NHS Type 2 Diabetes Path to Remission Programme referrer information

What is it?

A free programme designed to help participants reduce their diabetes medications, lose weight, improve their health, and potentially put their type 2 diabetes into remission. Participants will be offered low calorie, total diet replacement products (typically soups, shakes and porridges) totalling 800-900 kilocalories per day, to replace all normal meals for 12 weeks.
Participants will receive support and monitoring for 12 months, including help to re-introduce food after the initial 12-week period. We understand that everyone has their own preferences, and we provide two options for accessing the service. This will be either;
- One-to-one in person support; or
- One-to-one digital support
Coaching sessions are delivered by one of our qualified diabetes practitioners, along with online learning and resources including meal plans and recipes

“Findings from the NHS T2DR programme show that remission of type 2 diabetes is possible outside of research settings“

The Lancet, Sep 2024

What does the 12-month programme include?

An initial one-to-one assessment
20 sessions with your Health & Wellbeing diabetes practitioner
39 online support modules
Final one-to-one assessment

How does the NHS Type 2 Path to Remission programme work?

The programme involves 12 weeks of low-calorie diet (shakes and soups) followed by the reintroduction of food, focusing on movement and maintaining a new healthy eating lifestyle.

Healthcare professional requirements

How do I refer a patient?

After discussing the service with your patient and confirming eligibility please complete the referral form which is embedded into your clinical system and send it to: scwcsu.hiowt2dr@nhs.net

Who’s eligible?

To be eligible for the programme, you must be:

Aged 18‑65;

Diagnosed with type 2 diabetes within the last 6 year;

Have a BMI of 27kg/m2 or higher in people from a white background (or 25kg/m² or higher in people from all other ethnic groups;

HbA1c measurement within the last 12 months of 43‑87 mmol/mol if taking diabetes medication or 48‑87 mmol/mol if not taking diabetes medication;

Patient has attended a diabetes review when this was last offered, inc. retinal screening, and commits to continue attending annual reviews, even if remission is achieved. (If a patient is newly diagnosed then there is no requirement to wait for retinal screening to take place before offering referral)

Exclusions

Current insulin user

Pregnant or planning to become pregnant within the next 12 months

Currently breastfeeding

Has at least one of the following significant co‑morbidities; Active cancer; Heart attack or stroke in last 6 months; Severe heart failure (defined as New York Heart Association grade 3 or 4) Severe renal impairment (most recent eGFR less than 30mls/min/1.73m2)

Active liver disease other than non‑alcoholic fatty liver disease (NAFLD) (i.e. NAFLD is not an exclusion criterion)

Active substance use disorder

Active eating disorder (including binge eating disorder)

Known proliferative retinopathy that has not been treated (this does not exclude individuals who are newly diagnosed and have not yet had the opportunity for retinal screening)

Has had bariatric surgery

Health professional assessment that the person is unable to understand or meet the demands of the programme and/ or monitoring requirements (due to physical or psychological conditions or co‑morbidities)

Discharged in the last 12 months from the NHS Type 2 Diabetes Path to Remission Programme after having commenced the programme (for clarity, this does not apply to people previously referred to the programme but who dropped out or declined prior to commencing the TDR Phase)

Resources for healthcare professionals

1) Proactive Searches & Letter/Text Invitations

A clinical search will provide a list of possible eligible patients; however, the exclusion criteria of the programme and readiness/motivation must also be considered before making a referral

Supporting resources:

“The NHS Type 2 Diabetes Path to Remission Programme can help you reduce your diabetes medication and lose weight. Find out more by signing up to our information session: https://bit.ly/t2dr-info“