Weight Management for Type 2 Diabetes Prevention and Remission
Preventing and achieving remission (reversal) of Type 2 Diabetes is primarily about losing and maintaining clinically significant weight loss. NHS Tayside offers effective lifestyle programmes to support this. Full information on these programmes is available here: Type 2 Tayside
Here's who can benefit from the programmes:
- The Diabetes Remission Programme is for adults up to 65 years old, diagnosed within the last 3 years.
- The Diabetes Prevention Programme is for adults up to 70 years old, who have prediabetes or a past history of gestational diabetes.
Discussing weight is a sensitive topic. Healthcare professionals can do this effectively whilst having a brief (1-2 minute) conversation. Here's an overview:
ASK
Start by respectfully asking permission to discuss the patient's weight or diabetes management. This supports their autonomy and sets a collaborative tone for a sensitive subject. Follow up with open-ended questions to gauge their readiness and interest in lifestyle changes related to weight.
- "Would it be okay if we briefly discussed your weight (and how it relates to diabetes)?"
- "Would it be ok if we briefly discussed ways to help you prevent or reverse diabetes through lifestyle changes?”
ADVISE
Provide clear advice about the benefits of weight management for prevention or remission, directly linking it to the relevant NHS Tayside programmes based on their specific health status.
Type 2 diabetes is caused by a build up of fat in the liver and pancreas. This causes a fall in insulin production and makes you less sensitive to the insulin you do produce. This leads to too much sugar (glucose) in the blood, which can cause potentially serious health problems over several years. The good news is that most people can come off their tablets and put their diabetes into remission (reverse) with 10-15kg, at least in the early years after diagnosis. If prevention is the aim, smaller amounts of weight loss are needed (5-10kg).
Sharing some information like this can be more helpful than simply advising someone to lose weight.
- For individuals with prediabetes or a history of gestational diabetes (Prevention Programme):
"Losing even small amounts of weight can significantly reduce your risk of developing Type 2 Diabetes. The Prevention Programme is a 9-month programme offering personalised health coaching via a smartphone app, with participants achieving an average weight loss of 6kg."
· For individuals with Type 2 diabetes and motivated for significant weight loss and potential remission (Remission Programme):
"If you're keen to achieve significant weight loss, potentially reduce or stop medication, and put your diabetes into remission, the Tayside Diabetes Remission Programme is a 6-month structured plan. It includes 12 weeks of free meal replacements and is led by NHS Tayside Dietitians and Health Psychologists. It has an average weight loss of 15kg (2 and a half stone) and around half of the people who enrol get their diabetes into remission."
ASSIST / ACT
Support the individual in taking the next steps toward joining a suitable programme. Provide clear information on how to access, offer encouragement and be positive about their chances to succeed! It's helpful if you are familiar with the programme details to answer initial questions.
- "Based on our conversation, the [Prevention/Remission] Programme sounds like it could be a great option for you. Would you like more information on how to join?"
- Direct them to the website for details: "You can find all the information on the Type 2 Tayside website at [provide the web address: Our Programmes - Type 2 Tayside] or simply search online for 'Type 2 Tayside' and navigate to the [Prevention/Remission] Programme."
- Arrange a follow up appointment to see how they are getting on. Encouragement, care additional support from a trusted healthcare professional is really helpful.