Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial

Lean, Michael E. J.; Leslie, W. S.; Barnes, Alison C.; Brosnahan, Naomi; Thom, George; McCombie, Louise; Peters, Carl; Zhyzhneuskaya, Sviatlana; Al‐Mrabeh, Ahmad; Hollingsworth, Kieren G.; Rodrigues, Angela; Rehackova, Lucia; Adamson, Ashley J.; Sniehotta, Falko F; Mathers, John C.; Ross, H. M.; McIlvenna, Yvonne; Welsh, Paul; Kean, Sharon; Ford, Ian; McConnachie, Alex; Messow, Claudia‐Martina; Sattar, Naveed; Taylor, Roy

doi:10.1016/s2213-8587(19)30068-3

Cited by 631 publications

(580 citation statements)

References 28 publications

Supporting

Mentioning

520

Contrasting

Unclassified

Order By: Relevance

“…Nurses’ strong beliefs in the benefits of NE on health outcomes were evident in the present study. Subsequent dissemination of the DiRECT study findings, which demonstrates that diabetes remission is attainable through weight loss, should strengthen this further . As a result of DiRECT, services are re‐designing diabetes care to introduce a local remission service.…”

Section: Discussionmentioning

confidence: 93%

Exploring the provision of diabetes nutrition education by practice nurses in primary care settings

Gianfrancesco

Johnson

2019

J Human Nutrition Diet

View full text Add to dashboard Cite

Background High‐quality nutrition education is recommended as an essential component of diabetes care. In the UK, there has been a gradual shift of inter‐professional boundaries with respect to providing nutritional care for people with type 2 diabetes. Only a minority now regularly receive advice from a dietitian. Instead, increased demands for nutrition education are being absorbed by practice nurses. The present study seeks to explore this situation through the views of practice nurses on the services that they provide and the issues they face. Methods A qualitative approach using semi‐structured interviews was employed. Practice nurses were recruited using purposive sampling, and nine were interviewed. Data were analysed using the Framework Method. The Theoretical Domains Framework from the COM‐B (‘capability’, ‘opportunity’, ‘motivation’ and ‘behaviour’) model of behaviour change, as increasingly employed to explore the behaviour of healthcare professionals, was used to further frame the findings. Results Practice nurses reported that ongoing diabetes nutrition education only took place at annual review appointments and was limited to 5–10 min. They described how they are expected to take on a more advanced role in diabetes nutrition education than they can provide and are becoming increasingly isolated in this role as a result of a lack of time, practical and informational support, and training standards and provision. Conclusions A range of service improvements led by dietitians, which focus on strengthening the working environment and enhancing professional support available for practice nurses who provide diabetes nutrition education, could improve quality of care and health outcomes in people with diabetes within current time restraints.

show abstract

Section: Discussionmentioning

confidence: 93%

Exploring the provision of diabetes nutrition education by practice nurses in primary care settings

Gianfrancesco

Johnson

2019

J Human Nutrition Diet

View full text Add to dashboard Cite

show abstract

“…The show focused on two patient stories: one patient, called Russell, had been recently diagnosed with diabetes, and the show observed him losing around 17kg over four months and putting his diabetes into remission. This very public showcase of diabetes reversal some 10 years ago, was ahead of its time; the diabetes reversal concept having only recently become popularised in medical circles through the work of Roy Taylor, Mike Lean and others …”

Section: Scaling Education: Multimedia Toolsmentioning

confidence: 99%

The future of diabetes education

Wake

2019

Practical Diabetes

View full text Add to dashboard Cite

“…A cluster randomised controlled study1 in Lancet Diabetes and Endocrinology that looked at a structured weight management programme for reversing type 2 diabetes. The two year update to the Diabetes Remission Clinical Trial (DiRECT trial)—which is based on a low calorie (825-53 kcal per day) formula diet for 12 to 20 weeks followed by structured support in primary care—found sustained remissions at 24 months for 53 of 149 people in the intervention arm (36%).…”

Section: What Prompted This Latest Glut Of Coverage?mentioning

confidence: 99%

Sixty seconds on . . . reversing type 2 diabetes

Iacobucci¹

2019

BMJ

View full text Add to dashboard Cite

Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial

Abstract: This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International licence Newcastle University ePrints -eprint.ncl.ac.uk Lean MEJ,

Cited by 631 publications

References 28 publications

Exploring the provision of diabetes nutrition education by practice nurses in primary care settings

Exploring the provision of diabetes nutrition education by practice nurses in primary care settings

The future of diabetes education

Sixty seconds on . . . reversing type 2 diabetes

Contact Info

Product

Resources

About