CCD Rounds: Sharing knowledge and scaling up action to bend the curve on diabetes- latest one 18 June

Cities Changing Diabetes | June 2021 | Sharing knowledge and scaling up action to bend the curve on diabetes

Cities Changing Diabetes is a partnership created to address the social and cultural factors that increase type 2 diabetes vulnerability in urban environments. The partnership is pleased to bring CCD Rounds: a new webinar series for global sharing of best practice and hands-on insight to bend the curve on diabetes. CCD Rounds webinars are an opportunity to learn about diabetes and obesity prevention through real-world examples of health promotion, activities around childhood obesity and best practice policy initiatives.

Tackling the causes of type 2 diabetes & overcoming health inequities with Healthy Goals

Tune in tomorrow (Friday 18 June) from 15:00 –16:00 pm and discover how a sport-and-lifestyle education programme sparked a healthy living movement in a vulnerable community in Leicester, UK. Leicester is home to one of the largest populations of people with diabetes in the country, with around 9 per cent of residents diagnosed with the condition – well above the national average.

Join us to engage with Dr Sophie O’Connell, from the Centre for BME Health, together with Alisson Tripney, from Leicester City in the Community, and learn how Healthy Goals is helping people sustainably improve their wellbeing. The programme has built enthusiastic support among the city’s South Asian society and has leveraged the city’s pride in its home football team to reach an underserved group with practical, fun and educational sessions over a twelve-week programme (Source: Cities Changing Diabetes)

You can read more about the case from Cities Changing Diabetes

Cost-effectiveness of Diabetes Prevention Interventions Targeting High-risk Individuals and Whole Populations: A Systematic Review

Zhou, X. (2020)|Cost-effectiveness of Diabetes Prevention Interventions Targeting High-risk Individuals and Whole Populations: A Systematic Review | Diabetes Care | 43| (7)|P. 1593-1616| https://doi.org/10.2337/dci20-0018

Abstract

OBJECTIVE We conducted a systematic review of studies evaluating the cost-effectiveness (CE) of interventions to prevent type 2 diabetes (T2D) among high-risk individuals and whole populations.

RESEARCH DESIGN AND METHODS Interventions targeting high-risk individuals are those that identify people at high risk of developing T2D and then treat them with either lifestyle or metformin interventions. Population-based prevention strategies are those that focus on the whole population regardless of the level of risk, creating public health impact through policy implementation, campaigns, and other environmental strategies. We systematically searched seven electronic databases for studies published in English between 2008 and 2017. We grouped lifestyle interventions targeting high-risk individuals by delivery method and personnel type. We used the median incremental cost-effectiveness ratio (ICER), measured in cost per quality-adjusted life year (QALY) or cost saved to measure the CE of interventions. We used the $50,000/QALY threshold to determine whether an intervention was cost-effective or not. ICERs are reported in 2017 U.S. dollars.

RESULTS Our review included 39 studies: 28 on interventions targeting high-risk individuals and 11 targeting whole populations. Both lifestyle and metformin interventions in high-risk individuals were cost-effective from a health care system or a societal perspective, with median ICERs of $12,510/QALY and $17,089/QALY, respectively, compared with no intervention. Among lifestyle interventions, those that followed a Diabetes Prevention Program (DPP) curriculum had a median ICER of $6,212/QALY, while those that did not follow a DPP curriculum had a median ICER of $13,228/QALY. Compared with lifestyle interventions delivered one-on-one or by a health professional, those offered in a group setting or provided by a combination of health professionals and lay health workers had lower ICERs. Among population-based interventions, taxing sugar-sweetened beverages was cost-saving from both the health care system and governmental perspectives. Evaluations of other population-based interventions—including fruit and vegetable subsidies, community-based education programs, and modifications to the built environment—showed inconsistent results.

CONCLUSIONS Most of the T2D prevention interventions included in our review were found to be either cost-effective or cost-saving. Our findings may help decision makers set priorities and allocate resources for T2D prevention in real-world settings.

Full review from available from Diabetes Care

Diabetes Prevention Programme 2018-19, Short Report

The NHS Diabetes Prevention Programme (NHS DPP) is a joint commitment from NHS England, Public Health England and Diabetes UK to deliver, at scale, evidence based behavioural interventions that can prevent or delay the onset of Type 2 diabetes in adults who have been identified as having non-diabetic hyperglycaemia.

This short report uses data collected from GP practices alongside the National Diabetes Audit (NDA) for the period January 2018 to March 2019 inclusive. This report is for England only.

