Bridget Turner, director of policy campaigns and improvement at Diabetes UK, said: "We know that some people with type 2 diabetes want and need support from health care professionals to lose weight effectively and now as these programmes are piloted across the NHS, they will.

"People with type 2 diabetes who have put their diabetes into remission frequently tell us how it has changed their lives. We are so pleased to see that others will now have the same opportunity and hope that it won’t be too long before more remission programmes are rolled out across the country."

The low-diet programme is in addition to the Healthier You NHS Diabetes Prevention Programme which NHS England said has had more than 600,000 referrals.

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