The programme was developed with Dr David Unwin and feedback from over 20,000 people with prediabetes and type 2 diabetes.

The Low Carb Program provides NHS certified structured education for people with prediabetes, type 2 diabetes, non-alcoholic fatty liver disease (NAFLD) and polycystic ovary syndrome (PCOS) to achieve their selected health goals.

The user experience which includes the education received, resources and support is tailored to goal, disease profile, ethnicity, age, gender, and location and provides remote-monitoring capabilities for diabetes health self-management. 

The digital programme is available on the web and mobile devices (iOS, Android). An offline version if available for people who are digitally excluded.

NHS trusted education and support

The Low Carb Program provides a 16-week NHS certified structured education course and a weight management programme (if applicable, based on the user’s weight).

Education is supported with meal plans and resources tailored to the user’s diabetes type, budget, dietary preferences, cultural and social norms. Users can opt to choose the most appropriate education stream for them from low carb, Mediterranean, or balanced (EatWell) programmes.

Health coach support

Users also receive unlimited support from Health Coaches to keep them accountable. This includes 3 weekly virtual meetups which take place over Zoom and through the app. 

A peer-to-peer support community allows you to speak to people with similar goals and take part in further live events.

Keeping you active

You can also take part in at-home workouts, yoga flows and relaxation exercises tailored to your fitness level. Additionally, you can track your weight, activity, sleep, mood, blood glucose, and medications with data-driven feedback to support your behaviours. 

Recipes tailored to you

When it comes to food, the Low Carb Program has you covered.

Choose from over 2,000 recipes and 150 meal plans, updated weekly, tailored to your allergies and dietary preferences.

On top of this, use the food diary and scan barcodes, search for foods or add recipes from the in-app Recipes library.

Proven in 7 studies

The Low Carb Program has been validated in 7 peer-reviewed, published studies. The programme is demonstrated to support significant health improvements at 1-year for people with type 2 diabetes:

• Weight loss: 7.4kg / 7% average weight loss at 1-year
• HbA1c: 1.2% / 13mmol/mol average HbA1c reduction at 1-year
• Medication reduction: 40% of participants who start on medication eliminate it at 1-year
• Type 2 diabetes remission: 1 in 4 participants with type 2 diabetes is in remission at 1-year

The Low Carb Program is used across the NHS to provide digital care for people with obesity, prediabetes and type 2 diabetes.

The programme was instrumental in driving the acceptance of a low carbohydrate diet as a method of managing prediabetes and type 2 diabetes.

• Low Carb Program app shown to support weight loss and medication reduction in NHS primary care study
• Low Carb Program shown to be effective in improving glycemic control and enabling weight loss

More recently, the app was shown to be as effective as face-to-face care when used during the COVID pandemic to provide hospital weight management support.

Low Carb Program referral code

A referral code will enable you to redeem free access to the platform. There are currently no referral codes to share.

How do I enrol in the Low Carb Program?

The Low Carb Program is available in some parts of the NHS.

Ask your healthcare professional for a referral code or sign up here.

Anna Carling is a registered dietician leading Freedom4Life within Wiltshire for a selection of local PCTs and health organizations with specific responsibility for

diabetes care

Freedom4Life focuses on diet and

lifestyle changes
in order to improve blood sugar control but also for greater quality of life for the people who take the course.

Freedom4Life within Wiltshire

Anna explains how she became involved in the courses, saying, “I work closely with Becky Hanna, a specialist diabetes nurse. We were aware of various

diabetes education
courses, and looked at some in detail, such as the BERTIE course at Bournemouth, and decided we too wanted to offer something similar. Our initial course was a great success so we then undertook to get funding to be able to offer more.”

Freedom4Life course over five weeks

Each Freedom4Life course covers five weeks where the group meets once a week for three-and-a-half hours.

There are two courses a year that take place in the evening, two that take place in the afternoo, and two that take place in the morning – in this way fitting around people’s different commitments with jobs or family.

The

courses are free to attend
, with likely candidates either being recommended by consultants and diabetes specialist nurses in the area, or who contact the course organizers directly.

