Case study: Diabetes Remission in East Riding of Yorkshire
Oviva Diabetes Remission in East Riding of Yorkshire
The National Diabetes Audit identified 19,486 people were living with diabetes in East Riding of Yorkshire, with an average medication cost of £319.12 per patient (2017/18 data). Hull and East Riding of Yorkshire CCGs commissioned Oviva to deliver a digitally-enabled Low Calorie Diet programme with the aim to maximise programme attendance and completion rates.
The partnership also aimed to assess the retention and clinical effectiveness of such a service for adults living with Type 2 diabetes requiring no face-to-face appointments.
Oviva’s flexible delivery model enables us to tailor support for the local population by offering a highly accessible and personalised programme to encourage attendance and retention, and support outcomes for all.
What is Type 2 diabetes remission?
Remission of Type 2 diabetes can be achieved when a person with confirmed Type 2 diabetes has achieved all three of the following criteria:
- Weight loss
- Fasting plasma glucose or HbA1c below the WHO diagnostic threshold (<7mmol/l or <48mmol/mol, respectively) on
two occasions separated by at least 6 months - Complete cessation of diabetes medications
Definition provided by Diabetes UK.
Evidence has shown that intensive dietary intervention can help people with Type 2 diabetes achieve remission.
About Oviva Diabetes Remission
Oviva Diabetes Remission is a behaviour change programme including a Low Calorie Diet, which aims to achieve 15kg of weight loss and potential diabetes remission at 12 months.
The programme is delivered by a team of Diabetes Specialist Dietitians (DSDs), experienced health coaches and supported by Diabetes Specialist Nurses (DSNs) over 12 months. Care can be delivered either 1:1 or in groups according to participant preference.
Oviva Diabetes Remission was developed by an expert panel of specialist clinicians and is based on the DiRECT study and published principles from Diabetes UK. Oviva’s approach is aligned with this evidence to ensure our patients have the highest possible chance of achieving remission, with 12 months of support to ensure sustained results.
Background
In East Riding of Yorkshire in 2017/18:
As measured by the National Diabetes Audit
Oviva Diabetes Remission programme pathway
Participants were guided through a core educational curriculum, supported by one-to-one or group personalised coaching in the form of frequent app coaching or phone calls over three stages of the 12 month programme.
Start
Initial Consultation with the Diabetes Specialist Dietitian to set goals and provide a personalised health care plan.
Change
12 weeks of Low Calorie Diet using Total Diet Replacement, followed by 4 weeks of food reintroduction.
Sustain
Focusing on maintaining new healthy weight for life, the patient will continue to have access to the Oviva app and learning resources.
Impact
Our evaluation of the Oviva Diabetes Remission service has shown impressive results, demonstrating the effectiveness of this intervention using a digital pathway with no in-person appointments.
| 12 weeks | 6 months | |
| Retention | 90% | 84% |
| Average weight loss | 13.8kg | 14.2kg |
| Average HbA1c reduction | – | 15.8mmol/mol |
At 12 months, for participants with two HbA1C results available, improvement in HbA1c in 75% of participants from baseline, with an average reduction of 33.4%.
Remission was achieved in 62.5% of participants, and 96 prescriptions were stopped with an average of 3.3 stopped per participant.
Conclusion
The introduction of a digitally-enabled Low Calorie Diet programme can achieve clinically significant weight loss,
improvements in glycaemic control, and reductions in medications at 12 months.
A 100% remote digitally-enabled Low Calorie Diet programme has shown the ability to achieve high service attendance and ongoing engagement rates and dramatic clinical outcomes. Our digitally enabled delivery model means these improved outcomes can be achieved at significantly lower delivery costs for commissioners compared to traditional face-to-face services.
Over half of patients who completed the programme achieved remission from their type 2 diabetes at 12 months, showing that results from published research (DiRECT study) can be replicated or even exceeded in the real world through our digitally-enabled delivery model.
Participants can access convenient support to suit their timing, travel and language needs, removing many of the traditional barriers to accessing diabetes services, reducing health inequalities and ensuring that all patients can benefit from this extremely effective programme.
If you’d like to learn more about how Oviva could support your patients and practice, get in touch today.
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