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NHS programme linked to 20% reduction in risk of diabetes

An NIHR-funded evaluation revealed that referring people with pre-diabetes to the NHS Diabetes Prevention Programme reduced their risk of progressing to diabetes by 20%. Their findings supported expansion of the programme which is helping hundreds of thousands of people to lead healthier lives.

Published: 11 December 2023

2 million people on the brink of type 2 diabetes

The NHS spends around £10 billion a year – 9% of its whole budget – caring for people with diabetes. Nearly £8 billion of this is spent on treating complications, such as heart disease, kidney problems and nerve damage. 

Helping people to avoid developing type 2 diabetes is the best way of preventing these life-changing illnesses.

Over 2 million people have been diagnosed with pre-diabetes in England, meaning they have high blood sugar levels and are more likely to develop type 2 diabetes in the future. Making positive changes to lifestyle choices can markedly reduce the risk. 

With this in mind, in 2016 the NHS Diabetes Prevention Programme was introduced in England. It aimed to identify people with pre-diabetes and offer them a 9-month behaviour change programme that supports healthier diet and exercise choices. Initially delivered as face-to-face advice by a health coach in groups, it’s now also available as a remote online version.

But was the programme really helping to reduce people’s risk of developing diabetes? With funding of £2.75 million, the NIHR supported a 6-year independent evaluation, known as the Diabetes Prevention - Long Term Multimethod Assessment (DIPLOMA) research programme, to assess its effects and guide NHS decisions on its future. 

Cutting the risk of diabetes by 20%

DIPLOMA was led by researchers from The University of Manchester, in collaboration with The University of Sheffield, University College London and patient contributors, and supported by the NIHR Clinical Research Network. 

Patients who had been referred to the programme were recruited from around the country to discuss their experiences. Using their feedback, and drawing on national datasets, the team built a picture of who used the service and what their experiences and outcomes were.

DIPLOMA found that 3 years after a person’s referral, they were 20% less likely to have type 2 diabetes than a similar person who was not referred. This means that more than 30,000 of the 1.2 million participants have been spared the consequences of diabetes. 

Their results have been published in numerous journals, including PLOS Medicine, and summarised for public audiences.

Supporting UK-wide access to a world-leading diabetes prevention programme

The findings from DIPLOMA’s large-scale evaluation supported the decision to continue the NHS Diabetes Prevention Programme, increase the number of places and promote the online version. As a result, more people have benefited from the programme’s advice, and similar programmes have been introduced in Northern Ireland, Scotland and Wales.

DIPLOMA’s lead researcher and Professor of Health Economics at the University of Manchester, Matt Sutton, explained how their research also led to improvements in the programme: “While half of the people referred to the programme eventually joined it, we made recommendations to improve uptake among particular groups, such as those of working age, younger adults and minority ethnic groups, and we highlighted the need to ensure the programme content stayed true to the evidence base”.   

“This important study is further evidence that the NHS is preventing type 2 diabetes and helping hundreds of thousands of people across England to lead healthier lives.”

Professor Jonathan Valabhji, NHS national clinical director for diabetes and obesity

The study was funded by the NIHR Health and Social Care Delivery Research Programme.

More information about the study is available on the NIHR’s Funding & Awards website.

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