Each course has six attendees, although they can bring a partner along if they wish. Among the events are a meal out and a supermarket tour.

Says Anna, “Before coming on the course, candidates are asked to commit to attend every session of the course. We find that the group gets to know each other and very often keep meeting up even after the end of the course, to offer each other support . They seem to really benefit form meeting others in the same boat – they realize that they are not alone, they are not the only ones struggling to hit the right numbers, and not the only one to get some wild
blood test results
sometimes. This sharing is important.”

Assessing the benefit of Freedom4Life

Some standard questionnaires are currently used within the NHS to assess the benefits of courses such as these, one of which looks at frequency of hypos for those who undertake the course and another asks them about their perception of their quality of life.

In addition,

Hba1c readings
are used to assess success.

She says, “HbA1cs are taken at the start of the course, then checked again at three months, six months and again after a full year from taking the course, and we see distinct improvements, but we’ve seen the most dramatic improvements in people’s views of their own quality of life. Its’ not just about the HbA1c results, though they are an important factor, it’s about giving people the skills and confidence

deal with their diabetes
”

Sometimes, Anna admits, there is ‘slippage’, where a patient may not maintain an improved HbA1c, which she says, “Even if the results may not be as good, the patients tell us that they know they have the skills to improve their control, it’s just that it can be tough and a bit? A big commitment, but they feel capable of doing it with the education they’ve taken on board. They still mention that while the numbers might have slipped, their anxiety levels about living with diabetes have lowered.”

Anna is confident that the courses will continue and is hoping to find funding for more in the local area. Her enthusiasm is based not only on the feedback of course attendees, but her own enjoyment of the process. As she says, “I love the fact that I learn something on every course.”

The course is also being recommended for those who want to be able to go on an

insulin pump

This level of education is considered an excellent pre-pump undertaking that ensures the best possible skills are learned before going on a pump to make the transition as simple and efficient as possible, as good pump skills include being able to assess

carbohydrates
in the diet and adjust insulin doses accordingly.

• Contact
  
  Anna Carling
  
  on
  
  01249 456512
  

Written by Diabetes Expert:

Sue Marshall

London Medical, based in Marylebone runs a Diabetes Education Programme that takes place throughout the year in the form of education days and evening meetings.

Within the NHS there are

DAFNE

and

DESMOND

courses. These are free, but not all PCT host them, and when they do, they are often over-subscribed so you might have a bit of a wait to get on one.

Private training courses

If you have the ability to fund diabetes training yourself then you can take courses, such as the ones run by London Medical, based in Marylebone. It’s Diabetes Education Programme takes place throughout the year in the form of education days and evening meetings.

The programme covers a wide variety of diabetes and nutrition related topics such as the Advanced

Carbohydrate

Counting & Insulin Dose Adjustment Course.

Hands on learning

There are three 4-hour sessions over a month. Attendees get practical hands-on learning with foods you eat and are encouraged to take their learning home to consolidate what has been covered and discuss the results on their return.

At London Medical it’s possible to hire a Continuous Glucose Monitor (Navigator) for 5 days to observe the effect of carbs and verify insulin dose accuracy.

There is also a separate course on

Insulin Pump & CGM Education

for Optimal Insulin Use in Diabetes. This course consists of three 6-hour sessions over 3-5 weeks and is intended as a joint learning event for people with diabetes, their family members and Health Care Professionals.

Accredited by RCN

The courses have been accredited by RCN and the accreditation has also been applied from the RCP/ABCD and BDA for doctors, nurses and dieticians respectively.

Courses are taking place in July and October. To register your interest for any of the London Medical courses, see below.

Course fees

• 
  £500
  
  – Insulin Pump and CGM Training Course (All 3 Days)
• 
  £400
  
  – Insulin Pump Training Course (Day 1 and Day 2)
• 
  £250
  
  – CGM Training Course (Day 3 Only)

Lite lunch and refreshment are included, discount also available for family & group bookings. To book a place or for more information, please use the form below.

Failure to spot these symptoms can lead to severe hypoglycemia – which occurs when blood glucose levels fall very low – and require help from others to restore levels back to normal.

