It’s been 20 years since the type 2 diabetes education course Diabetes Education and Self-Management for Ongoing and Newly Diagnosed (DESMOND) began changing lives. We’ve taken a look at its evolution and how Diabetes UK-funded research has helped shape DESMOND into what it is today.
From humble beginnings to a national programme, DESMOND has supported more than 800,000 people with type 2 diabetes to better understand their condition, build the skills and confidence to manage it, and improve their long-term health.
Living with type 2 diabetes is relentless and unpredictable, demanding daily decisions about food, activity, and medication, often with limited time and support from healthcare professionals. That’s why programmes like DESMOND are so important.
Developed by researchers at the Leicester Diabetes Centre, DESMOND recognises that people with type 2 are the experts when it comes to managing their condition. It empowers them by giving them the practical tools and support to find what works for them.
Early beginnings to national roll-out
It all started in 2003 when a group of diabetes clinicians and people living with type 2 diabetes came together to develop a new kind of education programme to support people when they’re first diagnosed.
It involved structured group sessions led by trained educators, where people learned about type 2 diabetes and shared experiences with others.
After a small pilot study in 2006 showed the programme’s potential, Diabetes UK funded a large UK-wide clinical trial, involving 824 people - still the largest studies of its kind.
It showed that DESMOND helped people feel more positive about managing their condition. And that it helped many people to make changes that supported their type 2 diabetes management, including losing weight and becoming more active.
This trial helped lay the foundations for what would become a national programme offered through the NHS. DESMOND was rolled out nationally in 2006, alongside another version for people who’d lived with type 2 diabetes for longer.
Since then, our research has shown that DESMOND offers value for money for the NHS. That’s because when people get the right support early on, it can help to reduce the risk of serious complications later.
Alison Northern, DESMOND Implementation Lead at Leicester Diabetes Centre, has been working on the programme for 20 years.
She said:
“It’s amazing to see the positive impact DESMOND has had. I’m extremely proud of how we’ve established DESMOND throughout the UK, and across the world. We work hard to keep the programme evolving to meet the changing needs of people with or at risk of diabetes”.
From strength to strength
Over the past two decades, DESMOND has continued to grow and evolve, with our support.
Today, it’s delivered by trained educators who bring both clinical expertise and lived experience of type 2 diabetes, after a study we funded showed this combination helped make the programme more accessible.
DESMOND is now much more than a single course. It is a family of programmes that have been shaped by the changing needs of people living with or at risk of type 2 diabetes.
With around 6.3 million people in the UK living with prediabetes, placing them at high risk of developing type 2, the need to support people earlier has grown.
In response, DESMOND has expanded beyond education at diagnosis to also focus on helping people understand their risk and act before type 2 develops. This includes the DESMOND Let's Prevent Diabetes programme, and culturally adapted versions designed to better support different communities, such as South Asian groups.
There is also growing recognition of the different needs of underserved groups who may face additional barriers to accessing support. For example, we funded a study to adapt the programme for adults with type 2 diabetes and learning disability - and their carers. This programme is now being tested in a large clinical trial and, if successful, could become standard care across the UK for this group.
Other DESMOND adaptations to support people with more complex health needs include programmes for the Deaf community and for people who are blind or partially sighted. It is also being used in the Diabetes UK-funded MiFoot programme, which aims to protect health heart in people with type 2 who have had foot ulcers.
Going digital
A major step forward came in 2018 with the launch of an online version of the programme, called MYDESMOND. Going digital has meant that people can access the programme at a time, place, and pace that suits them.
It removes barriers, like travel or mobility issues, that can make getting to in-person sessions more difficult, helping to reach those who might not otherwise attend. So far, MyDESMOND has supported over 65,000 people and is available in several languages.
In an exciting new development, the MyDESMOND team has been selected to deliver NHS England’s Healthy Living programme – the NHS’s national online support offer for people with diabetes.
This means DESMOND will help shape and deliver digital support at a much wider scale, making it easier for more people to access flexible support, including – for the first time – people living with type 1 diabetes.
MyDESMOND’s digital foundation also created new opportunities to further tailor support to different groups. In recent years, the numbers of people under 40 being diagnosed with type 2 has risen sharply. Younger people often face the challenge of managing their condition alongside work, family life, and other pressures.
Acknowledging this, the DESMOND team developed a digital programme which is designed specifically to meet their needs. We’re currently funding a study to test this version for younger people in the NHS, and pave the way for it to become part of standard care.
More younger people developing type 2 diabetes also means more women are living with the condition during pregnancy, bringing unique challenges. To meet this need and support safe pregnancies and healthy babies, we’re also funding the development of the first education programme tailored to managing type 2 in pregnancy.
These developments show how DESMOND continues to adapt to real lives, helping more people access the knowledge, skills, and confidence they need to live well with type 2 diabetes. From funding the very first clinical trial to continuing to support its evolution today, Diabetes UK is proud to be part of that journey.
