Early Outcomes From the English National Health Service Diabetes Prevention Programme.
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Authors
Barron, Emma
Bradley, Dominique
Bakhai, Chirag
Fagg, Jamie
O'Neill, Simon
Young, Bob
Smith, Jenifer
Publication Date
2020-01Journal Title
Diabetes care
ISSN
0149-5992
Volume
43
Issue
1
Pages
152-160
Language
eng
Type
Article
This Version
AM
Physical Medium
Print-Electronic
Metadata
Show full item recordCitation
Valabhji, J., Barron, E., Bradley, D., Bakhai, C., Fagg, J., O'Neill, S., Young, B., et al. (2020). Early Outcomes From the English National Health Service Diabetes Prevention Programme.. Diabetes care, 43 (1), 152-160. https://doi.org/10.2337/dc19-1425
Abstract
Objective
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.
Research Design and Methods
A service evaluation assessing intervention effectiveness for adults with non-diabetic hyperglycaemia (HbA1c 42-47 mmol/mol (6.0-6.4%)) or fasting plasma glucose 5.5-6.9 mmol/l) between programme launch in June 2016 and December 2018, using prospectively collected national service-level data in England.
Results
By December 2018, 324,699 people had been referred, 152,294 had attended initial assessment and 96,442 had attended at least one of 13 group-based intervention sessions. Allowing sufficient time to elapse: 53% attended initial assessment; 36% attended at least one group-based session; and 19% completed the intervention (attended over 60% of sessions). Of the 32,665 that attended at least one intervention session and had sufficient time to finish, 17,252 (53%) completed: intention-to-treat analyses demonstrated mean weight loss 2.3 (95% CI: 2.2-2.3) kg and HbA1c reduction 1.26 (1.20-1.31) mmol/mol (0.12 (0.11-0.12) %); completer analysis demonstrated mean weight loss 3.3 (3.2-3.4) kg and HbA1c reduction 2.04 (1.96-2.12) mmol/mol (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 smaller HbA1c reduction.
Conclusions
Reductions in weight and HbA1c compare favourably to those reported in recent meta-analyses of pragmatic studies and suggest likely future reductions in participant type 2 diabetes incidence
Keywords
Humans, Diabetes Mellitus, Type 2, Prediabetic State, Hyperglycemia, Obesity, Weight Loss, Preventive Medicine, Adult, Aged, Aged, 80 and over, Middle Aged, Preventive Health Services, State Medicine, England, Female, Male, Weight Reduction Programs, Outcome Assessment, Health Care
Sponsorship
NHS England funded programme development, implementation and evaluation.
Funder references
MRC (MC_UU_12015/1)
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0617-10149)
Identifiers
External DOI: https://doi.org/10.2337/dc19-1425
This record's URL: https://www.repository.cam.ac.uk/handle/1810/298158
Rights
All rights reserved