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DiRECT approach to type 2 diabetes remission value for money after only six years

Mike Lean and Roy Taylor who led on the DiRECT trial

An economic study has shown that the DiRECT programme that can put type 2 diabetes in remission for some people could result in huge savings for the NHS.

In 2017, the first results from our DiRECT study revealed that through a low-calorie weight loss programme, it was possible for some people to go into remission from type 2 diabetes. This was a ground-breaking moment for type 2 diabetes treatment. It was the first time we had robust, clinical evidence that type 2 diabetes does not have to be a life-long condition.

After these promising results, NHS England committed to trial programmes based on the DiRECT approach, due to start later in 2020. And NHS Scotland has already started to roll them out. We need studies to build a strong economic case for DiRECT style approaches, to help make the case for wider access, and make sure the benefits of this research reach people with type 2 diabetes as soon as possible.

Counting the cost

A newly published paper from Dr Yiqiao Xin and Andrew Davies at the University of Glasgow, as part of Professors Mike Lean and Roy Taylor’s DiRECT team, reveals that the use of a DiRECT style approach to remission is not only predicted to improve the life expectancy of people living with type 2 diabetes, but also results in an average saving to the NHS of £1337 per person over their lifetime. Compared to standard care, the DiRECT style approach would be cost saving within 6 years.

The researchers looked at the costs of delivering the DiRECT programme over the first two years, as well as the costs of any diabetes medication the participants were taking. They also predicted how life expectancy would change if a person with type 2 diabetes went into remission and used NHS data to estimate the cost of diabetes care over a person’s life.

While the DiRECT approach was found to be slightly more expensive than the standard approach to deliver, because people who go into remission no longer required blood sugar related medication, it resulted in a significant saving. Additionally, the number of diabetes related hospital visits and the chance of developing serious complications will both be reduced for people in remission. As a result, the long-term cost of diabetes care will be significantly lower.

Dr Elizabeth Robertson is Director of Research at Diabetes UK. She said:

“The impact of DiRECT has been huge. Not only is the trial changing lives now, but its findings offer hope to millions of people living with type 2 diabetes that their condition may not always have to be lifelong. We want as many people as possible to have the opportunity to put their type 2 diabetes into remission. By demonstrating the significant cost savings to the NHS, which currently spends 10% of its budget on diabetes care, this new study could help the DiRECT approach to become a fundamental part of type 2 diabetes treatment for all.”


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