Diabetes.co.uk – Low Carb Program

Summary

Diabetes.co.uk has an award-winning and experienced team of 30 employees. It is the world’s largest diabetes community and provides support, information and digital health interventions. The platform empowers patients and has had clinically validated health outcomes. The Low Carb Program (LCP), launched in November 2015, is a ten-week, automated, structured health intervention for adults with type 2 diabetes, prediabetes and obesity. Each patient’s journey is personalised through an AI-led engagement pathway. The program was developed in collaboration with Southport GP Dr David Unwin (NHS Innovator of the Year 2016) and the feedback of 20,000 patients with type 2 diabetes who completed a 54-question survey. Their responses highlighted gaps in education. The forum users instigated the program’s development, which takes account of patients’ personal goals, demographics, culture, associated co-morbidities, food preferences and budgets to influence changed lifestyles. It is accessible via mobile, PC or App. The program’s grass-roots origin has pushed scientific understanding and forced a growing acceptance of type 2 diabetes remission. Over 326,324 people have downloaded the program from 195 countries around the world.

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Innovation

Each patient’s experience with the program is personalised through an AI-led engagement pathway. Participants access nutrition-only modules, unlocked weekly, designed to help them reduce their total carbohydrate intake to <130g per day to meet self-selected goals. Weekly engagement is ensured through personalised emails and notifications. Lessons are taught through videos, written content, or podcasts. ‘Action Points’ encourage participants to make behaviour changes to reach their goals. Further support comes from downloadable resources, such as recipes, food substitution infographics and guides. Over 1,000 variables are collected from the patient in the first three months of using the program, including data from wearables and connected health devices (blood glucose meters, weighing scales, oximeters, etc). Models include one that detects the user’s risk of pancreatic cancer, with a non-threatening nudge to see a healthcare professional (HCP) if the prediction is of concern. Another can detect weight from a ‘selfie’. Members with type 2 diabetes who complete the LCP lose over 7kg, 40% eliminate at least one medication and 28% put type 2 diabetes into remission at one year. For every 10 people who start the program on insulin, six of them eliminate it upon completion. Moreover, there is 70% engagement at one year. Feedback from the first 100,000 members led to the launch of the updated LCP on 30 January 2018. It is now also available on iOS and Android, which seamlessly integrates with the web version. Further key device integrations were included in the app from 1 April 2018.

Method

Through the forum, Diabetes.co.uk discovered that patients themselves are a largely untapped, yet rich and powerful, resource for managing, and even reversing, metabolic conditions. The LCP is delivered as digital, structured education. It can be used regardless of how long the patient has had the condition and alongside medications. It employs a range of teaching methods and materials that are appropriate and relevant to the age, learning needs, cultural and ethnic background of the target population, so that individual learning styles can be accommodated where feasible. The program encourages users to track measurements and allows them to see the interaction between different areas of their health and well-being, giving them more information and more control of their new healthy lifestyle. With the LCP, individuals are never alone; they have the support of over 326,324 other patients who are going through the same journey. The program’s Lifestyle section is a constantly evolving, ever-expanding, online magazine that is updated every day, offering the latest low carb news, exclusive interviews, recipes, meal plans, low carb research and success stories. Highly qualified nutritionists also take part in the program’s daily discussion forum to support individuals. Success stories encourage participants to stay on track. Big Data collection has led further development and the LCP now offers over 120 variables to provide personalised education and support for patients. Delivery channels include text, video, audio (podcast) and Virtual Reality.

Results

Individuals with type 2 diabetes who complete the LCP lose an average of 7.45 kg and reduce their HbA1c by 2.2% (23.7mmol/mol). For people using insulin, 60% completely eliminate or decrease insulin requirements from their regime at the one-year follow-up point. The results of the LCP have been clinically validated and peer reviewed. 1,000 people with type 2 diabetes were randomly selected to be followed over the course of a year to assess how long they maintained their adherence to the teachings of the LCP. The study demonstrated that patients with type 2 diabetes can be taught to sustain adequate carbohydrate restriction to improve glycaemic control, decreasing medication use, and allowing clinically relevant weight loss. This can be achieved using highly personalised education that is delivered and supported online. Patients experienced significant elimination and reduction of medications from baseline to follow up.

Sustainability and Spread

Evidence demonstrates substantial improvements in health, diabetes-related complications, medication dependency and quality of life for patients who are able to control their blood glucose levels and meet recommended targets. The key is to provide an engaging, effective and scalable solution. The program provides significant benefits to the UK government and taxpayers through reducing GP and HCP burden, risk of complications, prescription medications and hospital admissions, while aligning with the UK government’s aim to ensure cost-effectiveness of the NHS and public services. The LCP has proved to be effective, scalable and low cost. It is set for delivery in several territories through global partnerships with reinsurance organisations and bill payers. The Diabetes.co.uk platform has over 36 million visitors and collects rapid, real-time data from its hundreds of thousands of members that is used to empower patients to take control of their health. An explosion in IoT devices, fitness trackers and health wearables means substantial data profiles of patients can be created.

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QiC Diabetes Highly Commended 2018
Diabetes Education Programmes - Adults
Diabetes.co.uk – Low Carb Program
by Diabetes.co.uk

Contacts

Dajana Vasilj

Job title:
Project Manager
Place of work:
Diabetes.co.uk

Resources

LCP_I.pdf - 2.9 MB
LCP_II.pdf - 3.7 MB

Quality In Care Diabetes

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  • 2021 KEY DATES
  • Open for entry:
    Tuesday 20 April 2021
  • Extended Entry Deadline:
    Monday 12 July 2021
  • Judging day:
    Tuesday 7 September 2021
  • Awards ceremony:
    Thursday 14 October 2021