Key facts

  • Non-diabetic hyperglycaemia refers to blood glucose levels that are above normal but not in the diabetic range (HbA1c 42-47 mmol/mol (6.0-6.4%) or fasting plasma glucose 5.5-6.9 mmol/l).
  • People with non-diabetic hyperglycaemia are at increased risk of developing Type 2 diabetes. They are also at increased risk of other cardiovascular conditions.
  • 1.8 million people in England were recorded as having non-diabetic hyperglycaemia for the period January 2018 to March 2019. This is an increase from 1.3 million in 2017-18. The difference is almost certainly due to an increase in the recording of the diagnosis during 2018-19, and not an additional 0.5 million people becoming non-diabetic hyperglycaemic.

Full detail at NHS Digital

Diabetes Prevention Programme 2017-18

Health Quality Improvement Partnership | July 2019| Diabetes Prevention Programme 2017-18 

NHS Digital has published a report on the Diabetes Prevention Programme (DPP), it  uses data collected alongside the National Diabetes Audit (NDA) for the period January 2017 to March 2018 in England.

Some of the findings include:

  • Non-diabetic hyperglycaemia populations and Type 2 diabetic populations are similar but a higher proportion of men have Type 2 diabetes
  • 15.4% of people recorded with non-diabetic hyperglycaemia are known to be from black, Asian and ethnic minority groups (BAME)

In future reports on the Diabetes Prevention Programme, deeper investigations will be made as to whether the behaviour change programmes are having an impact on reducing weight, progression to Type 2 Diabetes and other cardiovascular risk factors.

The report is available to download from HQIP

2,000 people referred to Type 2 diabetes prevention programme in Wakefield

Wakefield Express |July 2019 | 2,000 people referred to Type 2 diabetes prevention programme in Wakefield

A news story in the Wakefield Express reports that almost 2000 people in Wakefield at risk of developing type 2 diabetes, have been referred to a diabetes preventionprogramme – delivered by the NHS- since 2017.

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Coun Faith Hepenstall, Wakefield’s portfolio holder for health, said:

“The public health team working for Wakefield Council want to help these residents live healthier lives.

“In 2017 we were successful in attracting significant funding from the NHS to run a diabetes prevention programme across (West Yorkshire and Harrogate). 

“This involves education on healthy eating and lifestyle, help to lose weight, as well as access to physical exercise programmes, all of which together have been proven to reduce the risk of developing the condition.

Of these, 1051 attended their first session, an uptake of a little over 50 per cent.

She added that the participants (n=741) who have completed the programme, have lost an average of 6lb each (Source: Wakefield Express)

Read the full story in the Wakefield Express

Latest programme updates

Healthier You: NHS Diabetes Prevention Programme

Healthier You: NHS Diabetes Prevention Programme (NHS DPP) identifies those at risk of developing Type 2 diabetes and offers them a behavioural change programme. 

Current updates:

  • Data for 18/19 shows the Programme received over 212,000 referrals (now over 380,000 in total since launch) and delivered a total of 105,000 initial assessments, superseding it’s Five Year Forward View mandate target of 100,000 on programme per year.
  • Through the Long Term Plan, NHS England have committed to doubling the capacity of the programme to 200,000 people on programme by 2023/24.
  • Framework providers have been appointed to deliver the new framework which will include digital and remote intervention services. They are; Reed Momenta, ICS Health and Wellbeing, WW (formerly Weight Watchers), Ingeus, and Living Well Taking Control. The providers for the online programme are OurPath, Oviva, WW (formerly Weight Watchers), Changing Health and Liva Healthcare.
  • 45% of the country have been awarded contracts to commence onto this framework in August 2019, the remaining 55% will be on boarded in 2020.

To find out more about the NHS DPP visit www.england.nhs.uk/diabetes/diabetes-prevention/

Improving outcomes for people with diabetes

The Diabetes Treatment and Care Programme aims to improve outcomes for people with diabetes.

