Endocrine Abstracts

Background: The role of weight loss in the management and prevention of type 2 diabetes has grabbed the attention of the media and the NHS, supported by the extremely positive DROPLET trial results. Very Low Calorie Diets (VLCDs) are being recognised as a valuable treatment option for type 2 diabetes, with a qualified healthcare professional closely involved. The NHS has announced plans for a pilot project in 2019 to establish the feasibility of this approach within the NHS structure. Current Healthcare Experience - Pharmacy. I have assisted many people with weight management, in pharmacies since 2004. Data from the 1144 people who have used my VLCD option shows 991 people losing 5% or more of their initial weight, with a mean of 11.98% (range 5% to 58%). From the median, half of these dieters lost over 10%. Among this cohort, 80 people had an initial BMI in excess of 40 kg/m² (40 in excess of BMI 43). The mean weight loss in these 80 dieters was 16.03%. Of the 15 dieters who initially presented with type 2 diabetes, all experienced remission in the early days of their programme, attributed to the recognised rapid weight loss and rapid blood glucose normalisation seen with VLCDs. A significant number of diabetics were unnecessarily excluded by GPs refusing permission to significantly reduce prescribed hypoglycaemics which is essential to prevent hypoglycaemia. Effective weight loss programmes, like mine, are time consuming, with availability and flexibility essential. Surgery staff and GPs are already under extreme pressure, with any imposed limitations likely to dilute diet effectiveness and possibly compromising availability. Hundreds of other pharmacists are already offering VLCDs. Their medical knowledge, flexibility and extended availability is critical to establish effective weight loss and long-term weight management. These are features almost impossible to replicate in a surgery setting.

Conclusion: Diabetics do not have to wait for the outcome of the NHS trial. Pharmacists are effectively treating weight now. The overall acceptance of pharmacy-led VLCDs by the NHS and general practice, will help a much larger number of diabetic patients and like my pharmacy programme, at no cost to the NHS.