E.D.A.N (Escape Diabetes Act Now) 30th September 2015

Lorraine Harrison

Health and Exercise Coordinator Gemma Ptak

Sport and Physical Activity Manager

Escape Diabetes Act Now (E.D.A.N)

• Lifestyle prevention programme to reduce risk of developing Type 2 Diabetes for Hartlepool residents. •Originally piloted after a successful programme in Middlesbrough called New Life New You. •Significantly lower budget sourced and programme began in October 2012, with a small group of six patients from Gladstone House Surgery. •Patients are diagnosed as being Pre Diabetic, through clinical tests at their surgery, or identified through the EDAN risk score.

EDAN referral criteria

• Diabetes Risk Score Screening is an additional tool used to help identify appropriate patients . •Clinical referral based on recent HbA1c blood test that clearly shows they are at risk of developing Type 2 Diabetes. •If a patient has between 42-48mmol result this indicates ‘pre diabetes’ or a fasting blood glucose measure that also categorises the target group.

EDAN Risk Score

EDAN Programme offer

•Physical Activity and Dietary Support •Two sessions per week over the first 12 week referral period •Six healthy eating workshops with educational elements for healthier food choices. •After the initial 12 weeks a review meeting will be held with the patient to develop an action plan for the next 12 weeks.

EDAN Programme offer •Motivational Interviewing will be used to support patients to remain engaged and a person centred approach to action planning. 1-2-1 sessions are available throughout to address any barriers that transpire. •Ongoing supervised exercise is offered to continue their healthier active lifestyle. •Six month review at GP surgery is requested for those who are compliant with the EDAN programme. •Additional assessment is done at 12 months to identify sustained lifestyle changes and their long term impact on the risk of diabetes.

EDAN Programme offer •A small fee applies to access the service which is £1.90 for concessionary rate and £2.30 for others. •For every exercise session paid a complimentary pass is received to attend a second session for free (this is for the initial 12 week programme to support patients to establish a regular routine of exercise) •Home programmes are available for those who are unable to access supervised sessions twice a week.

EDAN Programme offer •Alternative activities can be accessed for those who have been sedentary for a long period of time. They are lower intensity to allow gradual progression. •All patients receive a free Active Card (allows subsidised access to all HBC leisure facilities for 12 month period.) •Patients continually monitored and given a key contact person to support them through the programme. •Any patients who lapse from the programme can re-engage at any point with the support of key officers.

Data Collection •Baseline data is collected for every patient that engages in the programme. This includes: Waist Circumference Weight Cholesterol Glucose Blood Pressure •This data is then collected again at 6 months and 12 months to identify change and therefore any change in the risk of Type 2 Diabetes.

Data Collection

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Glucose Start

Glucose 12 months

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Cholesterol start

Cholesterol 12 month

Key Findings •In most instances the risk factors for Type 2 Diabetes reduced, for those participants who had long term compliance to lifestyle change they reversed the risks completely. •Weight management was a key factor to support the patients to see significant changes. Some participants lost over 3 stone through engaging with the programme. •Gradual behaviour change is a key part of the programme as compliance rates are low amongst those who were referred due to their ambivalence to lifestyle change.

Summary •Greater cooperation with GP Surgeries would improve the impact of this programme, including data collection. •Increase in staff capacity would support greater retention of those who are referred as many of them need intensive support through motivational interviewing before they engage in any sessions. •Transport and poverty remains a barrier for some people to engage effectively. •The pilot has shown that a flexible approach focusing on lifestyle and behaviour changes is effective to reduce the onset of Type 2 Diabetes.

Thank you Lorraine Harrison

Health and Exercise Coordinator Lorraine.harrison@hartlepool.gov.uk

01429 284363

Gemma Ptak Sport and Physical Activity Manager

Gemma.ptak@hartlepool.gov.uk 01429 523441