The NHS Diabetes Prevention Programme started in April and 20,000 places will be offered in the first year rising to 100,000 places by 2020.

Those referred will get tailored, personalised help to reduce their risk of Type 2 diabetes including education on healthy eating and lifestyle, help to lose weight and bespoke physical exercise programmes, all of which together have been proven to reduce the risk of developing the disease.
Type 2 diabetes is the fastest growing long-term condition in England, driven largely by the relentless rise in overweight and obesity. A total of 3.2 million people are currently affected by the condition and this is expected to rise to 4 million in the next 10 years, and 6 million – that is 10% of the population – in the next 20 years.

Type 2 diabetes is the fastest growing long-term condition in England

Much of the impact of diabetes results from its serious complications. These include a doubling of the risk of heart attack and stroke, as well as kidney failure, blindness and amputations due to nerve and blood vessel damage.
There is robust evidence from a range of international studies which show that intensive support for behaviour change in people without diabetes, who have high blood sugar levels substantially, reduces the risk of conversion to Type 2 diabetes.

 

A preventative approach
 


A preventative approach is the rationale for the Programme. GPs and nurses are well aware of the need to take action to reduce the risk of Type 2 diabetes. Every year we see the progressive rise of overweight and obesity among our patients, with increasing numbers developing Type 2 diabetes.
 
As a result of this we see more people developing the serious complications of diabetes at an earlier age – heart attacks and strokes, kidney, eye and foot problems, all increasing the risk of early death or major disability in relatively young people.
 
As well as these personal disasters for our patients and their families, national spending on Type 2 diabetes currently uses up about 10 per cent of the NHS budget. As this proportion rises with the predicted increase in obesity and Type 2 diabetes, our health service risks becoming unsustainable. Yet despite these immense costs to individuals and the NHS, many people are unaware that diabetes can often be prevented or delayed through changes in personal lifestyle.

National spending on Type 2 diabetes currently uses up about 10 per cent of the NHS budget.

In general practice we often discover that people have raised blood sugar just as part of routine care. The NHS Health Check now supports us in this, with a more systematic approach to identifying people at high risk: when someone is found to have a raised HbA1c or blood sugar as part of the health check they are referred back to the GP for further management.
 
The challenge for many of us in primary care is that we don’t generally have access to evidence-based diabetes prevention services to refer those patients into. The NHS DPP will help us fill that gap. I think this is an encouraging development.

 

Personalised support


 
Once up and running we will be able to refer patients on to the programme, knowing they will be offered intensive professional support to lose weight, improve their diet and increase physical activity – all known to reduce the risk of diabetes.
Over a period of 9 months or more they will be offered regular face-to-face and group sessions with personalised support from experts to lose weight, increase physical activity and improve their diet. The evidence shows that this approach will work for many people, preventing or delaying the onset of diabetes and its complications.

There has been enthusiastic interest from CCGs and Local Authorities across the country, and in each location they will work together with nationally appointed providers to deliver the programme. A total of 27 areas, covering one third of the country, will begin offering places to people at high risk of diabetes over the next few months, and the service will then roll out across the rest of the country over the next couple of years.
Of course this service has to be part of a wider societal approach to supporting healthier lifestyles, but the launch of the Diabetes Prevention Programme does show that the NHS is getting serious about prevention.