East of Scotland leads the way in tackling type 2 diabetes

A pioneering, inter-agency partnership, led by NHS Lothian, NHS Fife, NHS Borders and the six local authorities in the region, is working together to reduce type 2 diabetes across the East of Scotland.

Type 2 diabetes has been on the rise across the country for the past decade, having a significant impact on the lives of individuals and health of Scotland’s population as a whole.

Over 62,000 people are living with type 2 diabetes in the East of Scotland – around 5% of the total population – and there are over 3,700 new cases in the region each year.

Recognising that diet and excess weight is driven by a range of environmental, societal and individual factors, regional health and social care providers have joined forces with stakeholders from the public, third and private sectors to advance sustainable change.

Growing evidence of the link between obesity and an increased risk of complications from COVID-19 has reinforced the importance of this shared vision, compounded by the measures recently revealed as part of the UK government’s new obesity strategy.

With national investment of £1.46 million in the East of Scotland programme this year, regional director Nicky Waters said: “Our programme is a priority initiative – reflecting the need for urgent action to reduce the prevalence of type 2 diabetes in Scotland and support people to lead healthy lifestyles.

“By adopting a Whole Systems Approach and bringing a wide range of partners together, our programme is centred on tackling structural, systemic root causes – such as poverty, inequality and childhood trauma – and the part that we all need to play in addressing them.”

Four core intervention programmes – Get Moving with Counterweight, Type 2 Diabetes Remission through Counterweight Plus, Gestational Diabetes education and Let’s Prevent Diabetes – are being rolled out across the region, with partners taking advantage of technology to support people throughout the pandemic.

Over 1900 adults have been referred to Get Moving with Counterweight and the remission programme since October 2019, with 60 patients currently taking part in Counterweight Plus.

Counterweight Plus, a free two-year programme being delivered by specialist NHS dietitians, is based on ground-breaking evidence from the Diabetes Remission Clinical Trial (DiRECT).

A combination of intensive, long-term support and Total Diet Replacement (TDR) of nutritional shakes and soups, is key to the intervention’s success.

Jenny*, a patient going through Counterweight Plus in Lothian, has overcome various hurdles to continue on the programme at home throughout the pandemic – receiving virtual support whilst juggling family and working life under lockdown.

Despite the challenges, Jenny’s blood glucose results, weight loss and largely positive experience to date, all indicate that she’s heading in the right direction. She said: “The programme hasn’t been easy but the consistent emotional support and awareness of the long-term health benefits has really spurred me on. I’ve lost twenty kilos since I was first diagnosed and feel great because of it.”

Jonathan Hayes, the dietitian supporting Jenny, reflected: “It’s brilliant to see that, despite this unprecedented situation, there are people out there like Jenny who have turned things around for the positive. And who stand a very good chance of coming out of the pandemic, having put their type 2 diabetes into remission. That is an incredible outcome.”

Partners are also working together to design services to meet the Children and Young People Weight Management Delivery Standards for Scotland and develop effective prevention initiatives.

Regional health and social care providers are further committed to improving the working environment for their 84,000 employees and local areas are rolling out community based pilot projects to test a Whole Systems Approach (WSA) to diet and healthy weight.

Laurie Eyles, one of the newly appointed professional advisers for diet and healthy weight at the Scottish Government, who prior to this had been supporting partners as the programme’s clinical lead, said: “From delivering targeted interventions, to addressing the widespread issue of weight stigma and tackling the health inequalities which exist across the region – partners are committed to making lasting improvements to the environment in which we live.

“It is this that will allow us to build an East of Scotland where we eat well, have a healthy weight and are physically active – reducing our risk of developing type 2 diabetes for the long-term.”

For weight management and type 2 diabetes support during this time, please visit:

To find out more about the programme, services and how to self-refer, please visit our website: www.eost2d.scot.nhs.uk

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davepickering

Edinburgh reporter and photographer