Study shows diabetes prevention programme reduced development of T2D by 20%

In England, the NHS Diabetes Prevention Programme is offered to adults with pre-diabetes, with lifestyle advice to help reduce the risk of developing type 2 diabetes. The programme is intended to reduce the yearly cost of type 2 diabetes to the NHS by £8.8 billion, which is almost 9% of its budget, according to Diabetes UK.

People with pre-diabetes are particularly at high risk of developing type 2 diabetes mellitus. Researchers from the University of Manchester have therefore set out to investigate whether people who were referred to the programme were less likely to develop type 2 diabetes, compared with those who were not referred to the programme. To do this, the investigators used a cohort study of patients attending primary care in England using clinical Practice Research Datalink data from 1 April 2016 (NHS Diabetes Prevention Programme introduction) to 31 March 2020. Patients referred to the programme from referring practices were matched to patients in non-referring practices to minimize confounding. Patients were matched based on age, sex, and date of pre-diabetes diagnosis (within 365 days). Analysis was adjusted for age (at index date), sex, time from pre-diabetes diagnosis to index date, BMI, HbA1c, total serum cholesterol, systolic blood pressure, diastolic blood pressure, prescription of metformin, smoking status, socioeconomic status, a diagnosis of depression, and comorbidities.

A total of 18 470 patients referred to the NHS Diabetes Prevention Programme were matched with 51 331 patients not referred to NHS Diabetes Prevention Programme in the main analysis. Mean follow-up from referral was 482.0 and 472.4 days, respectively.

The researchers identified that the risk of developing type 2 diabetes was 20% lower in people with raised blood sugars referred to the programme, compared with people who were not referred and who received usual care.

While caution is needed to fully interpret the findings of this observational study, findings from the study supported the overall effectiveness of the programme. In addition, it would support the decision of the ‘rapid large-scale implementation’ of the programme in England, rather than a slower or regional introduction, as well as the continuation of the programme and the introduction of similar programmes to the rest of the United Kingdom.