A new study led by the University of Glasgow and published today in Diabetes, Obesity and Metabolism, showed how effective the NHS Greater Glasgow and Clyde Glasgow and Clyde Weight Management Service lifestyle programme was at reducing the need for diabetic medication or insulin over a three-year period.
Researchers found that patients who successfully completed the programme had no increase in their oral diabetes medication, and were half as likely to progress to insulin as those who didn’t complete the programme and those who did not lose weight. As type 2 diabetes is a progressive condition, patients who were not referred, or did not successfully complete the programme, required increased amounts of oral diabetes medications over the subsequent three years.
The study also found that patients who successfully completed the programme went on to maintain that greater weight loss over a three-year period, than either those who didn’t complete the programme or those not referred to it.
In light of the findings researchers believe that this kind of lifestyle programme may be even more effective than some pharmacological alternatives in treating type 2 diabetes.
The study examined records from the NHS 16-week lifestyle programme, which included a regime of diet, exercise and behaviour change. The programme consists of nine fortnightly classes. Researchers defined ‘success’ as losing 5kg in that nine-week timeframe. Patients could then choose to stay on for further weight loss and maintenance classes (one per month) over the next year. Patients with type 2 diabetes had to have a body mass index of 30 or above, in order to qualify to be referred to the programme.
To judge whether the programme was a success, researchers compared the successful group against those who attended and didn’t lose weight, or those who didn’t complete, or those who were never referred.
Dr Jennifer Logue, lead author of the study from the University of Glasgow, said: “This is the first real-world study to show that the lifestyle weight management programmes that we deliver in the NHS can have a long lasting meaningful clinical effect on type 2 diabetes.
“This study shows that the common assumption that the weight lost is quickly regained is not true. Currently weight management programmes in the NHS are under-resourced and there is a lack of belief in their effectiveness by clinicians leading to low levels of referral, despite them being recommended by NICE.
“Our hope is that this study will convince patients, clinicians and NHS managers that these inexpensive programmes can make a clinically significant difference to patients with type 2 diabetes.”
The researchers believe these kinds of programmes need to be better resourced so that more patients can achieve the defined ‘success’ weight loss of 5kg. Currently, only a minority of those who attended the programme achieved the 5kg weight loss. However researchers believe that this number would go up in line with investment to address the accessibility of programmes, so that people are able to attend regularly while continuing with work and caring commitments.
The study, ‘The effect of non-surgical weight management on weight and glycaemic control in people with type 2 diabetes: a comparison of interventional and non-interventional outcomes at three years’ is published in Diabetes, Obesity and Metabolism.