Type 2 Diabetes Remission Programme (using Counterweight Plus®)
Type 2 Diabetes Remission Programme (using Counterweight Plus®)
The Type 2 Diabetes Remission Programme (using Counterweight Plus®) is a clinical intervention delivered by the specialist dietetic staff of the Adult Diabetes Service. The programme was established in 2020 as part of NHS Lanarkshire’s delivery plan to fulfil the recommendations set out in A healthier future: type 2 diabetes prevention, early detection and intervention framework. Current evidence indicates that a weight loss of ~15kg may restore beta cell function and produce diabetes remission.
Counterweight Plus® is an evidenced based and peer reviewed programme offering participants 12 months of support. The programme is split in to 3 phases with Total Diet Replacement (TDR) being used initially for 3 months. The aim of the programme is for participants to achieve diabetes remission by reaching and maintaining a 15kg weight loss at 12 months. The clinical definition of diabetes remission is having 2 HbA1c results at least 6 months apart that are under 48 mmol/mol in the absence of diabetes medications.
In year 1 (2020) 23 participants commenced the programme, with 56% of participants completing the full 12 months. The service was maintained during the initial wave of the Covid pandemic by the team adapting the care delivery model from face to face support to the use of Near Me and telephone appointments.
In year 2 (2021) clinical capacity increased by almost 70% through the maintenance of a remote delivery model.
As we move into year 3 retention rates have improved, with 74% or participants still progressing through the programme. People who commenced the programme in year 2 have typically completed more of the programme compared to those in year 1. The team have worked in partnership with clinical psychology staff from the Lanarkshire Weight Management Service to focus on increasing retention and completion rates.
Results so far for those who complete the programme:
- 90% saw their HbA1c improve at 12 months, average reduction was 14mmol/mol
- 55% achieved remission at 12 months
- The number of people on diabetes medications reduced from 72% pre programme to 18% at 12 months
- All participants lost weight after 12 weeks of TDR with 63% achieving >15kg
- At 12 months 60% of participants maintained >10kg weight loss
Referral Process:
- Check inclusion/exclusion criteria
- Discuss intervention with potential participant, assess readiness to change and ability to commit to intensive lifestyle programme
- Provide patient information booklet and encourage self-referral
For more information on the inclusion criteria please download the patient information booklet can via FirstPort
