Affordable Access

deepdyve-link
Publisher Website

Early Outcomes From the English National Health Service Diabetes Prevention Programme.

Authors
  • Valabhji, Jonathan1, 2, 3
  • Barron, Emma4
  • Bradley, Dominique5
  • Bakhai, Chirag5, 6
  • Fagg, Jamie4
  • O'Neill, Simon7
  • Young, Bob7
  • Wareham, Nick8
  • Khunti, Kamlesh9
  • Jebb, Susan10
  • Smith, Jenifer4
  • 1 NHS England, London, U.K. [email protected]
  • 2 Imperial College Healthcare NHS Trust, London, U.K.
  • 3 Imperial College London, London, U.K.
  • 4 Public Health England, London, U.K.
  • 5 NHS England, London, U.K.
  • 6 Luton Clinical Commission Group, Luton, U.K.
  • 7 Diabetes UK, London, U.K.
  • 8 MRC Epidemiology Unit, University of Cambridge, Cambridge, U.K.
  • 9 Diabetes Research Centre, Leicester Diabetes Centre, University of Leicester, Leicester, U.K.
  • 10 Nuffield Department of Primary Care Health Science, University of Oxford, Oxford, U.K.
Type
Published Article
Journal
Diabetes care
Publication Date
Jan 01, 2020
Volume
43
Issue
1
Pages
152–160
Identifiers
DOI: 10.2337/dc19-1425
PMID: 31719054
Source
Medline
Language
English
License
Unknown

Abstract

To assess weight and HbA1c changes in the Healthier You: National Health Service Diabetes Prevention Programme (NHS DPP), the largest DPP globally to achieve universal population coverage. A service evaluation assessed intervention effectiveness for adults with nondiabetic hyperglycemia (HbA1c 42-47 mmol/mol [6.0-6.4%] or fasting plasma glucose 5.5-6.9 mmol/L) between program launch in June 2016 and December 2018, using prospectively collected, national service-level data in England. By December 2018, 324,699 people had been referred, 152,294 had attended the initial assessment, and 96,442 had attended at least 1 of 13 group-based intervention sessions. Allowing sufficient time to elapse, 53% attended an initial assessment, 36% attended at least one group-based session, and 19% completed the intervention (attended >60% of sessions). Of the 32,665 who attended at least one intervention session and had sufficient time to finish, 17,252 (53%) completed: intention-to-treat analyses demonstrated a mean weight loss of 2.3 kg (95% CI 2.2, 2.3) and an HbA1c reduction of 1.26 mmol/mol (1.20, 1.31) (0.12% [0.11, 0.12]); completer analysis demonstrated a mean weight loss of 3.3 kg (3.2, 3.4) and an HbA1c reduction of 2.04 mmol/mol (1.96, 2.12) (0.19% [0.18, 0.19]). Younger age, female sex, Asian and black ethnicity, lower socioeconomic status, and normal baseline BMI were associated with less weight loss. Older age, female sex, black ethnicity, lower socioeconomic status, and baseline overweight and obesity were associated with a smaller HbA1c reduction. Reductions in weight and HbA1c compare favorably with those reported in recent meta-analyses of pragmatic studies and suggest likely future reductions in participant type 2 diabetes incidence. © 2019 by the American Diabetes Association.

Report this publication

Statistics

Seen <100 times