UCLPartners and Newham CCG supported research, published in the BMJ this month, suggests that the national programme to prevent people developing Type 2 diabetes is unlikely to have a major impact.
Type 2 diabetes leads to 22,000 early deaths every year in England and treating the disease costs the NHS just over £8 billion, 9% of its annual budget.
With instances of Type 2 diabetes on the rise, implementing effective ways of identifying those at risk and preventing them from the developing the disease is crucial.
The current prevention programme, launched by the NHS in 2015, identifies those at high risk of developing diabetes through two types of blood test, conducted as part of an NHS health check. Those flagged as being at risk are then offered follow-up interventions including lessons on healthy eating, help to lose weight and bespoke exercise programmes.
Following an analysis of the results of 49 studies of screening tests and 50 intervention trials, this research, led by the University of Oxford and supported by UCLPartners, concluded that the blood tests used to detect those at high risk of developing the disease were often inaccurate, leading to some people receiving an incorrect diagnosis and being referred by their GP for interventions while others were falsely reassured and not offered interventions.
Research co-author and Consultant Physician at Barts Health NHS Trust, Dr Shanti Vijayaraghavan, said: “Our findings suggest that ‘screen and treat’ policies alone are unlikely to have substantial impact on the worsening epidemic of Type 2 diabetes. Whilst the National Diabetes Prevention Programme will benefit some of those screened, it is unlikely to identify all those at high risk of developing the disease”
This paper suggests that population-wide approaches for effective diabetes prevention are needed to compliment the current ‘screen and treat’ programme, acknowledging that lifestyle interventions have been shown to work.
Professor Martin Marshall, UCLPartners Primary Care Development Programme Director said: “This critical research is a fantastic example of the insight collaborative working between academics and health care professionals can bring. This solution oriented work highlights the necessity for a more sophisticated approach to address the need of an ever growing population at risk of developing Type 2 diabetes.”
Effective prevention strategies for Type 2 diabetes in the current climate are vital, as are accessible and evidence based management strategies for those already living with the disease. Diabetes UK report that there are almost 3.6 million people who have been diagnosed with diabetes in the UK.
Research currently underway in the UCLPartners region is targeting this issue. UCL researcher and Islington GP Professor Elizabeth Murray is leading a team of researchers developing a new web-based diabetes self-management programme: “Our programme, HeLP-Diabetes, has been shown to help users take control of their diabetes, resulting in significant cost savings to the NHS. The programme contains information, behaviour change tools, and provides emotional support through a mixture of videos, graphics and text. It is suitable for people of all ages and ethnic backgrounds, and can be used by people with low literacy.
While preventing type 2 diabetes is clearly vital, effective support for people who already have established diabetes to maintain their health and avoid complications is crucial to ensure this large population have a good quality of life and make cost savings for our health service.”
UCLPartners continues to support important work within the partnership that addresses both the prevention and management of diabetes.
*The Newham Partnership Programme which aims to improve the health of the local population, by focussing priority health needs including the definition, identification and management of pre-diabetes.