The Hypo Program is an education course, the first of its kind, which aims to improve your knowledge of these hypo symptoms and the number of reasons that hypos can develop.

Who is the Hypo Program for?

Hypo awareness training is beneficial for anyone with diabetes taking insulin, sulphonylureas or glinides, and therefore susceptible to hypos.

If you have good hypo awareness, the program can help you acknowledge hypos at an earlier stage and prevent hypo unawareness from developing in the future.

Additionally, the Hypo Program is useful for family members and friends of someone who has hypos to recognise their symptoms, especially if the person with diabetes cannot do so.

How to take part in the Hypo Program

It is free to sign up to the Hypo Program, and it takes just 30 seconds to do. The modules of the course can then be completed at your own pace. Alternatively, you can watch them below without additional resources.

Watch the Hypo Program

The videos for the patient stream have been made available on YouTube, and we’ve embedded them below.

All 12 modules are available to watch from this page.

What will I learn from the Hypo Program?

Aside from improving your hypo awareness, the course also teaches users to how distinguish between hypoglycemia and hyperglycemia (high blood sugar).

By understanding how hypo awareness can benefit your day-to-day life, you can focus on your normal activities and spend less time worrying about your diabetes.

Does the Hypo Program work?

Many graduates of the Hypo Program have reported genuine, marked improvement in their hypo awareness. From the feedback provided by users:

• 75% report their understanding of hypo awareness has improved
• 74% know to avoid hypos and how to treat a hypo
• 75% understand the hypo symptoms linked to driving and how to prevent lows when driving

As well as leading to fewer cases of severe hypoglycemia among patients with diabetes, education resources such as the Hypo Program will result in better health and fewer hospitalisations.

• Take part in the (free) Hypo Program

The DAFYDD education course was the first accredited patient education programme in Wales.

The DAFYDD course teaches how patients with type 1 diabetes can match their insulin doses to food intake through

carbohydrate counting

As well as helping to improve blood glucose levels, participants will learn how to adapt insulin doses to compensate for exercise, illness and alcohol, which can affect blood sugar readings.

How can I join the DAFYDD programme?

The DAFYDD course is held across Wales. If you live in Wales and would like to be referred then you should consult your GP, DSN or consultant.

Otherwise, the diabetes education courses available to you will depend on where you live. If you live near Wales, it may be you live in a particular city where other courses such as

DAFNE
and BERTIE are provided.

Am I eligible for the DAFYDD course?

To be eligible for the DAFYDD course, you must have had type 1 diabetes for at least six months and be treated with

multiple daily injections
(MDI).

Participants are required to be on MDI treatment involving fast-acting insulin with meals and a long-acting insulin taken once or twice a day.

What does the DAFYDD course entail?

The DAFYDD course involves attending a four-day course. These four days are held once a week across four consecutive weeks – each day lasts for six hours.

There are three trained educators that will guide you through the program.

On the course, participants should be prepared to adjust their insulin doses. You will also keep records of food intake, blood glucose levels and insulin doses given. There are normally no more than eight participants on each course.

Does the DAFYDD course work?

A number of measures are examined by the education providers during and after the course, including HbA1c, weight and hypo awareness.

The DAFYDD course has been shown to increase participants’ diabetes control, as well as having more control over how much they eat, while exercise and alcohol have reportedly shown enhanced management from DAFYDD participants.

Like DESMOND and DAFNE, ASPIRE is a structured education course for people with diabetes to learn more about tools to manage their diabetes.

The ASPIRE course aims to show people with diabetes how to accurately adjust insulin to match the amount of

carbohydrate
they eat and how much exercise they do.

How does ASPIRE work?

The ASPIRE course was designed to help adults with type 1 diabetes to focus on new diabetes self-management skills.

This includes calculating insulin dose to more closely match diet and exercise levels.

What are the goals of ASPIRE?

The aim of ASPIRE, which it succeeds in accomplishing, is to improve

HbA1c
and quality of life. Results to date are encouraging.

ASPIRE runs for 4 weeks, and is generally undertaken within groups of 6 or 8 participants. The course started in October 2005 and is held at a venue with both kitchen and exercise facilities.

What underpins ASPIRE?

