Desang diabetes magazine diabetes news


Commenting on recent NICE

recommendations that the NHS funds

weight management programmes such

as Rosemary Conley, Slimming World

and Weight Watchers in order to address

obesity, Sally Norton, Consultant Bariatric

and General Surgeon and Founder

and Medical Director of Vavista, says,

"I welcome the recent NICE guidelines

to help the two-thirds of our population

who are overweight or obese. The

NICE recommendation rightly notes

that weight management programmes

should be assessed to ensure that they

deliver meaningful weight loss beyond a

year, the hard facts are that weight-loss

programmes, such as Weight Watchers,

rarely do. Richard Samber, a former

finance director of Weight Watchers has

said that the financial success of the

company ($31 million profit last year) lay

in the fact that 84% of people regained

weight. Having spent years sitting in clinic

listening to patients tell me how they have

lost and regained weight on more diets

than I can count, I do not want to start

people on the dieting merry-go-round,

where weight regain is more common

than weight loss."

Dr Norton argues that obesity is too

big an issue for the NHS to tackle alone.

"Engaging the help of private initiatives


may seem a sensible solution," she say,

"But shifting responsibility without good

evidence of long-term success is not the

answer. In trials, it was noted that the

average weight loss in lifestyle weight

management programmes was just 3%,

or only 1.5kgs at two years. I would

question how many people outside a trial

would attain even that modest degree

of weight loss. According to the NICE

economic analysis, the cost of a £100

weight loss programme is only worthwhile

if a person loses 1kg and keeps this

weight difference for life. If someone

regains weight within two-to-three years

or less, the money spent was worthless."

She concludes, "As an NHS employee

and a tax-payer, I want us to try harder to

develop more holistic behaviour change

programmes that really work, backed

by robust long-term data, before we

encourage commissioners to spend

NHS resources on them. Until then, I

believe money would be better spent on

such things as encouraging industry to

provide healthier choices for consumers,

addressing the sale of fizzy drinks in

schools and asking the NHS to lead by

example by replacing those hospital

vending machines full of chocolate and

crisps with something much healthier."


Medtronic's results of its OpT2mise trial,

which have been published in The Lancet,

have shown that MiniMed insulin pumps

safely achieve better glucose control for

people with Type 2 diabetes who are

treated with insulin. While the benefits

of insulin pump therapy for people with

Type 1 diabetes are well proven, this is

the largest global study to evaluate the

comparative efficacy of insulin pump

therapy versus multiple daily insulin

injections in people with Type 2 diabetes

with poor glycemic control.

In the OpT2mise trial, those using

insulin pumps achieved a mean HbA1c

(average blood glucose) reduction of

1.1% compared to only a 0.4% reduction

by those using multiple daily injections.

This improvement in glucose control was

achieved without any episodes of severe

hypoglycemia. In addition, those in the

insulin pump group lowered the total daily

dose of insulin by more than 20%. There

was no difference in weight gain between

the two groups.

Prof. Yves Reznik from the University

Hospital of Caen, France, comments,


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