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Study calculates cost of type 2 diabetes remission programmes

By Editor
21st December 2018
Research, Type 2 diabetes Type 2 prevention

Research funded by Diabetes UK has calculated the cost of delivering a type 2 diabetes remission programme in the NHS to be £1,000 per participant.

The figure of £1,067 represents the first year, but when factoring in the likelihood of success it rises to £2,564 for each case of remission, according to the economic analysis published in the Lancet Diabetes and Endocrinology.

The study was carried out by researchers at the University of Glasgow and Newcastle University, using data from the Diabetes UK-funded Diabetes Remission Clinical Trial (DiRECT).

The DiRECT study is a weight management programme involving an 800-calorie liquid diet and structured, long-term support from a healthcare professional to reintroduce healthy food and maintain the weight loss. Researchers are testing the programme in more than 300 people across Glasgow and Tyneside in a bid to establish if the approach could put people with type 2 diabetes into remission for the long-term.

In this economic analysis, researchers compared the treatment costs of the two groups in DiRECT, firstly the intervention group and then also the control group, where people receive current standard NHS care.

Healthcare professional training costs were taken into account as well as providing the low-calorie formula diet, review appointments and also supporting literature. Routine healthcare costs during the 12 months were also factored in, including primary care and community care, hospitalisations as well as diabetes and anti-hypertensive medications.

Taking into account for savings for reduced drug and medical needs, the cost of the 12-month programme stood at £1,067.

By the end of the first 12 months of the DiRECT study, 46% of participants were in remission. Taking this likelihood of achieving remission into account, the team estimated that each case of remission would cost £2,564.

Diabetes UK reported that the most recent, comprehensive analysis  in 2010, cited the cost of treating and managing type 2 diabetes across the whole UK population – coincidentally – at £2,564. Allowing for inflation, this cost rises to £2801, the charity said. However, the average annual cost of delivering care through the NHS does include the treatment of serious complications, and covers all stages of type 2 diabetes throughout a person’s lifetime, which this new analysis does not, Diabetes UK said.

Health Economist at the University of Glasgow Professor Andrew Briggs said: “This intervention is relatively inexpensive when compared to managing Type 2 diabetes, and we anticipate that there will be cost-savings further down the line. If people can stay in remission and therefore reduce their chances of developing diabetes complications, the cost savings to the NHS could be substantial.

“We can’t know this for certain yet. Which is why the long-term follow-up of these participants – alongside those accessing any NHS remission pilots in the near future – is very important. However, these findings are encouraging, and – in our view – begin to make the case for shifting resources to offer remission-based models of care in the future.”

Bridget Turner is Director of Policy and Campaigns at Diabetes UK. She said: “The first year results of DiRECT were very encouraging and, while we don’t yet have all the answers, this economic study, and its findings, are particularly timely.

“We’re delighted that, thanks to a growing body of evidence – including that from DiRECT – NHS England and Scotland have committed to exploring the potential of intensive lifestyle interventions as an option which may lead to remission for more people with Type 2 diabetes near to diagnosis. We hope this economic analysis will help to inform the set up and delivery of more pilots – with appropriate monitoring, follow up and support – in the future.”

NHS England also recently committed to piloting a remission programme for 5,000 people with type 2 diabetes in 2019, which Diabetes UK welcomed.

To date, Diabetes UK has committed £2.8 million to DiRECT.

Meanwhile, the award-winning Low Carb Program developed by Diabetes Digital Media is achieving impressive results in helping people to reverse, prevent and manage type 2 diabetes. A study published in the summer revealed participants were lowering their HbA1c levels, reducing their medications and weight as well as reversing type 2 diabetes.

To read the study, click here.

Comments (1)

  1. Peter Palmer says:

    Highly unlikely that the calorie restricting DiRECT programme will work longer term. Low calorie intake programmes ignore carb/insulin interaction. Not all calories are equal. High carbs, even in low calorie diets, will stimulate insulin production. Insulin is there to store energy…in the liver and fat cells. Only cutting carbs reduces insulin production and thus storage of glucose.

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