Welcome to Type 2 Diabetes Path to Remission

THE PROGRAMME | HOW IT WORKS | CHOOSING YOUR PATHWAY | CLINIC DETAILS | VIDEO | FAQs

• When do I need to take my measurements?

  We will ask you to check your blood glucose and weight on a weekly basis. Your first readings will be on the same day you start TDR. This is the same day as your first phone call with your coach. It is essential to provide these readings during the programme. We may also ask you to monitor your blood pressure.

• Do my blood glucose readings need to be fasting?

  Ideally a blood glucose reading first thing in the morning before you have your first shake is best. However you can provide a non-fasting reading later in the day if your forget do to the morning reading.

• I don't know how to use my blood glucose or blood pressure meter, what should I do?

  Please follow the instructions that come with your equipment. If you still need help please call the helpline from the equipment leaflet. They will be able to help you and signpost you to a video to watch.

• How do I change from kg to stones and pounds on the scales?

  There is a switch on the bottom of the scales.

• What should I do if I have a high or low blood glucose level?

  There will be different actions depending on the level. We will give you all the information you need in the Learn section of the Oviva app about staying safe and what to do if you are unwell or if you have out of range readings.

• Do the scales have to stay in the same place all the time?

  No, you can store them somewhere handy and then get them out when you need to. When you use the scales please put them on a flat floor. You should ask family/friends not to use your scales. This is to prevent their weight readings being added to your record.

• Can you add extra water to shakes and soups?

  Please make the shakes up exactly according to the pack instructions. This helps your body to absorb the nutrition in the best way.

• What happens if you don't like the flavour of your TDR after you've already ordered for the first 4 weeks? Can you order more?

  Unfortunately we cannot provide replacement shakes. Please make sure you try the flavours in the starter pack before you make your 4 week order. If you are struggling with the shakes please speak with your coach who will be able to support you with ideas to add different flavours to them.

• How do I measure out my food replacement?

  Your shakes and soups will be provided in large pouches with a scoop. Please use the correct scoop for each pack and don’t mix the scoops up. Each pack will provide the instructions about how many scoops to use and how much water to add.

• Can you have 2 soups and 2 shakes per day?

  Yes, you can use your products in any combination as long as you have a total of 4 products per day. For example, you could have 4 shakes per day, or 4 soups per day, or a combination such as 2 shakes and 2 soups.

• Do we have to have the soups or can we purely have shakes?

  The shakes and soups contain the same nutrition. If you don’t like the soups it is fine to have 4 shakes per day.

• Do I need to spread the meals out? I have a busy job so might not be able to have 4 products

  It is essential to your health that you take 4 products per day. If you are struggling with the timings of these your coach will be able to help you with ideas and strategies.

• Is there a set time to have the 4 TDR sachets over the day?

  There is no set time. It is essential to take 4 products per day but you can work out the best timing to suit you and your lifestyle. Your coach will be able to help with ideas if you’re struggling.

• Is there a vegetarian option?

  Yes, all of the products are vegetarian.

• Is there a milk free/vegan option?

  Yes, we can provide milk free vegan products if needed. Please note that their are fewer flavour choices for the vegan options.

• Why do I need the fibre supplement?

  Fibre is important for a healthy digestive system. When you stop food and start TDR you will miss out on the fibre from food. Your fibre supplement helps to replace the missing fibre. The dose of the fibre supplement can be adjusted to suit you. Ask your coach for advice about this.

• What should I do if the fibre causes side effects?

  In most cases the fibre supplement helps with digestive side effects. The type of fibre in the supplement can help to improve constipation as well as loose bowel movements. If you are struggling with side effects your coach will give you individualised advice about this.

• Should I add the fibre supplement to my shakes?

  No, the fibre supplement should be made up with water according to the pack instructions.

• Is tea, coffee and herbal tea allowed during TDR?

  Yes, you also have a milk allowance of up to 100ml of skimmed milk (or dairy free alternative) per day to add to teas and coffees.

• Can I add any mint leaves or lemon to my water?

  Yes, but please don’t add any sugar.

• Can I drink sugar free squash or fizzy drinks?

  Yes, as long as they are sugar free.

• How much milk can I have?

  You can have 100ml of skimmed milk per day. You coach can give you ideas and amounts for dairy free alternatives if you prefer.

• Can I use a sweetener in tea or coffee?

  Yes you can use sweetener in tea or coffee.

• What if I miss chewing solid food?

  Switching from a food based diet to TDR is a big challenge! The first few days and sometimes weeks are the most difficult and we will support you closely. If you are missing chewing your coach can provide some ideas for distractions. You may also wish to try some chewing gum. Please be aware that some chewing gum can have a laxative effect and too much could cause digestive side effects.

• Is celery allowed? Or other vegetables?

  No, this is a total diet replacement approach and it is most successful when all food is replaced with the TDR products. If you are struggling with missing food your coach will be able to support you with lots of different strategies.

• I've not had my first appointment yet, do I need to be logging all my meals before the first conversation with the coach?

  You don’t have to record your meals at this stage. However, we would encourage you to log because tracking your meals is a really powerful tool for making long term healthy changes. Logging your meals now gives you a good chance to reflect on your eating patterns. You may have some ideas about what you will like to continue doing, and what you would like to change after TDR. You can put these thoughts into action after you reintroduce food. Logging on the app now also helps you to get familiar with the app and all its features

• Why haven't you replied to my message on the app?

  Please note that the app isn’t monitored until after your first phone call with your coach. If you need to contact us in the meantime please phone us.

• I am going abroad, how does this work?

  We can provide you with a travel letter to explain that you are carrying your shakes and monitoring equipment. You should pack your blood glucose monitor in your hand luggage. If we have asked you to monitor your blood pressure you should also pack your blood pressure monitor. You should pack enough shakes for your trip, and a little extra in case of delays. You can split your shakes between your hand luggage and hold luggage.

• Should I continue TDR on holiday, or at a special event?

  Ideally it is best to continue your TDR. It can disrupt your weight loss and goals if you stop, and may make side effects more difficult to manage. If you think you may struggle to continue at an event or holiday please discuss with your coach who will have lots of ideas and options to consider.

• What happens after the 12 weeks of TDR? What support will I get?

  We know that re-introducing food after 12 weeks of TDR can be very challenging. We will closely support you with lots of coaching and advice during a 6 week food reintroduction phase. During that time you will gradually reduce the number of shakes you are having and increase food instead. We have meal plans and recipe ideas to support you. It is a great time to adopt a new healthy lifestyle and we will support you every step of the way!

• Are there any support groups that I could join?

  Yes, we run a peer support group that you are welcome to join alongside your coaching. It is an online support group that you can access via the Oviva app. Just reply to the email that we send you about the support group, or email us at at oviva.mail@nhs.net and we can add you in.

• Will I need to change my medications?

  You may need to make changes to your diabetes or blood pressure medications. Your GP will advise you exactly what to change.

• What about other medications such as cholesterol medications?

  Most other medications do not need to be changed for this programme. However please discuss any medication questions directly with your GP.

• Will my remission/diabetes be reviewed regularly after the end of the programme?

  Yes, your GP surgery should still offer you an annual review of your diabetes, or your ‘diabetes in remission’. Please continue to attend these because they check many aspects of your health, not just your blood glucose.

• I’m concerned the weight loss won’t be sustainable, what can I do?

  Weight loss is very challenging, and keeping weight off in the long term is even more challenging. We have designed this programme to be 12 months long in order to give you lots of support with making long term, meaniningful healthy choices that you can continue, rather than as a short term fix. You will work closely with your coach to find the right approach for you to do this.