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NHS Type 2 Path to Remission Programme FAQs
T2DR Programme
Yes, the programme is safe to follow. It is supported by research and experience. During the programme, your health and your medications will be monitored by your healthcare team. Your Diabetes Practitioner will be working closely with you and your healthcare team, to provide support at every step.
There are strict medical criteria that you must meet in order to participate in this programme. There are some medical conditions that might mean you are not able to take part, however this is something you will be screened for before getting started. If there is any cause for concern, or any changes to your health, please update your Diabetes Practitioner or your GP as soon as possible. Please also inform your Diabetes Practitioner of any changes to your blood glucose lowering medications whilst you are on the programme.
Diabetes remission in people with type 2 diabetes means that their blood sugar levels are healthy for at least 6 months (a HbA1c of less than 48mmol/mol) without needing to take any diabetes medication (Diabetes UK, 2000).
The programme is based on research which shows that the more weight you lose, the more chance you have of achieving type 2 diabetes remission. It is important to know that remission may not be possible for everyone. However, losing even 5% of your weight can have health benefits, including fewer medications, improved blood glucose levels and reduced risk of complications of type 2 diabetes.
With Xyla you will always be speaking to a qualified health coach who is an expert in the Type 2 Diabetes Pathway to Remission programme. Your coach will support you on your journey by answering any questions you have and coaching you through the 12 months. They are there to support you in any challenges you face and celebrate your successes at this exciting time.
When you complete the programme you will have gained a vast depth of knowledge in the field of nutrition and understanding the right levels of physical activity to support your health. Not only that, but you will also have taken the time to understand what lifestyle factors influence your health, this can include stress, sleep and mental wellbeing.
Following 12 months of 1:1 coaching support you will have everything you need to continue to improve your health long after the programme. At Xyla, we also provide you with an extended support package packed full of webinars from our expert clinicians.
During the first stage of the programme, you will be on a Total Diet Replacement products (also called TDR products). You will consume specially designed products, typically in the form of shakes and soups, instead of your usual meals. The TDR products will provide you with the vitamins and minerals your body needs whilst also leading to weight loss. The drinks you have in addition to TDR must be calorie free, which means no drinks containing sugar, no milk in tea or coffee and no alcohol. In the second stage of the programme, you will be gradually reintroducing balanced meals into your diet.
Some people don’t experience any side effects during the programme however, others will experience some at times. This is a summary of commonly reported side effects and suggested solutions. We find that most of these are easily managed.
One of the more common side effects of being on TDR products is hunger. This happens more in the beginning. However, your body does adapt. Appetite and hunger levels tend to decline as you progress through the programme. This is because of a process called ketosis. One of the side effects of ketosis can be suppressed appetite and hunger levels. People only tend to feel genuine hunger on TDR if they snack on foods that are not advised in this stage and disrupt the ketosis process.
In the beginning, many people find that they feel slightly more tired than usual. However, as their body adjusts to a lower calorie intake, many find that their energy levels increase. A lot of people tell us that their energy levels increase once they have adapted to TDR products.
We recommend that you maintain your current activity levels whilst in the TDR stage. It is important to listen to your body and only do what you are able to. You may find that there are some days when you are unable to be as active as you would like to be – especially in the beginning when you may be experiencing side effects. If you feel like this, do an activity that feels doable to you. A lot of people report having more energy once they have adapted to TDR products.
We recommend that you find a 12-week period that gives you the best chance of staying on TDR for the full 12 weeks without taking a break.
The NHS Type 2 Diabetes Path to Remission programme is free of charge. You will be provided with a free code to order your TDR products (soups and shakes) and you will receive a sample pack as well. If you choose the digital delivery model, you will also receive a self-monitoring kit free of charge including scales, glucometer and blood pressure monitor if you are required to monitor you blood pressure. You will be required to take these measurements before each session and report them to your Diabetes Practitioner.
Please watch the instructional video that can be found here.
If you have any ongoing issues, please contact Diabetic Supply directly on 01473 845453.
If you are on a digital pathway, please take your measurements before each session and have these ready to report to your Diabetes Practitioner. If you meet with your Diabetes Practitioner face-to-face, then they will take your measurements during each session.
TDR products are nutritionally complete and therefore supplementation is not necessary, unless you have been prescribed supplements by your healthcare team. In this case, we recommend that you follow the advice of your healthcare team. Other supplements may be used to manage some of the side effects that you may experience whilst on the programme e.g., fibre supplement for constipation/diarrhoea. You will receive a fibre supplement with your first TDR order. If you require more fibre during the programme, please contact us on 0333 577 3561 or query@xylaservices.com.
The first and second sessions are vital because they provide a lot of information about the programme and how to prepare for the TDR stage. If you miss these sessions, you will miss out on a lot of important information. The programme is also set out in a very specific way to support you at key points. If you miss the first or second session, we recommend that you start the programme again. We will try to facilitate this; however, places are limited and therefore this cannot be guaranteed.
If you miss a session without informing us, we will try to contact you to arrange a catch up call/session. If we are unable to reach you after multiple attempts, you will be advised of the risk of being discharged from the programme. If you are unable to attend a session, please contact our friendly team on 0333 577 3561 or query@xylaservices.com.
Please contact the patient support team on 0333 577 3561 or query@xylaservices.com and we will try and find another suitable option for you.
