In Depth

When are the ‘golden opportunities’ for GPs to help turn people’s health around?

“When is the best time offer patients a choice?” GP Dr David Unwin asks this question because he knows there are optimal moments for people to make significant decisions. These are moments he calls ‘golden opportunities’.

Dr Unwin’s ubiquitous presence within the low carb community has led to him receiving a number of distinctions in recent years. He was the 2016 NHS Innovator of the Year and was included in a list of top 50 most influential GPs in the UK last year. He also helped to develop the Low Carb Program app which was approved by NHS Digital earlier this year.

Dr Unwin says there are several golden opportunities for GPs to help people put type 2 diabetes into remission or prevent it altogether among people with prediabetes. These opportunities include:

  • First being diagnosed with type 2 diabetes or prediabetes
  • When someone’s type 2 diabetes control has deteriorated, for example when an extra medication is being considered

“The period you’re diagnosed with type 2 diabetes is a time of questioning and worrying. At that point, if you give patients a choice between lifelong medication and trying a diet with support, I’ve seen so many patients pick the diet,” Dr Unwin told Diabetes Digital Media.

When Dr Unwin discusses diabetes control with his patients, he finds that many are motivated to avoid insulin treatment. “We’ve had a number of successes with people with severe type 2 diabetes who have managed to avoid going onto insulin, and some have taken the next step and come off other drugs they were taking. Some have even been able to achieve remissio, coming off all their drugs. This is an amazing success.”

In order to achieve sustainable change, Dr Unwin says that patients and GPs need to be clear about what the patient is hoping for. Some want to come off medication; some want to lose weight. Identifying shared goals is important to ensure that a patient is aware of how improving their diet and lifestyle leads to health benefits, and gives the patient something to strive towards.

Positivity is central to success. It can be easy for people with type 2 diabetes to experience a bad day. And reflection is paramount.

“If you start an approach and it’s working, it’s good to reflect on what has worked. If you’ve had a particularly successful day where you’ve ate really well and you feel good – ask yourself what made it good? Equally, you can learn from disasters. If you have a bad day, instead of punishing yourself, think about what you could have done differently. Even a disaster can be turned into a learning experience.”

Dr Unwin and GPs across the country are inspiring people to make change. It is possible to resolve prediabetes and put type 2 diabetes into remissio, and highlighting the benefits of diet and lifestyle changes over medication is a fundamental step.

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