This project assessed which type-2 diabetes screening programmes are the most effective and provide value for money.
April 2012 - March 2014
Community-based Prevention of Diabetes (ComPoD): A randomised trial with a waiting list control group to evaluate the effectiveness and cost-effectiveness of a third sector led, community-based diabetes prevention programme (Living Well, Taking Control [LWTC] Programme)
Research Team: Dr Jane R Smith, Professor Colin Greaves, Professor Janice Thompson & Dr Mathew Jones
Who's involved: University of Exeter
July 2014 - December 2016
Type 2 diabetes is a serious, expensive and growing public health problem. International research has demonstrated that intensive programmes which support people at risk of diabetes to make lifestyle changes and lose weight can prevent or delay diabetes onset.
However, there is a lack of robust information on how such programmes can best be implemented and whether they can produce similar results in UK ‘real-world’ settings. This project assessed whether an existing community-based diabetes prevention programme being delivered by voluntary sector organisations in two areas (Exeter, Birmingham), was better than usual care received by those who are at risk of developing diabetes to lose weight, modify other diabetes risk factors and improve their health.
GP practices helped recruit 314 adults aged under 75 years who were at risk of diabetes as they were overweight and had a recent test showing raised blood sugar (‘pre-diabetes’). Individuals taking part in the study were randomly allocated to go on the programme immediately (intervention group) or go on a waiting list for 6 months (control group).
The programme, called Living Well Taking Control (LWTC), was led by trained lifestyle coaches and comprised four initial 2-hour group sessions held weekly in local venues, follow up contacts at 2, 3, 6, 9, and 12 months, plus attendance at 5+ chosen classes/activities. Researchers assessed individuals at the start of the study and followed up their progress after six months and twelve months.
More than 3,000 people were invited to join the study, of which 10% were eligible and happy to take part. Many individuals taking part in the study were male, from ethnic minorities and from deprived areas which comprised mainly older, retired, obese adults with existing long-term conditions.
Individuals taking part in the Living Well Taking Control programme lost on average 1.7kg more at 6 months than individuals on the waiting list. They also saw improvements in waist circumference, diet, and health status, but not in blood sugar, blood pressure, physical activity or well-being. Individuals across both groups who attended more sessions lost more weight. Individuals taking part in the study were mostly able to maintain positive effects at six months but saw no further improvements at 12 months.
These findings have been used to inform and improve The Living Well Taking Control Programme which is one of four programmes running as part of the National Diabetes Prevention Programme in England.
This collaborative research was undertaken as part of the SPHR Public Health Practice Evaluation Scheme (PHPES):
SPHR research briefing: Community-based Prevention of Diabetes