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Walking Away from Diabetes - a new initiative for those at risk

Walking Away from Diabetes is a new module for those at risk of developing diabetes, which supports the aims of the government’s new vascular checks programme. It is a good example of a simple, but effective, intervention aimed at improving cardiovascular health.

With the advent of the vascular screening programme in the UK there is increasing pressure on healthcare organisations to identify and treat those at risk of vascular disease, such as Type 2 diabetes.

A central requirement of this module is to offer ‘at-risk’ individuals appropriate lifestyle counselling and education which supports positive behaviour change. Whilst there is clear evidence that lifestyle interventions can successfully reduce the risk of progressing to Type 2 diabetes by 30%-60% in ‘high risk’ individuals, there are several limitations when it comes to translating this research into practice.  

The best performing diabetes prevention programmes have involved multiple and intensive 1:1 counselling appointments, an approach that is unfeasible in a UK ‘real-world’ health care setting. And although some traditional lifestyle counselling programmes are cost-effective in the long- term, they would place a crippling effect on healthcare organisations in the short-term if implemented at regional or national level.  

So, although intensive diabetes prevention programmes are academically interesting and were necessary to prove the efficacy of lifestyle change, they have limited translational relevance. As a result, we are now seeing a new generation of programmes designed specifically to take account of the infrastructure and resources available to national healthcare providers. These make use of existing strategies for promoting self-management, including those used in a variety of patient groups.

The PREPARE programme

One of these programmes is PREPARE (Pre-diabetes risk education and physical activity recommendation and encouragement). Developed by the Diabetes Research Unit at the University Hospitals of Leicester in the UK, it consists of a 3-hour group-based educational session.

The programme was based on the approach to fostering self-management as currently recommended in the UK for all individuals with Type 2 diabetes. It promotes behaviour change, and has a track record of being compatible with the infrastructure and resources available to the NHS.  
                        

Implementation

Following a successful scientific study, PREPARE has gone on to form the basis of a larger randomised controlled trial, and provided with a complementary training programme for educators ready for national implementation. As part of this transition, 3 healthcare organisations are currently acting as early adopter sites of the 3-hour structured education programme for people at risk of diabetes, now known as ‘Walking Away’.  

The 3 early implementer sites

• Brighton & Hove NHS Trust
• Cumbria NHS
• West Cork (Eire)

are very different in terms of their population and urban v. rural areas. The implementation team are hoping to add to their learn from these sites on how people perceive risk and take up the opportunity to access these programmes.

Watch this space!…………..