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From April 2018, two schemes have been launched in the Devon STP area aiming to prevent the onset of Type 2 Diabetes in the at-risk population. The schemes will both be delivered by WW Health Solutions and a local provider, Westbank, through a direct contract for a national programme [Healthier You] and a local contract [Healthier Devon] commissioned by Devon County Council. Both schemes have the same eligibility criteria.
The schemes deliver evidence-based behavioural interventions to individuals at high risk of developing Type 2 diabetes and associated long-term illnesses.
Non Diabetic hyperglycaemia (NDH) identified by blood test in last 24 months (without diabetes diagnosis) e.g.:
Women with a history of Gestational Diabetes Mellitus (GDM) and normoglycaemia (FPG lower than 5.5mmol/l or HbA1c lower than 42 mmol/mol)
Consider red cell abnormalities
Health Care Professional (HCP) (e.g. GP, practice nurse, community nurse) sends/gives a self-initiative letter to eligible patients, which encourages patients to directly contact the provider to book an appointment.
Fill out and send the referral form to firstname.lastname@example.org
Please note pre-referral criteria are applicable in this referral and referrals may be returned if this information is not contained within the referral letter.
Send the self-initiative letter directly to eligible patients including NHS number, blood test result and date.
For women with a history of GDM and patients aged over 80 years old, please only use the referral form and send to email@example.com, do not use the self-initiative letter.
|Introduction, including risk and prevention of Type 2 diabetes; goal setting|
|Pre-diabetes and a healthy lifestyle including: 5 key healthy lifestyle messages: (1 Eating a healthy diet; 2 Undertaking regular exercise; 3 Achieving and maintaining a healthy weight; 4 Positive mental health and wellbeing; 5 Making healthy lifestyle choices)|
|Healthy Easting, including risk and prevention of Type 2 diabetes; goal setting|
|Barriers to Healthy Eating, including risk and prevention of Type 2 diabetes.|
Eating Less and Food Labelling
|Physical Activity, including risk and prevention of Type 2 diabetes; goal setting|
|Physical Activity Barriers, including risk and prevention of Type 2 diabetes; goal setting|
Barriers to Behaviour Change
|Positive Mental Health and Wellbeing, including risk and prevention of Type 2 diabetes; goal setting|
Pre-diabetes patient information - MyHealth
Patients have said that they want more support to manage their condition. Consultants, GPs and nurses have said that they want to be able to support patients to self-care more easily.
People joining the programme have seen HbA1c reduced to below the 'at risk' range quickly, have reduced their weight and made lasting changes to their lifestyle during the 9 or 24 month programme. There is good published evidence of a 26% reduction in progression to diabetes for people who complete the programme.
This guideline has been signed off by the Diabetes Prevention Programme working group on behalf of NHS Devon CCG.
Publication date: April 2020
Updated: August 2021