Current updates:

  • Since the national funding arrangements and criteria for the prescription of flash glucose monitoring were published in March, local teams have been progressing with their implementation plans. Nationally we have developed a set of FAQs to help support this implementation phase, these will be available on the website soon.
  • Work is underway to develop the approach to piloting low calorie total diet replacement programmes within the NHS following the encouraging results seen in those who undertook the Diabetes Remission Clinical Trial (DiRECT) and Doctor Referral of Overweight People to Low Energy Treatment (DROPLET) trials. We are currently in the early development phase of this work programme, ensuring that we are aligned to other work programmes and that processes are in place to implement the next steps. We will be engaging with stakeholders as the work progresses in the coming months.
  • The final transformation fund allocations of 2018/19 were made to lead CCGs in mid-March 2019. Regional and clinical network teams are currently reviewing the progress made during 2018/19 and working with project leads to finalise their delivery plans for 2019/20 and develop longer term sustainability plans.
  • 2019/20 transformation funding has now been confirmed, supporting the current funded sites to continue to deliver improvements over the coming year. Q1 allocations will be made at the end of June 2019.
  • The Q4 transformation data collection through the Strategic Data Collection Service (SDCS) closed on 15 May 2019. This data will be published in the next iteration of the diabetes transformation dashboard which is due for publication in July 2019.

For more information on this stream of the programme visit www.england.nhs.uk/diabetes/treatment-care/

Patients on NHS type 2 diabetes prevention programme lose almost 60,000kg between them

NHS England | April 2019 | Patients on NHS type 2 diabetes prevention programme lose almost 60,000kg between them

New figures released by NHS England show that the 17 000 participants of the diabetes prevention programme (DPP), lost on average 3.4 kg. This is more than 1 kg than they were predicted to lose.

The programme  provides advice on dieting, exercise and healthy lifestyle, is being doubled in size over the next few years to treat around 200,000 people annually as part of the NHS Long Term Plan’s renewed focus on prevention.

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The diabetes prevention programme is set to expand further in July this year as wearables and apps will enable patients who cannot attend DPP sessions due to work and family commitments, to participate online.

DPP is designed to stop or delay onset of Type 2 diabetes through a range of personalised lifestyle interventions, including:

  • education on lifestyle choices
  • advice on how to reduce weight through healthier eating
  • bespoke physical activity programmes (Source: NHS England)

Professor Jonathan Valabhji, NHS England national clinical director of diabetes and obesitysaid: “Around two thirds of adults and one third of children are now overweight or obese, driving higher and higher rates of Type 2 diabetes that we are now focusing huge efforts to address, as outlined in the NHS Long Term Plan.

“I’m delighted that our work so far in this area has been producing really positive results. This weight loss is promising – and we hope to help many more of those who are at risk of Type 2 diabetes to not get it in the first place.”

Full story from NHS England 

In the news:

OnMedica Weight loss targets exceeded on NHS type 2 diabetes prevention programme

Diabetes Prevention Week 2019: toolkits now available

diabetes prevention week

Diabetes Prevention Week 2019 will run from 1-7 April 2019.

The campaign aims to:

  • Raise awareness of the Healthier You: NHS Diabetes Prevention Programme – with the public and healthcare professionals (specifically GPs, Practice Nurses and Pharmacists)
  • Raise awareness of the causes of Type 2 diabetes
  • Raise awareness of the complications associated with Type 2 diabetes
  • Raise awareness of at risk groups – particularly BME populations

Local NHS organisations can order a toolkit from Public Health England which includes everything you need to run your own event, including posters, leaflets and more.

Full detail at Public Health England

Consultation on the new NHS Diabetes Prevention Programme framework

NHS England has published summaries of results from a consultation on the development of the NHS Diabetes Prevention Programme framework. The consultation covered the potential to use remote and digital technologies in the new service specification to enable the programme to offer greater uptake and access for service users.

Assessing the value of diabetes intervention programmes

NIHR | August 2018 | Assessing the value of diabetes intervention programmes

A new blog post on the NIHR blog assesses the NHS DPP (Diabetes Prevention Programme). Designed by NHS England and Public Health England, working alongside Diabetes UK, the Diabetes Prevention Programme  (NHS DPP) is an ambitious and world-leading attempt to bring about behaviour change, through a standardised intervention delivered by four different providers, implemented across England to people at risk of developing diabetes. People at risk are identified and referred to a group programme which helps them understand the repercussions of diabetes and make changes to their lives to reduce their risk of getting it in the future.
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The authors of the post  indicate that aspects of the NHS DPP are very successful. Although there had been concerns that groups in need of support would not attend, initial findings suggest that some of these groups (ethnic minorities, and those living in deprived areas) were showing good engagement.

The authors also emphasize that the early findings  do not tell us what would have happened if the programme had not been introduced, or whether it is a good investment compared to other alternatives. Programmes such as this tend to produce positive results at the outset but these may not be sustained.   As a result the authors have been commissioned by NIHR to conduct an independent evaluation of NHS DPP called DIPLOMA.

Further details of the DIPLOMA project  including a video and webinar slides are here

The full post can be read at NIHR 

The research study’s findings are also available from NIHR