Please review our Microsoft Teams guidance here.
Please see the support section of the Wellbeing Way app, which can be found in the menu, or click here.
Try to think of your online learning modules as pieces of a puzzle, having all the pieces makes for a much clearer picture! We strongly recommend you work through all modules, as they have been created with you in mind and are your stepping stones to success.
Ordering
For a detailed list of FAQ’s for Altralife TDR products, ingredients, ordering and delivery please visit https://altralife.co.uk/pages/faqs
You will receive an email from Xyla around 3-5 days after your Initial Assessment. This will have a link to the Altralife website and code to cover the cost of the products when you check out.
Please check that you have the correct items in your basket for the T2DR programme. If you are still having issues, please contact Xyla on 0333 577 3561 or query@xylaservices.com.
You are due to receive an email from us 7-10 days before you run out of product. The email will have the Altralife link and your code for the next month.
Within the bounds of this programme, we cannot recommend it, as per NHSE guidance, any decision around continuing TDR must be in association with your GP, and once the T2DR programme is complete.
Health tracker FAQs
When making lifestyle changes it’s important to monitor weight, especially if the changes you’re making are aimed at weight loss, maintenance, or gain.
You can measure your weight using a set of scales. If you do not have access to scales at home, you can often weigh yourself at your GP surgery, local pharmacy, and some leisure centres.
Tips for measuring your weight:
• Take your weight measurement at roughly the same time of day
• Wear similar clothing each time you measure your weight
• To see how your weight may be changing over time, use the same set of scales each time you weigh yourself (we suggest no more than once weekly)
• Place the scales on a hard surface before stepping on (i.e. avoid soft rugs and carpet)
High blood pressure (hypertension) or low blood pressure (hypotension), rarely have noticeable symptoms. If you are diagnosed with either of these conditions; it is important that steps are taken to manage them. The risk of heart attack and stoke increases if high blood pressure is left untreated.
Walking is a great way to boost your activity level, it’s free and can fit around your schedule.
Tracking your step count can help you to understand how active you are during a day, week or month. A brisk 10 minute walk has lots of health benefits and counts towards your physical activity minutes for good health. Tracking steps can also support you to set & monitor goals to increase your activity if this is important to you.
If you would like to become more active, consider trying to increase your step count gradually. Plan in walks and find moments through your day where you could increase your steps. For example, walking rather than driving to the local shops or getting off the bus a stop early.
BMI or Body Mass Index is a measure of your weight in relation to your height and is measured in kg/m2. It can help to identify if your weight puts you at risk of some health issues including diabetes and heart disease. You will learn more about BMI as part of your programme.
Tracking your BMI can be helpful if you are aiming to manage your weight, taking small steps towards a healthier BMI will support your overall health.
Please note, BMI is one way to track weight in relation to health, but it should be considered as one of many health tracking measures including waist circumference and resting heart rate.
Blood glucose is a measure of how much glucose is circulating in your blood over a specific period. It is measured through a blood test typically organised by your GP or medical team. The two most common blood glucose tests include:
Capillary blood glucose (taken using a finger prick; may be fasting or at other time points in the day)
HbA1c (glycated haemoglobin)
Capillary blood glucose tells you how much glucose is circulating in your blood at the moment the blood sample was taken, whereas HbA1c is an average measure of blood glucose levels over the last 3 months.
It can be helpful to monitor blood glucose levels when making changes to your lifestyle, particularly if you have had a diagnosis of low (hypoglycaemia) or raised blood glucose (pre-diabetes/ diabetes).
The size of your waist is an indication of fat storage around your middle. A waist measurement higher than the recommendations indicates increased risk of heart disease, Type 2 diabetes, cancer and stroke.
It can be helpful to track the changes to your waist circumference whilst on your programme, as it can tell you how you are getting on outside of your weight on the scales. It can take a little while to see changes to your waist measurement, so try measuring and tracking monthly.
To measure your waist accurately, find the bottom of your ribs and the top of your hips, wrap a measuring tape around your middle between these two points. Breathe out naturally and take your measurement. Alternatively, you can take the measure from two fingers width above your belly button; choose the measurement approach that feels the most easily repeatable for you.
Your resting heart rate is measured by taking your pulse and counting the number of times your heart beats in one minute when you are at rest. This is an indication of your fitness, generally the fitter you are the lower your resting heart rate.
Most adults have a resting heart rate between 60 and 100bpm (beats per minute). If you are concerned that your resting heart rate is regularly too high or too low, speak you your GP.
When making healthy behaviour changes you may want to track your resting heart rate to indicate if and by how much your fitness level is improving.
Tracking activity minutes involves measuring the length of time you are active through the day and logging the duration. For example, a 10-minute walk and 30-minute swim, will accumulate to 40 active minutes in the day.
By tracking the length of time you spend being active, you can gain an understanding of how active you typically are. In your programme you will learn about the recommendations for minutes of activity for people of varying ages, and therefore will be able to assess if you are meeting those recommendations. You will also then be able to set realistic and manageable activity goals so that you might gradually increase your activity levels in a sustainable way.
There is strong evidence to show that setting goals is an effective step towards creating change. If you would like to improve on any of your health tracker items, set realistic goals and take small steps to create sustainable change. For example, if you would like to increase your step count, think about how many steps you would usually take in a day and then set a step goal which challenges you but feels achievable.