NCL Low-Calorie Diet Programme for Type 2 Diabetes

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This service will launch on 2 November 2020 as part of a two-year pilot. NCL is one of ten sites across England and there are five hundred places available.


A low-calorie diet service for people with Type 2 diabetes.

A one-year programme to support healthier lifestyle, weight loss and remission of Type 2 diabetes. The programme is based on two large studies that showed that as a result of low-calorie diet treatment, people living with Type 2 diabetes who were overweight, could improve their diabetes control, reduce diabetes-related medication and even achieve remission.

Programme objectives

  • reduction in weight of service users and maintenance of weight loss achieved
  • achievement of remission of Type 2 diabetes
  • reduced HbA1c, blood pressure and cholesterol
  • reduction of medication

Programme overview

The one-year programme consists of 12 weeks of low-calorie total diet replacement (shakes and soups, products provided by ICS) followed by reintroducing food, focusing on movement and maintaining a new healthy eating lifestyle.

The unique programme: 

  • combines specialist nutrition, psychology and physical activity
  • supports rapid weight loss and long-term behaviour change
  • delivered entirely remotely via our app, with supporting resources and 1-2-1 telephone coaching
  • supported by GPs, practice nurses, diabetes practitioners, dietitians, clinical psychologists and exercise specialists  

Eligibility criteria

Inclusions

  • aged 18-65
  • diagnosed with Type 2 diabetes within the last six years
  • BMI of 27kg/m2 or higher (adjusted to 25kg/m2 or higher in Black, Asian and Minority Ethnic (BAME) people) ◦A BMI obtained from self-measured weight is acceptable for referral. If this cannot be obtained, a clinic-measured value within the last 12 months may be used, provided there is no concern that weight may have reduced since last measured such that the individual would not be eligible for the programme at present.
  • HbA1c measurement taken within the last 12 months, with values as follows; ◦if on diabetes medication, HbA1c 43 mmol/mol or higher
    • if not on diabetes medication, HbA1c 48 mmol/mol or higher
    • in all cases, HbA1c must be 87 mmol/mol or lower
    • if there is any concern that HbA1c may have changed since last measured, such that repeat testing may indicate that the individual would not be eligible for the programme at present, HbA1c should be rechecked before referral is considered
  • have attended a monitoring and diabetes review when this was last offered, including retinal screening, and commit to continue attending annual reviews, even if remission is achieved

Exclusions

  • current insulin user
  • pregnant or planning to become pregnant within the next 6 months
  • currently breastfeeding
  • has at least one of the following significant co-morbidities; active cancer, heart attack or stroke in last six 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) or active liver disease (not including NAFLD) or active substance use disorder, active eating disorder, porphyria, known proliferative retinopathy that has not been treated
  • has weight loss of greater than five per cent body weight in the past six months, or is currently on a weight management programme
  • has had, or is awaiting, bariatric surgery (unless willing to come off waiting list)
  • health professional assessment that the person is unable to understand or meet the demands of the NHS LCD Programme and/or monitoring requirements (due to physical or psychological conditions or co-morbidities)

How to refer

EMIS form

Referral methods: Email

After discussing the service with your patient and confirming eligibility for the pathway, complete the referral form which will be available from the EMIS forms page once this service is launched, and email to Scwcsu.ncllcd@nhs.net

Please note: referrals cannot be made until service launch in October is confirmed.


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