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. In the UK, 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) is evaluating whether a tailored behavioural weight management programme that can be delivered at scale achieves better glucose control and other health outcomes than education alone. It will also evaluate whether any improvements in health and wellbeing justify the higher cost of the programme.
Starting in Summer 2018, we recruited 577 adults resident in the UK with overweight and obesity who have been diagnosed with type 2 diabetes within the last 3 years. We randomised participants to either standard care (a 1-day structured diabetes education course) or a new tailored diabetes education and weight management programme, which combines dietitian-led diabetes education with 6 months free attendance at a weekly commercial weight management group (WW, formerly Weight Watchers).
Participants were followed up at 6 months and 1 year, and we measured 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.