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Diabetes Professional Care
15-16 November 2023, Olympia London

The UK's leading event for the entire team involved in the prevention, treatment and management of diabetes and its related conditions.

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The Lifestyle Club: A new model of healthcare

The Lifestyle Club Hall: National Stand: P4
The Lifestyle Club: A new model of healthcare

Diabetes is the leading cause of blindness for people of working age in the UK and type 2 diabetes complications cause more than 180 leg, foot and toe amputations each week (1). An HbA1c greater than 58mmol/mol has been shown to reduce life expectancy by 100 days each year, which represents one third of an individual’s remaining lifespan (2). Yet sadly, one in three people with diabetes fail to control their blood glucose levels to these targets, despite increasing medication (3).

The Lifestyle Club (TLC) developed by charity Public Health Collaboration (PHC) provides an 8- week diet and lifestyle course and on-going support. Each class is led by an experienced health coach who works with participants to help them feel empowered to make sustainable diet and lifestyle changes. The course introduces carbohydrate restriction as a powerful tool for addressing metabolic issues, often reversing these conditions altogether (4).

Since June 2021, over 700 participants from across the country have attended TLC courses, with 88% completion. After 6 months, mean weight loss was 4.5kg (95%CI -5.2 to -3.8) and waist circumference was reduced by 9.4cm (95%CI -9.9 to -8.9). Glycaemic control was also improved, with HbA1c improving by 10.4mmol/mol (95%CI -11.1 to -9.7). This significant reduction was despite 91.6% of participants who were taking diabetes medication reducing the amount they needed (n=142); eleven of whom were able to omit their diabetes medication altogether!

GP Dr David Unwin founding member of the PHC charity, has embraced the low carbohydrate approach at his practice following a 9-fold increase in prevalence of type 2 diabetes since 1986. Since doing so, 133 of his patients with diabetes have achieved remission. In a recent paper, he reported 51% overall remission rate in patients choosing this approach, 77% in those diagnosed with type 2 diabetes within the previous year. (5)(6).

“If all practices in England prescribed as we do, the NHS would save £270 million per year” Dr David Unwin GP (7)

A report commissioned by the British Dietetic Association and Diabetes UK concluded that “low carbohydrate diets, if appropriately supported, are considered safe and should not be avoided in suitable individuals who find these approaches acceptable.” (8)

How a low carbohydrate diet helps

Dietary carbohydrate directly impacts blood sugar levels by quickly turning into glucose. Quality protein including meat, fish, eggs, dairy and nuts and healthy fats found in butter and olive oil have a low glycaemic index. Eating this type of food lowers insulin levels resulting in reduced hunger, less snacking and accelerated weight loss (4).

Educating patients on how different foods impact blood sugar helps them to make healthier choices. This infographic designed by Dr Unwin shows why basing meals on vegetables, protein and healthy fats instead of rice potatoes and pasta can quickly stabilise blood glucose levels.

TLC costs £150 per participant for the 8-week course, handbook and lifetime support representing excellent value for money. Support is key, so all participants are offered class WhatsApp groups, fortnightly drop-in sessions with a health coach, monthly webinar style catchups all over Zoom and, in some areas, local support hubs connect them with participants from their neighbourhood. It is possible to offer The Lifestyle Club using the Additional Roles Reimbursement Scheme funding. Contact Director of TLC, Helen Gowers to find out more on helen.gowers@phcuk.org

Let us help you to support your patients living with prediabetes and type 2 diabetes. Commission The Lifestyle Club and help them feel empowered to improve their health today!

www.TheLifestyleClub.uk

References

1) Diabetes UK www.diabetes.org.uk/professionals/position-statements-reports/statistics (accessed May 2022)

2) Heald AH, Stedman M, Davies M, Livingston M, Alshames R, Lunt M, et al. Estimating life years lost to diabetes: outcomes from analysis of National Diabetes Audit and Office of National Statistics data. Cardiovascular Endocrinology & Metabolism. 2020;9(4):183-5.

3) National Diabetes Audit 2018–19: Care Processes and Treatment Targets Report Published February 2021 available from https://www.diabetes.org.uk/professionals/resources/national-diabetes-audit/nda-reports

4) Wheatley SD, Deakin TA, Arjomandkhah NC, Hollinrake PB and Reeves TE (2021) Low Carbohydrate Dietary Approaches for People With Type 2 Diabetes—A Narrative Review. Front. Nutr. 8:687658

5) Unwin D, Delon C, Unwin J, et al What predicts drug-free type 2 diabetes remission? Insights from an 8-year general practice service evaluation of a lower carbohydrate diet with weight loss BMJ Nutrition, Prevention & Health 2023;e000544. doi: 10.1136/bmjnph-2022-000544

6) Matthew C Riddle, William T Cefalu, Philip H Evans, Hertzel C Gerstein, Michael A Nauck, William K Oh, Amy E Rothberg, Carel W le Roux, Francesco Rubino, Philip Schauer, Roy Taylor, Douglas Twenefour, Consensus Report: definition and Interpretation of Remission in Type 2 Diabetes, The Journal of Clinical Endocrinology & Metabolism, Volume 107, Issue 1, January 2022, Pages 1–9

7) Unwin D, Khalid AA, Unwin J, Crocombe D, Delon C, Martyn K, et al. Insights from a general practice service evaluation supporting a lower carbohydrate diet in patients with type 2 diabetes mellitus and prediabetes: a secondary analysis of routine clinic data including HbA1c, weight and prescribing over 6 years. BMJ Nutrition, Prevention & Health. 2020 Nov 2;3(2):285-294

8) Brown A, McArdle P, Taplin J, Unwin D, Unwin J, Deakin T, Wheatley S, Murdoch C, Malhotra A, Mellor D. Dietary strategies for remission of type 2 diabetes: A narrative review. J Hum Nutr Diet. 2022 Feb;35(1):165-178

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