Preventing type 2 diabetes in Salford

The impaired glucose tolerance (IGT) care call project reduced the risk of people with IGT developing type 2 diabetes.


The NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Greater Manchester and Salford Diabetes Care impaired glucose tolerance (IGT) care call project aimed to delay or reduce the risk of people with IGT developing type 2 diabetes. IGT is a condition where patients have a blood glucose level that is above normal but not high enough for a diagnosis of diabetes.

The CLAHRC team worked with Salford Diabetes Care’s existing care call service to develop and implement a telephone-based lifestyle intervention, delivered by trained health advisors, for patients diagnosed with IGT. The IGT care call service developed evidence-based scripts to provide educational messages, specifically for people with IGT.

The service provided a structured six month programme of proactive educational support, offering lifestyle advice by a dedicated health advisor. Rather than teaching patients in a directive manner, health advisors engaged in motivational discussions with patients, identifying key areas of their lifestyle that could be improved such as weight loss and healthy eating.

Both the International Diabetes Federations and Diabetes UK stress that lifestyle modification involving weight loss strategies, dietary modification and/or physical activity are the most effective way to prevent the onset of type 2 diabetes for IGT patients. Lifestyle interventions are recommended as the first choice in therapy for people at risk of developing type 2 diabetes.

The prevalence of diabetes in England among adults is predicted to rise to 8.5% by 2020 and 9.5% by 2030. Research shows that without any lifestyle or medical intervention, about 50% of people with IGT will develop type 2 diabetes within five to 10 years. Intensive lifestyle interventions, such as IGT care call, can reduce the risk of developing type 2 diabetes by up to 58% for people with IGT.

Key benefits

  • IGT care call helped most patients achieve sustained, healthier lifestyles
  • IGT care call won the Quality in Care (QiC) award for ‘Best Type 2 Diabetes Prevention Initiative’ in 2011
  • 90% of patients felt they received relevant, up-to-date advice on how to reduce their risk of developing type 2 diabetes
  • 88% of patients achieved or partially achieved their lifestyle goal
  • 78% of patients reported they definitely felt more confident about how they could reduce their own risk of developing type 2 diabetes
  • 75% of patients lost weight
  • 65-75% of patients saw improvements in oral glucose tolerance tests, showing the positive effect of their lifestyle changes

Our research


The CLAHRC team have developed a methodology for getting research into practice so that patients benefit from best practice and evidence-based care. The approach involves the mobilisation of knowledge from research in parallel with local active support programmes to introduce and embed change.

The research builds on three areas of expertise in:

  • The ‘Promoting Action on Research Implementation in Health Services’ (PARIHS) framework which identifies the factors that influence the successful implementation of research evidence into practice
  • Quality improvement models in healthcare
  • Knowledge Transfer Partnerships to drive change through incremental, small-scale improvements

References

People


Professor Ruth Boaden
Ms Linda Savas (CLAHRC Greater Manchester)
Ms Katherine Grady (Salford Diabetes Care)