Whenever you hear the word “intervention” you may automatically think of an ‘addiction intervention’’, or a ‘surgical intervention’, as these terms have almost become synonymous with the word. But how about a lifestyle intervention?
Currently, the NHS England spends around 10% of its budget on treating diabetes, with recent projections showing that the growing number of people with the condition could result in nearly 39,000 people suffering a heart attack and over 50,000 people suffering a stroke by 2035.
There is progress within the sector to redress the prevalence of type 2 diabetes (T2DM) in particular, through a prescription of- lifestyle changes.
There are plans proposed by the NHS to roll out a national Diabetes Prevention Programme (DPP) in the form of ‘lifestyle interventions’ to curb the demand the health service is under. The evidence shows that diabetes prevention programmes significantly reduce progression to T2DM compared to traditional care by ~26%.
The approach will involve GPs prescribing a liquid diet of just over 800 kilocalories a day for three months, then a period of follow-up support to ultimately help achieve remission of their Type 2 diabetes. NHS England’s chief executive, Simon Stevens, announced the program on 30th November. It will first be offered to 5000 patients before being rolled out nationally.
The announcement followed a series of recent studies that have overturned the widely held view that type 2 diabetes is incurable and must be managed with medication.
Large population-based studies in China, Finland and the USA have recently demonstrated the feasibility of preventing, or delaying, the onset of diabetes in overweight subjects with mild glucose intolerance (IGT). With these studies leading to the conclusion that even moderate reduction in weight and only half an hour of brisk walking each day reduces the incidence of diabetes by more than fifty percent.
The objectives for the DPP are:
- To support more people at high risk of developing diabetes to receive lifestyle
interventions to help them lower that risk.
- To slow down the increase in the incidence of type 2 diabetes compared with current predictions.
- To reduce the incidence of heart disease, strokes, kidney, eye and foot problems (and associated
mortality) related to diabetes compared with current predictions.
The benefits include not only saving the NHS money by alleviating the demand diabetes puts on numerous services within the sector, but the money and resources will then be reallocated and reinvested into providing more essential frontline care.
Chris Askew, the Chief Executive of Diabetes UK states:
“Plans to double the size of the NHS Diabetes Prevention Programme is excellent news. The programme is already the largest of its kind globally and shows England to be a world leader in this area. The ambition being shown by the NHS needs to be matched across all government policy — we need stronger action on marketing to children, and clearer nutritional labelling to support people to make healthy choices.”
There are even plans for online versions of the DPP, involving wearable technologies and apps to help those at risk of Type 2 Diabetes better self-manage. These will also be provided to those who find it difficult to attend regular sessions due to work or family commitments.
The aim is to better integrate the available solutions and help patients feel more in control of their treatment. This will hopefully stop the chance of patients withdrawing from their therapy and in feeling more accomplished with short-term goals- by achieving a certain number of steps for instance. This move by the NHS brings us one step closer to achieving a patient-centric health service, a more integrated solution.
By Medicalchain’s Tim Robinson