Can a digital and IoT-enabled behaviour change programme achieve >15kg weight loss and 70% type 2 diabetes remission rates?

"Type 2 diabetes (DM2) affects 4.1 million people in the UK. DM2 can be hard to manage, with many people needing more than one medication to control their blood sugars, which often come with medications to manage high blood pressure or cholesterol. Furthermore, people are also often receiving treatment for other conditions linked to their DM2 such as kidney disease.

In the long-term, DM2 is associated with a range of devastating complications including blindness, lower limb amputation and stroke.

The DiRECT clinical study has recently shown that rapid and substantial weight loss, typically 10-15kg using an 800-kcal diet for 12-weeks, can help people achieve healthy blood-glucose levels and reduce or even stop their diabetes medications (when someone diagnosed with DM2 has a healthy blood-glucose level and is no longer taking diabetes medications, this is called 'remission').

However, to achieve 'remission' most people require weekly support from specialist dietitians and nurses to undertake this diet safely, and to develop new behaviours to maintain their weight loss and health improvements in the long term.

The main challenge of this is that frequent face-to-face appointments are very costly for the NHS and inconvenient for people to access, requiring time off work or from caring responsibilities to attend appointments. Hard to attend appointments can make people less likely to stay on the diet and achieve weight loss and health benefits.

To address this challenge, Oviva has created the Diabetes-800 programme which helps people with DM2 achieve \>15kg weight loss. Diabetes-800 is a remote service, providing one-to-one support from a diabetes specialist dietitian and nurse via the telephone and the NHS Digital approved Oviva smartphone app. The app allows people to monitor their diet and goals which they receive personalised feedback on.

This approach maximises accessibility and flexibility for patients, helping more people to lose weight, achieve remission, and come off diabetes medications, in turn helping the NHS reduce the cost of treating DM2\.

This project will add a weight scale and activity tracker that connects to the app, as well as a new Machine-Learning algorithm that provides encouraging support, to helping patients better achieve their weight loss goals.

This modified Diabetes-800 programme will be evaluated by the University of Westminster in 300 with DM2 from GP practices to see if it can safely generate the same patient benefits as face-to-face approaches. This evaluation will inform NHS decision-making about commissioning such services, and further research."