Janice had Type 2 diabetes. She was stuck in some unhealthy habits – drinking four cans of coca cola a day, eating three-person portions of pasta, binging on pringles – and she needed help to make a change. In January 2018 she was diagnosed with an Hba1c level of 89, indicating a severe lack of glycaemic control.

And make a change is what she did. It began when, soon after her diagnosis, her GP referred her onto Changing Health’s Transform programme for diabetes management. Transform combines a course of digital education on diabetes with personalised behaviour change support from a lifestyle coach, and aims to give users the psychological tools to sustain a positive health behaviours over the long term.

She got off to a flying start. Kirsten, her lifestyle coach, was impressed; Janice had already begun prepping her meals in advance, swapping carbs at lunch for a healthier alternative, and dancing each night to an exercise routine – and lost a kilo in a week as a result. While it’s important to start with small changes, Janice felt she could do more, so Kirsten worked with her to set a clear, achievable short-term goal for physical activity: three brisk, 10 minute walks per day on the way to work, at lunchtime and on the way home.

By March, Janice had accelerated her progress, decreasing her portion sizes, increasing her fluid intake, cutting out crisps, swapping white bread for wholemeal and potatoes for sweet potatoes.

“She wanted to know more about the carb and sugar content of fruits and vegetables,” Kirsten says. “So I gave her a document about GI of foods and a link to a website that could be useful too. I told her carrots are quite high in GI and sugar, but they’re still vegetables and better than other things you could be eating!”

“I was very honest with Kirsten,” says Janice. “She was equally honest back, and without being judging – she was supportive and positive. I wasn’t very active – partly because I was ill and partly because of the weather, and we spoke about my frustrations with that. We discussed mini exercises I could do during the day.”

May rolled around, and it was time for another visit to the GP. There was some excellent news: Janice had reduced her HbA1c to just 55 in four months. She was well on the way to reversing her condition for good.

“I kept making swaps – I like to go to concerts, so I swapped beer for sparkling water. I haven’t touched Coca Cola, no red meat, no processed foods – I’m eating lots of fish, veggies, grilled halloumi. My partner enjoys the new diet too. I’d led him astray to be honest, but he’s just brilliant – he supports me every day”

The last time Janice and Kirsten spoke, in July, things were looking even better. Janice had reduced her HbA1c to 42 – meaning she no longer had diabetes! She’d now lost a total 14.8kg on the programme, and dropped two dress sizes to boot.

“Janice has been amazing throughout her journey on the Changing Health programme,” Kirsten adds. “She recognises that the changes she’s made are long-term lifestyle changes, rather than a short-term fix. She deserves this fantastic news!”

Does Janice have any advice for others in her position? “Be honest. That’s the key, that’s the tough thing. When I’ve been low, I’ve rung up Kirsten and beat myself up, but she looks at the bigger picture. She’s brilliant. I’ll miss her.”

Changing Health’s behaviour change programme is now available to provide 150,000 people living in Greater Manchester Type 2 diabetes support, as part of a suite of digital resources to help them better manage their condition and live healthier lives.

The NHS England and Innovate UK funded initiative makes diabetes support available from a range of providers any time, anywhere via a one-stop shop web platform, Greater Manchester Diabetes My Way. Users will benefit from digital education on lifestyle and personalised, one-to-one behaviour coaching, delivered by Changing Health, alongside tools for easier sharing of glucose monitoring data and care records with healthcare professionals.

The Idea Behind Changing Health’s Type 2 Diabetes Support Programme

The scheme was launched with the aim of giving people with diabetes all the skills and knowledge they need to play a more active role in managing their condition, by adopting positive diet and exercise habits and learning how to maintain lifestyle changes over the long term.

Type 2 diabetes support in Greater Manchester has in the past been limited to classroom education programmes, which are often inaccessible for those unable to travel or take time off work, or who have learning difficulties. Digital tools overcome these challenges, and in some cases, have been shown to improve uptake of diabetes support by more than 500%.

In addition to improving the support on offer for people with diabetes, the initiative is also likely to deliver significant cost savings for healthcare delivery in Greater Manchester, with fewer complications arising from the condition, fewer hospitalisations and fewer A&E attendances.

