Online type 2 diabetes support linked to better health outcomes – study

A free NHS online programme has been linked to better outcomes for adults with type 2 diabetes across England, according to a new study.

The NHS programme, Healthy Living for people with type 2 diabetes, is a website with written articles, videos, self-assessment quizzes and tools.

It supports people to live well with type 2 diabetes by offering information and advice on eating well, being more active, living with diabetes and emotional wellbeing.

Lead author Dr Salwa Zghebi said: “What this study shows, in the plainest possible terms, is that a free, nationally available NHS educational programme can help people with T2D make measurable improvements to their health, even when used in the complex reality of everyday life.

“It’s not a silver bullet, but it is a practical tool that works, and the challenge now is ensuring that everyone who could benefit has the opportunity to do so.

“We feel Healthy Living offers a scalable, accessible option for supporting type 2 diabetes self-management, particularly for people who face barriers to attending in-person diabetes education programmes.

“Improving uptake among underserved groups will be essential to ensuring the programme reduces existing health inequalities.”

Researchers at the University of Manchester analysed data from people with type 2 diabetes who activated a Healthy Living account and found they had better health outcomes after one year than those who did not take part.

They examined who was most likely to use the programme and how engagement was linked to changes in HbA1c, a blood test that measures average blood sugar levels, blood pressure, body mass index, a measure of weight in relation to height, insulin use, and completion of essential diabetes care processes.

The findings showed uptake of the programme was highest among women, people from the least deprived areas, people of White ethnicity and current smokers.

To assess clinical outcomes, researchers compared 4,940 Healthy Living users with 24,685 similar people who did not register for the programme.

After a year, Healthy Living users saw an average HbA1c drop of 1.3 mmol/mol, alongside small reductions in body mass index and blood pressure, pointing to better day-to-day control of their diabetes.

They were also 1.6 times more likely to complete the routine yearly checks that help spot problems early and protect the eyes, feet, heart and kidneys over the long term.

However, the study highlighted that even small average improvements can translate into meaningful reductions in type 2 diabetes-related complications when applied across large populations.

It also underlined the need to address inequalities in uptake, with notably lower participation among Asian and Black communities despite higher prevalence of type 2 diabetes.

Co-author Dr Sarah Cotterill, principal investigator and honorary reader at the University of Manchester, said: “People’s outcomes were better for those who attended more of the Healthy Living programme, so it would be worthwhile for the NHS to find ways to encourage people to attend for longer, such as improved signposting and motivational messages.”