Diabetes team finalistsBMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i2183 (Published 22 April 2016) Cite this as: BMJ 2016;353:i2183
- Nigel Hawkes, freelance journalist
- London, UK
Beating obesity and diabetes
The scale of the twin epidemics of obesity and type 2 diabetes is daunting. “Back in 2012 there was a tendency to see it as hopeless,” says David Unwin, senior partner at the Norwood Surgery in Southport. “I think we were a little demoralised. We were particularly concerned about younger patients, who we felt were at the greatest risk of the long term effects of diabetes. So we trialled the idea of a more collaborative approach, identifying patients’ personal health goals and linking them with a low carbohydrate diet.”
A pilot was launched in January 2013 and 68 patients volunteered to join it. The plan involved group work that included family members, underpinned by a positive, solution focused psychological model to improve motivation to adopt a low carbohydrate diet. The first results showed significant reductions in haemoglobin A1c, weight, blood pressure, and cholesterol levels, with several patients coming off medication altogether. So the approach was broadened to the whole practice.
“What has really surprised us is how enthusiastic the patients have been, particularly in joining in with our regular group meetings which include interested family members,” Unwin says. “The other surprise was how well tolerated the low carb diet was. Three years later eight members of the team are on the diet with our patients.”
As a practice Norwood Surgery now spends £45 000 (€57 000; $64 000) a year less on drugs for diabetes than is average in the area. Obesity prevalence dropped from 9.4% to 7.5%, and blood glucose levels have been reduced by 10%. The practice has worked with Diabetes UK to put what has been learnt into a 10 week online low carbohydrate programme. “In the first 110 …