Oxford study claims NHS Diabetes Prevention Programme will be ineffective

The NHS Diabetes Prevention Programme is unlikely to have a major impact, according to University of Oxford researchers.
The programme was initiated in 2016 and on Wednesday received a £15m funding expansion to create 50,000 more spaces across the UK. By 2020 it will cover all of England.
But this new study, published in the BMJ, suggests that the two blood tests used to screen for high risk of type 2 diabetes – HbA1c and fasting plasma glucose – are inaccurate.
“As screening is inaccurate, many people will receive an incorrect diagnosis and be referred on for interventions while others will be falsely reassured and not offered the interventio,” said the authors.
The Diabetes Prevention Programme involves a screening test for prediabetes followed by appropriate treatment or advice on diet and exercise to prevent type 2 diabetes from developing.
The programme director Matt Fagg said it is “based on a comprehensive collation of robust evidence”, but Oxford researchers do not believe the programme will have a substantial impact in reducing type 2 diabetes rates.
They evaluated 49 studies of screening tests and 50 intervention trials, finding that the NHS policy would benefit somen, but not those at high risk of type 2 diabetes.
Lifestyle interventions lasting three to six years led to a 37 per cent reduction in relative type 2 diabetes risk, while among those treated with a blood glucose-lowering medication 80 fewer participants out of 1,000 developed type 2 diabetes.
“These findings suggest that ‘screen and treat’ policies alone are unlikely to have substantial impact on the worsening epidemic of type 2 diabetes,” added the researchers.
“A screen and treat policy will be effective only if a test exists that correctly identifies those at high risk (sensitivity) while also excluding those at low risk (specificity); and an intervention exists that is acceptable to, and also efficacious i, those at high risk.”