Wales diabetes prevention programme cuts risk of developing type 2 diabetes by nearly a quarter

A diabetes prevention programme run by NHS Wales cuts the risk of developing type 2 diabetes by nearly a quarter, a new report suggests.

According to the evaluation report compiled by Public Health Wales, the All-Wales Diabetes Prevention Programme (AWDPP) is shown to be successfully preventing or delaying the onset of type 2 diabetes. Funded by the Welsh Government and launched by local health boards in 2022, the programme has now been offered to more than 10,000 people across Wales.

Participants are identified as being at risk through a simple blood test, and support is delivered through specially trained primary care teams. The programme currently operates in 35 out of 60 primary care clusters across Wales.

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More than 220,000 people in Wales are estimated to live with diabetes currently, predominantly type 2 diabetes. Without prevention interventions, projections indicate that one in eleven adults in the country will develop type 2 diabetes by 2035.

Following a pilot in two parts of Wales, the scheme has been delivered to over half of the primary care clusters in the county, prioritising areas with a high prevalence of type 2 diabetes. However, despite the success of the scheme, the report suggests that to maximise its impact, there is a need for ‘sustained investment’, which will enable the model to be expanded to all regions and achieve health equity throughout Wales.

Under the programme, people who have had a blood test that shows that they are at an increased risk of type 2 diabetes (prediabetes, indicated by HbA1c between 42-47mmol/mol) are invited to attend a 30-minute consultation with a trained healthcare support worker.

The healthcare support worker explains their risk of developing type 2 diabetes and what they can do to reduce it and offers guidance on maintaining a healthy weight, including exercise and dietary interventions. Healthcare workers and dietitians support patients and can refer them to additional sources of support if needed.

The programme evaluation, summarised in the recent report, shows evidence that the scheme is working. Researchers compared 1,970 adults with prediabetes, who had an average HbA1c at baseline of 43.7mmol/mol and undertook the AWDPP, with 1,494 adults with prediabetes who had an average HbA1c at baseline of 43.6mmol/mol and did not participate in the programme.

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Participants in the programme were more likely to return to normal blood glucose levels or maintain blood glucose levels within the prediabetes range, and were less likely to progress to diabetic blood glucose levels, than those who did not participate.

Specifically the evaluation showed that the probability of people remaining at prediabetes or returning to normal HbA1c levels was 23% higher in the group offered AWDPP, and the probability of people progressing to diabetes HbA1c levels was 23% lower in the group offered AWDPP.

Alisha Davies, Head of Research and Evaluation at Public Health Wales, said: ‘The evaluation shows us that the diabetes prevention programme is effective in stalling and reducing progression to diabetic blood glucose levels. Continuing to capture the benefits to patients through robust monitoring and evaluation will help us to understand its sustained impact over time on an important preventable disease in Wales.’

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Dr Sarah Davies, GP in Cardiff and Primary Care lead for Diabetes in Wales, said the report showed the positive impacts of ‘timely support’ to help people make small but impactful changes to their diet and level of physical activity.

She added: ‘I wholeheartedly support making this intervention available to everybody in Wales who needs to receive it, as the benefits are clear to see.’