The ASPIRE course is underpinned by Social Learning Theory. This described the way people become confident to self-manage diabetes and develop ability to make behavioural changes.

Ways to encourage participants include group work, role-play and workshops.

Key topics include:

• 
  What is diabetes
• Hyperglycaemia and DKA
• Hypoglycaemia,
• Action and types of insulin
• Blood glucose monitoring
• Exercise (theory and practice)
• Travel
• 
  Complications
• What’s new in diabetes
• Nutrition and healthy eating
• Carbohydrate counting
• Calculating insulin to carbohydrate intake
• Food label interpretation
• Alcohol
• 
  Glycaemic index
• Eating out and takeaways

What does ASPIRE achieve?

The core of the ASPIRE course is to share experience, and the course involves pre and post assessment appointments. Diaries of food, exercise and reflection are also kept.

As well as improvements in

glycaemic control, additional benefits in psychosocial health were also observed.

BERTIE is a structured diabetes education course that teaches people with type 1 diabetes how to manage insulin doses compared to carbohydrate intake.

It was created by the Bournemouth Diabetes and Endocrine Centre (BDEC) with the aim of teaching patients how to recognise and

count carbohydrates

, how to work out insulin doses, and how this affects blood glucose levels.

Participants are encouraged to solve problems individually to assess what works best for them, and learn what to do to stay healthy.

Is the BERTIE course only in Bournemouth?

The BERTIE course is taught at The Royal Bournemouth and Christchurch Hospitals (RBCH), but trained diabetes teams across 40 centres in the UK offer a programme based on BERTIE.

Can I attend the BERTIE course?

Anyone with

type 1 diabetes

who is over the age of 16 can attend the BERTIE course, while patients with type 2 diabetes who are treated with

multiple daily injections

(MDI) will also be considered.

Individuals looking to participate in the BERTIE course are required to be on MDI treatment involving fast-acting insulin with meals and a long-acting insulin.

Patients not being treated with MDI, such as those on twice daily injections, would be encouraged to switch to these before the course, but may still be included if possible.

What does the BERTIE course involve?

The BERTIE course involves attending a six-hour group programme once a week for four consecutive weeks.  It is led by a diabetes specialist nurse (DSN) and a diabetes dietitian.

As well as learning how to carb-count, and adjust insulin doses accordingly, participants will keep records of food intake, blood glucose levels and insulin administered between sessions.

How can I join the BERTIE programme?

You should consult your GP, DSN or consultant if you would like to be referred onto the BERTIE course. Aside from in Bournemouth, the other courses held across the country are not accredited, but most belong to the Diabetes Education Network and reiterate the philosophy.

Otherwise, which diabetes education courses are available to you will depend on where you live. It may be you live in a particular city where courses such as

DAFNE

are provided.

Does the BERTIE course work?

The RBCH report that over 80 per cent of participants meet their goals on the BERTIE course, while reductions in

HbA1c

levels are noted for up to six years afterwards. Many participants also report reductions in hypoglycemia that requires assistance from someone else.

DESMOND is the acronym for Diabetes Education and Self Management for Ongoing and Newly Diagnosed. It is part of a school of patient education for people with diabetes, developed by a number of NHS Organisations.

Educators on the NHS may now be specifically trained in DESMOND.

So what is DESMOND?

• DESMOND is a way to learn more about Type 2 diabetes.
• DESMOND is a resource to help manage diabetes-related changes.
• DESMOND is a way to meet and share life experiences with others.
• DESMOND is a group of education programmes designed for people with diabetes.

DESMOND is an NHS organisation that helps to deliver high quality patients education to people with type 2 diabetes, or those who are at risk of diabetes.

Once a research programmen, DESMOND is now an established part of care improvement for

type 2 diabetes
in the UK. DESMOND is also a research programmen, building on shared experience to prove how effective education and training can be.

Is DESMOND widely available?

DESMOND is expanding quickly in the UK. Many programmes are in the research phase but will develop over the next 2-3 years, meaning DESMOND will become even more widely available in the UK.

What does DESMOND entail?

DESMOND varies depending upon the individual person.