Here’s what the experts have to say

John Grumitt, Changing Health Chief Executive, said: “It’s great to be selected as one of the Greater Manchester Diabetes My Way providers and build on the evidence that with access to the right support, people with diabetes can make big changes in their lives and manage their condition more effectively.

“Health Secretary Matt Hancock shared his vision last week of delivering more patient-centric care, facilitated by digital tools. Greater Manchester Diabetes My Way will play a key role in making that vision a reality.

“We know that a large proportion of people with Type 2 diabetes want to make a change in their lives – but often, they simply aren’t sure how best to go about it. This initiative aims to change that.

“Where previous behavioural interventions faced some major practical and financial challenges, today’s launch is a win-win: people with diabetes are empowered to sustain long-term lifestyle changes, while healthcare providers benefit from better communication with their patients, better health outcomes and a lesser administrative burden.”

Naresh Kanumilli, SCN Clinical Lead for Diabetes, said: “This has the potential to be a real game-changer in Greater Manchester. With a large and growing Type 2 diabetes population, we need to adapt to the modern world and harness the power of new digital technology to embrace changes in how we support people living with diabetes.”

ENDS

Notes to editors

• Wave 2 of the Innovate UK Test Bed funding programme has agreed a grant of £975,000 towards the £1.2m project cost, with the remainder contributed by the industry partners involved.
• John Grumitt, Changing Health CEO, is available for interview
• Case studies of people who have achieved diabetes remission using digital tools are available.

Meet Sheinaz. She’s a GP Practice Manager in Gateshead, Newcastle, and she was largely sceptical of the power of digital interventions to help people Type 2 diabetes change their lifestyle and better manage their condition. Until she tried one out for herself.

On 13 January 2018, Sheinaz was diagnosed with diabetes. Her GP told her that her HbA1c level, an indicator of blood glucose control, was at 52. That meant her condition was under control – but only just. It was enough to motivate Sheinaz to begin making some big lifestyle changes, and when her GP offered to refer onto the Changing Health programme to help her do so, she accepted – albeit with some reservations about whether it would be of much use.

Changing Health Programme

The programme comprises a course of digital education on diabetes to improve participants’ understanding of how diet impacts on their condition, combined with one-to-one lifestyle change coaching from an expert in health psychology and behavioural science.

“I was devastated to hear the diagnosis, absolutely devastated” she says. “I just thought, ‘I have a healthy diet, I do all the things I could possibly do, what more can I do?’ Going to a group session wasn’t really sustainable for me, and the other option was having a health app.

“When you’re being monitored by your GP practice you’re only seen once a quarter, so I thought having the app available will help me to maintain that consciousness of the long term condition I have, and it’s an alternative that actually works better than seeing your GP”

As Sheinaz worked her way through the programme, her preconceptions of digital health apps changed entirely. She was moving more. She had more energy. With a few pointers from her lifestyle coach on the best changes to fit her own circumstances, soon she was cooking tasty, healthy meals every day, building positive habits into her daily routine rather than treating weight loss as a chore. “I increased my physical activity on a daily basis using the app, and having my own personal health coach really helped too.”

It was a complete change of mindset for Sheinaz – and it paid off. In just ten weeks she had lost 18lb, or a little over 8kg. Then came more good news.

It Really Happened: Type 2 Diabetes Reversal

“I spoke to my GP on the phone. He said ‘you don’t have diabetes’ – I said ‘yes I do, I was diagnosed ten weeks ago!’ – and he said ‘well your blood sugars are normal; you’ve reversed your diabetes.’”

Sheinaz was ecstactic. And six months on from the original diagnosis, she’s living a whole new life. “In myself I feel better, my memory’s much better… I’m sleeping really really well, bouncing with energy, and bouncing with confidence. I love the diet and I’ve got so much energy as a result, and I’m still losing up to half a pound per week but I never feel like I’m on a diet.

The Changing Health programme was designed to empower users not only to adopt healthier habits, but crucially, to keep them up – for good. That looks promising for Sheinaz. As of mid-July, she’s now lost a total of 24lb and dropped two dress sizes.

“I can still use the app and the coaching sessions for another six months, but I don’t really need them; it’s become a habit now. I’m being creative about cooking, and I’m eating less carbs, but you know what? I don’t miss them at all.”