More than a third of patients at risk of developing type 2 diabetes who reside in the UK avoided developing the condition after they were referred by their family doctor (GP) to a diabetes prevention program delivered by the commercial weight management provider, Weight Watchers, finds research published in BMJ Open Diabetes Research & Care.
The initiative also helped more than half of those referred either to reduce their risk of developing diabetes or to get their blood sugar levels back to normal. The number of people diagnosed with type 2 diabetes in the UK has increased from 1.4 to 2.9 million since 1996. An even more substantial increase can be seen in the United States (U.S.) with a rise from 7.6 to 23.4 million. A new diagnosis is made every 2 minutes, and by 2025, an estimated 5 million people in the UK and 53 million in the U.S. will have the condition. Horrifying statistics! Risk of developing type 2 diabetes is strongly influenced by lifestyle factors but can be significantly reduced by weight loss, achieved by eating less and exercising more.
The UK’s national health and social care guidance organization, the National Institute for Health and Care Excellence (NICE) says that certain commercial weight management providers, such as Weight Watchers, can help obese people shed pounds. A U.S. study showed that participation in a commercial weight management program succeeded in reversing progression to type 2 diabetes. However, the effectiveness of this approach in UK primary care has not been thoroughly evaluated. Therefore, the researchers identified 166 patients from 14 general practice surgeries at high risk of developing type 2 diabetes: Those with impaired glucose regulation known as pre-diabetes or non-diabetic hyperglycemia and with a body mass index (BMI) above 30 kg/m2.
These patients were then invited to contact Weight Watchers to book a place on their diabetes prevention program, which included a 90-minute induction session followed by 48 weekly group meetings. From among the 166 primary care referrals, 149 patients were eligible. Some 117 attended the induction, and 115 started the weekly sessions, representing a take-up rate of 70%, which is high for a lifestyle intervention, according to the researchers. The program focused on improving diet quality, reducing portion size, increasing physical activity levels, as well as boosting confidence in the ability to change and a commitment to the process.
Blood tests were repeated at 6 and 12 months to check risk factors, and any changes in weight were recorded by trained Weight Watcher staff. Analysis of the results showed that the initiative led to an average fall in HbA1c (a measure of average blood glucose levels over several weeks) of 2.84 mmol/mol after 12 months to levels regarded as standard. Blood glucose levels also returned to normal in more than a third (38%) of the patients and only 3% developed type 2 diabetes after 12 months. The average weight loss amounted to 10 kg (22lb) at the 12 month time point (a reduction in BMI of 3.2kg/m2).
The researchers acknowledge that not all patients at high risk go on to develop type 2 diabetes, added to which the referral numbers were low, based on the funding available, with few black or minority ethnic participants, men, or those on low incomes. Nevertheless, they conclude that the initiative has the potential to have considerable impact. “A UK primary care referral route partnered with this commercial weight management provider can deliver an effective diabetes prevention programme,” they write. “The lifestyle changes and weight loss achieved in the intervention translated into considerable reductions in diabetes risk, with an immediate and significant public health impact.”
Adapted from: Carolyn Piper, Agnes Marossy, Zoe Griffiths, Amanda Adegboye. Evaluation of a type 2 diabetes prevention program using a commercial weight management provider for non-diabetic hyperglycemic patients referred by primary care in the UK. BMJ Open Diabetes Research & Care, 2017; 5 (1): e000418 DOI: 10.1136/bmjdrc-2017-000418
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