Jonathan Valabhji1,2,3, Emma Barron4, Dominique Bradley5, Chirag Bakhai5,6, Jamie Fagg4, Simon O'Neill7, Bob Young7, Nick Wareham8, Kamlesh Khunti9, Susan Jebb10, Jenifer Smith4. 1. NHS England, London, U.K. jonathan.valabhji@nhs.net. 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.
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 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. RESULTS: 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. CONCLUSIONS: 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.
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 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. RESULTS: 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. CONCLUSIONS: Reductions in weight and HbA1c compare favorably with those reported in recent meta-analyses of pragmatic studies and suggest likely future reductions in participanttype 2 diabetes incidence.
Authors: James A Dunbar; Abirami Jayawardena; Greg Johnson; Karen Roger; Amy Timoshanko; Vincent L Versace; Jane Shill; Benjamin Philpot; Erkki Vartiainen; Tiina Laatikainen; James D Best; Edward D Janus Journal: Diabetes Care Date: 2013-12-06 Impact factor: 19.112
Authors: Timo Saaristo; Leena Moilanen; Eeva Korpi-Hyövälti; Mauno Vanhala; Juha Saltevo; Leo Niskanen; Jari Jokelainen; Markku Peltonen; Heikki Oksa; Jaakko Tuomilehto; Matti Uusitupa; Sirkka Keinänen-Kiukaanniemi Journal: Diabetes Care Date: 2010-07-27 Impact factor: 19.112
Authors: J Graham; K Tudor; S A Jebb; A Lewis; S Tearne; P Adab; R Begh; K Jolly; A Daley; A Farley; D Lycett; A Nickless; P Aveyard Journal: BMC Med Date: 2019-03-01 Impact factor: 8.775
Authors: Giulia Testa; Lucía Camacho-Barcia; Carlos Gómez-Martínez; Bernat Mora-Maltas; Rafael de la Torre; Xavier Pintó; Dolores Corella; Roser Granero; Aida Cuenca-Royo; Susana Jiménez-Murcia; Nancy Babio; Rebeca Fernández-Carrión; Virginia Esteve-Luque; Laura Forcano; Jiaqi Ni; Mireia Malcampo; Sara De Las Heras-Delgado; Montse Fitó; Jordi Salas-Salvadó; Fernando Fernández-Aranda Journal: J Clin Med Date: 2022-06-16 Impact factor: 4.964
Authors: Emma Barron; Shivani Misra; Emma English; W Garry John; Michael Sampson; Max O Bachmann; Julian Barth; Nick Oliver; K G M M Alberti; Chirag Bakhai; Simon O'Neill; Bob Young; Nicholas J Wareham; Kamlesh Khunti; Susan Jebb; Jenifer Smith; Jonathan Valabhji Journal: BMJ Open Diabetes Res Care Date: 2020-12
Authors: Elizabeth Howarth; Peter J Bower; Evangelos Kontopantelis; Claudia Soiland-Reyes; Rachel Meacock; William Whittaker; Sarah Cotterill Journal: BMJ Open Diabetes Res Care Date: 2020-12
Authors: Raffaele Palladino; Adam G Tabak; Kamlesh Khunti; Jonathan Valabhji; Azeem Majeed; Christopher Millett; Eszter P Vamos Journal: BMJ Open Diabetes Res Care Date: 2020-04
Authors: Rhiannon E Hawkes; Elaine Cameron; Sarah Cotterill; Peter Bower; David P French Journal: BMC Health Serv Res Date: 2020-11-27 Impact factor: 2.655