Very low calorie diets trialled by NHS to tackle diabetes
Hundreds of thousands of people will receive NHS help to battle obesity and type 2 diabetes under radical action set out by Simon Stevens, Chief Executive of NHS England.
Very low calorie diets that have been shown to put type 2 diabetes in remission in those recently diagnosed with the condition in research led by Newcastle University. These will now be trialled as part of the NHS long term plan, which will increase the focus on prevention as well as treatment.
The moves will not just improve the health of patients but also save the NHS money that can be reinvested in frontline care. Currently, the health service in England spends around 10 percent of its budget on treating diabetes.
Simon Stevens announced that very low calorie diets will be piloted at scale by the NHS for the first time, from next year.
Patients who will be prescribed a liquid diet of just over 800 calories a day for three months and then a period of follow up support to help achieve remission of their type 2 diabetes.
This approach will initially be piloted in up to 5,000 people following the Diabetes UK funded DiRECT trial, where almost half of those who went on a very low calorie diet achieved remission of their type 2 diabetes after one year. A quarter of participants achieved a staggering 15 kg or more weight loss, and of these, 86 percent put their type 2 diabetes into remission.
A more recent trial of very low calorie diets, DROPLET, has demonstrated similar weight loss in obese individuals.
Simon Stevens said: "The NHS is now going to be ramping up practical action to support hundreds of thousands people avoid obesity-induced heart attacks, strokes, cancers and type 2 diabetes. The NHS Long Term Plan is going to give people the power and the support to take control of their own lifestyles – so that they can help themselves while also helping the NHS.
"Because what's good for our waistlines is also good for our wallets, given the huge costs to all of us as taxpayers from these largely preventable illnesses. However this isn't a battle that the NHS can win on its own. The NHS pound will go further if the food industry also takes action to cut junk calories and added sugar and salt from processed food, TV suppers and fast food takeaways."
Around nine out of 10 people with diabetes have Type 2, which is closely linked to obesity and obesity can lead to a string of serious illnesses, including 13 types of cancer.
Recent projections also show that the growing number of people with diabetes could result in nearly 39,000 people living with diabetes suffering a heart attack in 2035 and over 50,000 people suffering a stroke.
Professor Roy Taylor, co-chief investigator of the DiRECT study, said: "This is a hugely important step forward for the NHS, allowing people with type 2 diabetes to return to full health. This approach has gradually been taken up by doctors, nurses and dieticians, but now practical support will be provided."
Professor Jonathan Valabhji, National Clinical Director of Diabetes and Obesity for the NHS in England said: "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.
"Our work so far in this area has been producing really positive results and today's announcement will allow us to go even further – it will help patients who have type 2 diabetes to achieve remission and importantly, help more of those who are at risk to not get it in the first place."
Chris Askew is Chief Executive of Diabetes UK. He said: "The first year results of Diabetes UK DiRECT study showed that – for some people with type 2 diabetes – an intensive, low-calorie weight loss programme delivered with ongoing support through primary care could put their condition into remission. While this ground-breaking study continues to explore how long-lasting these benefits are, we are delighted that NHS England have been inspired by this work to pilot a Type 2 remission programme through the NHS.
"Plans to double the size of the NHS Diabetes Prevention Programme are excellent news. The programme is already the largest of its kind globally, and shows England to be a world leader in this area. The ambition being shown by the NHS needs to be matched across all government policy – we need stronger action on marketing to children, and clearer nutritional labelling to support people to make healthy choices.
"We look forward to working alongside NHS England to shape how both these bold initiatives will work in practice, and seeing the positive impact these decisions will have on the health of those at risk of – or living with – type 2 diabetes."