Supported Self-Management for People with Type 2 Diabetes in Primary Care

Type 2 diabetes (T2DM) affects a large number of people in England. Locally there are 10,000 people living with T2DM in North East Hampshire and Farnham. Blood glucose management is central to reducing the short and long term complications of diabetes, such as damage to the heart and eyes. We know that following a healthy diet and lifestyle (being active, a healthy weight, not smoking) is the best way to manage blood glucose levels but these lifestyle changes are hard to achieve and to stick at. This is partly due to psychological issues which are more common amongst people with long term conditions, like diabetes.

Existing services for people with diabetes are also not set up in a way that fully supports people to make lifestyle and behaviour changes. These services are under increasing demand to cope with higher numbers of people with T2D. An effective service would offer ongoing, proactive support for behaviour change (before there are problems), tailored to the needs of the individual and which address both their physical and psychological health.

Our overall aim is to set up and evaluate a package of online programmes to promote healthy eating, weight management and physical activity, in a patient-centred and cost-effective way, and reduce the psychological distress that is very common amongst people living with type 2 diabetes.

After 6 months of our proposed intervention (see below) we aim to show improvements in health: improved long term blood glucose management, reduced weight or body mass index (weight for height), improved blood fats and blood pressure and improved emotional well-being.

This project brings together 2 industrial partners and 1 not-for-profit organisation to recruit 2,000 people with T2DM. During routine care appointments in their local GP practices eligible patients will be offered a package of additional digital tools to support them in making and maintaining healthy lifestyle changes:

*OurPath, a 3-month online coaching programme to support weight loss and physical activity

*Silvercloud (Space from Diabetes programme)

*Commit to Change, an online goal setting programme to support users to set and achieve their own health goals, e.g. weight loss, alcohol reduction, smoking cessation.

The content of each patient's package will be personalised according to their identified needs and it is anticipated that many patients will be signposted from one tool to another as their goals and needs change.