Health Exchange’s alternative model for diabetes care reveals encouraging preliminary findings

 LWTC twitter profile #2

Developed by Health Exchange, the Living Well, Taking Control (LWTC) program adopts a non-clinical approach to both preventing and managing type 2 diabetes. It is currently being delivered by four community and voluntary sector partner agencies in the North East, West Midlands and Devon.

Between October 2013 and June 2015, The University of the West of England is conducting effectiveness research into the ongoing efficacy of the program. The trial is assessing the value of our methods in treating and deescalating the diabetes condition.

We are very encouraged by the early findings and anticipate that the LWTC model will become widely used and accepted in the years ahead.

 Self-responsibility – the Way Forward?

The Living Well, Taking Control (LWTC) program is designed to respond to the needs, identified by GP’s, of a population insufficiently educated on how to manage their personal health and wellbeing. This has a particularly discernible impact amongst sufferers of long term conditions, such as diabetes.

For the past seven years, Health Exchange has been providing education sessions for patients with long-term conditions including both diabetes and pre-diabetes, with the aim of improving the self-management of their condition.

Alongside its primary aim of self-responsibility, this model has been proven to reduce the amount of clinical contact-time required by patients which, in turn, could lead to a substantial unburdening of NHS resources.

Research Brief

The key aims were to establish:

–  Is a community-based diabetes prevention program, delivered by voluntary sector organisations(the “Living  Well, Taking Control” programme), more effective than routine care from GP practices alone in modifying diabetes risk factors (weight, physical activity and blood sugar levels)?

–  Is providing the Living Well, Taking Control programme a good use of health care resources in terms of any improvements in quality of life gained after 6 months?

–  Are any changes in weight, physical activity, blood sugar levels and self-reported quality of life and wellbeing resulting from the programme maintained up to 12 months?

–  What population, participant and provider characteristics influence the effectiveness and cost effectiveness of the Living Well, Taking Control programme?

Participant Demographics

Data was provided for 491 participants in total (265 Health Exchange, 31 HealthWORKS, 11 PCP, 184 Westbank).

  • Diagnosis: 185 participants had diabetes (37.7%), 298 had pre-diabetes (60.7%)
  • Gender: 191 participants were male (38.9%), 294 were female (59.9%)
  • Age: Participant ages ranged from 24-91 years old
  • Body Mass index (BMI): 80 were normal weight (17.1%), 167 were overweight (35.7%), and 221 were obese (47.2%)
  • Smoking status: 30 participants were smoker (6.1%)
  • Other conditions: high cholesterol 25.5%, arthritis 20.2%, mobility problems 10.6%, coronary heart disease 7.9%, depression 5.3%, stoke 4.1%, and chronic kidney disease 3.3.%

Key Findings

6 month follow-up results

The following graphics are taken from a total of 59 participants who provided 6-month follow-up data.

Difference between data for participants from baseline and six months:

Within this short research-period, the LWTC program facilitated substantial and positive change amongst participants. The initial findings suggest several encouraging signature indicators including a reduction in BMI, waste circumference and glucose levels.

Leon Sewell, Senior Chronic Disease Educator at Health Exchange, comments: “As well as being a problem for general public health, diabetes also has a significant impact on NHS resources. If we are able to empower individuals to make more informed choices, then we can prevent the onset of type 2 diabetes in a cost-effective manner.

“The results so far indicate that with supported education in self-management, we may be able to prevent or at least delay the onset of type 2 diabetes through weight reduction and an improvement in blood glucose levels.”

 For more extensive information on the trial visit: http://www.isrctn.com/ISRCTN70221670

Looking Ahead

The final research findings are due to be published in June 2016. From the results so far, we expect these to prove significant not only for the management and prevention of type 2 diabetes, but also for patients with other long-term conditions such as high cholesterol, cardiovascular disease and arthritis, who could benefit from the Living Well, Taking Control approach.

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