At this stage, there are three different DESMOND education programmes available in the UK and Eire. These are listed below:

• DESMOND
  
  Newly Diagnosed
• DESMOND Foundation (for people with established diabetes)
• DESMOND BME – delivered in Gujarati, Punjabi, Urdu and Bengali

DESMOND is a group course for up to 10 people with type 2 diabetes.

The course is built around group activities, with individuals able to speak to an educator.

Why does DESMOND work?

DESMOND is designed to support the diabetic, making them the expert. Educators help to increase knowledge and understanding of what having diabetes means, but empowers the patient to make their own decisions.

What do I get from a DESMOND course?

Current information about diabetes, with practical skills to help you manage it. DESMOND attendees can discuss and explore all aspects of the condition, including diet and

medication
They are able to meet and talk with others in the same situation.

DESMOND courses are designed to be informal and friendly. There is no pressure to contribute, and participants can bring a partner, family member or friend.

DESMOND teams

The local DESMOND team running the programme are very approachable and part of their job is to make you feel welcomen, and comfortable about attending the programme.

If you find the idea of joining in at these sessions too difficult, no one will make you contribute.

Family and friends

But you will get much more out of the sessions if you come prepared to share your experiences, thoughts and opinions. If you would like to bring your partner, a family member or a friend with you to the course – they will be very welcome.

How do I attend?

There are online maps of DESMOND centres in the UK, and most provide specific booking systems. Patients can self-refer or be referred by their GP.

Whereas the DAFNE course is aimed specifically at people with type 1 diabetes and DESMOND for people with type 2 diabetes, the X-PERT Diabetes Programme runs in three different formats to cater for people with different types of diabetes as well as those at risk of diabetes.

The course has been demonstrably proven to aid long-term control of diabetes, giving patients the knowledge and power to be in control of their diabetes.

What diabetes courses are run?

• X-PERT Prevention of Diabetes – asn intensive lifestyle programme aimed at reducing risk of developing type 2 diabetes for people at higher risk
• X-PERT Diabetes – for people with type 1 and type 2 diabetes, with an emphasis on lifestyle choices.
• X-PERT Insulin – for people with type 1 or type 2 diabetes and are treated with insulin.

What do the diabetes X-PERT courses entail?

The diabetes X-PERT courses are structured to provide as much diabetes and lifestyle information as possible. This includes guidance as to:

• What diabetes is
• Carbohydrate awareness
• How physical activity can help
• Understanding food labels
• Diabetes complications
• Avoiding hypos – sas part of the X-PERT insulin course
• Advice towards preventing diabetes from occurring for those at high risk

How is the diabetes X-PERT course structured?

The X-PERT course runs through six weekly sessions, each session lasting two and a half hours in local communities and also includes follow up sessions after the course has been completed.

The courses are run by trained diabetes educators, who are either diabetic themselves or work as diabetes specialists.

Who can do the X-PERT course?

Anyone diagnosed with diabetes can undertake the X-PERT diabetes and insulin courses. Furthermore, patients can bring their partners or carers, who are encouraged to join in.

The X-PERT Prevention of Diabetes is open to anyone who is deemed to be at higher risk of diabetes.

How can I join an X-PERT programme?

The courses are delivered through the NHS at no cost to the patient and X-PERT health centres are located throughout most of the UK.

Ask your GP, Diabetes Specialist Nurse or Consultant if you would like to be referred onto an X-PERT course.

How does X-PERT help diabetics?

The X-PERT course can help people with diabetes to learn new diabetes management skills, increase confidence in food choice and diet enhancement.

Furthermore, it can help to meet others with shared experience, and provides diabetics with the power to work with healthcare professionals to manage diabetes in the long-term.

How has diabetes X-PERT helped others?

By taking part in a diabetes X-PERT course, in the past patients have achieved the following: An improvement in body weight and diabetes control, reduced diabetes medication, increased skill to manage diabetes, an improved lifestyle, lower blood pressure and lower cholesterol

Does it really work?

In the UK, there is a scarcity of diabetes information, particularly for newly diagnosed people. One X-PERT course patient was reported by the NHS as commenting: “This is the first time in 10 years of being a diabetic that anybody has told me these things.”

