Tackling fatty liver to manage diabetes and other diseases
- 30 September 2024
- 3 min read
Supported by an NIHR Senior Research Fellowship award, Professor Trenell developed a digital behaviour change platform for people with type 2 diabetes, excess weight or liver disease.
Professor Trenell's platform now underpins the service used across England to empower NHS patients with diabetes to take control of their health.
Link between liver fat and type 2 diabetes
Up to 1 in 4 people in the UK has excess fat in their liver. The condition – non-alcoholic fatty liver disease – is a common cause of liver disease and is linked to developing type 2 diabetes. The NHS spends around £10 billion per year (10% of its budget) treating the 3.9 million adults with type 2 diabetes.
Reducing liver fat can prevent people from developing type 2 diabetes but they need effective ways to make changes.
Supported by a £750,000 NIHR Senior Research Fellowship award, metabolic specialist Professor Mike Trenell investigated how lifestyle changes could reduce liver fat. Alongside his team at Newcastle University, he developed exercise advice to cut liver fat and the risk of developing type 2 diabetes.
Encouraging behaviour change to reduce diabetes risk
Professor Trenell’s study showed that changes in lifestyle could significantly reduce liver fat and improve heart function. The results were published in journals Gut and Journal of Hepatology.
It revealed that exercise successfully managed the effects of liver disease on heart health. Importantly, weight management could also put non-alcoholic fatty liver disease into remission.
“It was clear that if you can help somebody manage their weight, move more, eat better, you can reverse type 2 diabetes, and if you’re at risk of type 2 diabetes you can prevent it,” said Professor Trenell.
Changing people’s behaviour can be difficult. However, with evidence from his NIHR-supported research and a sabbatical in San Francisco, Professor Trenell devised a digital platform that succeeded.
The new behaviour change platform, Changing Health, combines personalised online learning with one-to-one lifestyle coaching for people with type 2 diabetes. This allows more people to access diet and exercise advice without waiting for appointments. Professor Trenell then created a separate platform called DAISER. Using DAISER, researchers can build digital health services without writing their own computer code.
Changing Health was chosen to support the NHS Diabetes Prevention Programme. The programme reduces the risk of developing type 2 diabetes by 20% and has been offered to over 1.2 million people in the UK so far. NHS England also chose Changing Health to develop an online Healthy Living tool. This is freely available across England to support people with type 2 diabetes.
Translating research into nationwide health benefits
The NIHR Fellowship was pivotal to Professor Trenell’s pathway from research to technology development. During the Fellowship, Professor Trenell completed an MBA specialising in strategy and innovation and also retrained in artificial intelligence.
He used these skills to found and direct the NIHR Innovation Observatory, which supports those in healthcare to deliver better and more efficient clinical care. Today, any new medicine approved by NICE starts this process at the observatory.
“My NIHR Senior Research Fellowship transformed my career. It gave me focus, time and confidence to find my purpose - how to better health, not just publish papers.”
As a leading expert in the field, Professor Trenell advised on the NICE guideline for non-alcoholic fatty liver disease (2016) and behaviour change: digital and mobile health interventions (2020). He has also served on numerous committees, including the DHSC Physical Activity Taskforce.
The NIHR Senior Research Fellowship award was funded by the NIHR Academy.
More information about the study is available on the NIHR’s Funding & Awards website.
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