Type 2 diabetes is typically characterised as a progressive irreversible condition. However, there is evidence that people with type 2 diabetes can achieve good glucose control or even remission through weight loss. Most studies that demonstrate this have used bariatric surgery or formula diets, which are rarely commissioned in the UK because of their high cost and reliance on specialists. Standard care for people with a new diagnosis of type 2 diabetes is structured diabetes education, which has low uptake and small, short term effects on weight and blood glucose.
The GLoW (Glucose Lowering through Weight management) trial will evaluate whether a tailored behavioural weight management programme that can be delivered at scale achieves better glucose control and other health outcomes than education alone and whether any improvements in health and wellbeing justify the higher cost of the programme.
Starting in Spring 2018, we will recruit 576 people with overweight and obesity who have been diagnosed with type 2 diabetes within the last 3 years. We will randomise participants to either standard care (a 1-day structured diabetes education course) or a new tailored weight management programme that combines diabetes education and dietitian support with 6 months attendance at a weekly commercial weight management group (Weight Watchers).
Participants will be followed up at 6 months and 1 year, and we will measure clinical outcomes (such as blood glucose and body weight), diet and physical activity behaviours, and use of medications and other health care resources. We will analyse which group has better changes in health outcomes and which programme offers best value for money. Findings from this trial will inform the decisions of commissioners of services for weight management and diabetes about the most cost-effective use of limited health-care resources.
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Joint Principal Investigators
Unit led trial with responsibility for data
University of Sheffield, University of Leeds, University of Oxford, Fakenham Medical Practice, NHS North Norfolk Clinical Commissioning Group,
The trial will be jointly sponsored by the Cambridgeshire and Peterborough Clinical Commissioning Group and the University of Cambridge.
The trial is funded by an NIHR Programme Grant for Applied Research; grant reference RG-PG-0216-20010.
The tailored weight management programme will be provided by Weight Watchers UK at no cost to patients or the NHS.