medwireNews: The latest update from the NHS Diabetes Prevention Programme (DPP) shows that more people than expected are engaging with the scheme.
The DPP achieved 75% coverage of England during the past year, with full coverage anticipated by April 2018.
Presenting the latest update at the Diabetes UK Professional Conference in London, Emma Barron, from Public Health England, revealed that there have so far been more than 150,000 referrals to the scheme, and more than 65,000 people attended the initial assessment. This represented 59% uptake, which is well in excess of the predicted 40%.
There was greater uptake among:
- women than men (87 vs 74 per 100,000 people);
- older than younger patients;
- Black, Asian or other ethnic minorities than White people (119 vs 68 per 100,000); and
- people in the most versus the least socioeconomically deprived quintile (72 vs 60 per 100,000).
Barron described the results for ethnic minorities and socioeconomically deprived people as “really good news,” which “shows that the programme is reaching those who are most at risk of developing type 2 diabetes.”
To date, just over 4300 participants have completed the programme. Session Chair Jonathan Valabhji (NHS England National Clinical Director for obesity and diabetes) stressed that the small number of completers to date reflects the time delay between referral and actually starting the programme, in addition to its 9-month duration.
Barron reported that 52% of the completers attended at least eight of the 13 sessions. Those completers who had an elevated BMI at baseline achieved an average weight loss of 3.7 kg, or 4.2% of their bodyweight. Changes in glycated hemoglobin levels were difficult to analyze at this early stage, she said, with results so far appearing to represent regression to the mean (ie, falling back to average levels after a period of being higher than normal for the individual).
The session closed with Matthew Fagg, from NHS England, outlining the intended next steps for incorporating digital delivery of diabetes prevention. This approach can potentially greatly increase the overall capacity of the programme, facilitate its delivery in sparsely populated areas where it is hard to find sufficient numbers of patients for regular group sessions, and appeal to younger people who may prefer digital formats.
Although these benefits are clear, there is as yet little evidence to support digital delivery of diabetes prevention, so this is included in the DPP on a trial basis. Five promising systems are being tested in eight areas, involving a planned 5000 patients who will be recruited by this summer. The final report is not due until late 2019, but the new programme framework is due to be procured in March of that year, creating “something of a dilemma.”
For this reason, the core programme will remain based on face-to-face contact, with hybrid and fully digital services included as optional extras that NHS England can introduce in a controlled way as the evidence becomes clearer.
medwireNews is an independent medical news service provided by Springer Healthcare. © 2018 Springer Healthcare part of the Springer Nature group
See also:
- Retention key for US national diabetes prevention efforts
- Teaming up with commercial weight management providers aids type 2 diabetes prevention
- ‘Screen and treat’ unlikely to halt diabetes epidemic