Knowledge is power when it comes to diabetes management.

DAFNE is an educational course for managing type 1 diabetes, giving diabetic patients the necessary skills to administer the right amount of insulin for the amount of carbohydrate you choose to eat.

The aim of the DAFNE course is to improve health outcomes for type 1 diabetics, by providing well-structured information and guidance.

The DAFNE programme is continually developing and improving.

What is the DAFNE course?

DAFNE is a method of managing type 1 diabetes for adults.

DAFNE

stands for

Dose Adjustment for Normal Eating

The primary goal of DAFNE is to help diabetics live the most normal life possible, whilst keeping

blood glucose levels
stable and lowering the risk of diabetes complications.

What does a DAFNE course entail?

There are a number of questions often asked about the DAFNE course which are detailed below.

How long is a DAFNE course?

DAFNE is a 5-day training course, with a follow-up 8 weeks after the course finishes.

How many people are in a DAFNE course?

Groups of 6-8 participants are given guidance by educators trained in DAFNE, allowing patients to learn by experience and practice the key skills of estimating

carbohydrate
and adjusting insulin dose.

So I won’t do DAFNE alone?

Usually, DAFNE is conducted as part of a group. Patients can share their experiences, but also speak with DAFNE Educators privately about their individual circumstances.

Will I have to change everything?

One of the core goals of DAFNE is to allow people to fit diabetes within their current

lifestyle, rather than making huge lifestyle adjustments for their diabetes.

How do I get on a DAFNE course?

DAFNE is offered throughout the UK and ROI, 77 different diabetes centres offer the course. However, DAFNE is currently only offered by diabetes units that have DAFNE trained educators and doctors, and private DAFNE courses are not yet available.

Ask your health team about the opportunities to be booked onto a DAFNE course.

Diabetes education is an essential part of good blood sugar control, and avoiding long-term healthcare complications.

For each individual, there is a vast amount of condition-specific information necessary for successful diabetes management.

What type of diabetes education is available?

People with diabetes need to know what to do if something goes wrong, how to adjust their diet, exercise, lifestyle, medication or insulin.

A range of diabetes education programmes now exist in the UK, including DAFNE, DESMOND and X-PERT. These diabetes courses are structured to empower diabetes patients to manage their own condition successfully.

Diabetes Education Guides:

Aspire

DAFNE

DESMOND

X-PERT

Freedom4Life

BERTIE

DAFYDD

Hypo Program

Which diabetes course you enrol on may depend on which type of diabetes you have, how recently you have been diagnosed, and your current management approach.

There are bespoke education courses for type 1 diabetes and type 2 diabetes,

newly diagnosed diabetics
and those using insulin pumps.

How do I get enrolled onto structured diabetes education?

NICE recommends that every newly diagnosed diabetes patient should be given the opportunity to get diabetes training, and most patients agree that they need help to manage their condition.

Despite the NICE recommendations, data from charity Diabetes UK shows that only a small number of newly diagnosed patients are provided with a place on a diabetes education course.

If you are interested in taking part in structured diabetes training, speak to your GP, diabetes specialist nurse or diabetes consultant. You may need to wait for an available slot but the NICE guidelines state that you should be offered the chance to go onto a course if you have not done so already.

If you have previously attended a structured education course a number of years ago but feel you would benefit from refreshing your knowledge, most GPs should be happy to help you enroll onto a course.

Education for insulin users and non-insulin users

The course you get enrolled onto may depend on what courses are running in your area. Whilst there are differences between some of the diabetes courses available, many of the courses share similarities in their approach and the knowledge provided.

For non-insulin users, such as people with type 2 diabetes that have been recently diagnosed, the DESMOND course is one of the courses that is highly recommended.

The X-PERT course has been designed to be appropriate for people with type 1 diabetes and type 2 diabetes.

The DAFNE course has been specifically designed towards insulin management for people with

type 1 diabetes

Structured diabetes education courses are usually highly regarded by people with diabetes that have attended them and can contribute to improved HbA1c results, fewer episodes of too high or low blood glucose levels, improved confidence in controlling one’s health and better quality of life.