NHS Path to Remission Programme

[Steve1984]

Does anybody have any experience with the above?

My GP has sent me some info as a newly diagnosed Type 2.

I've lost three stone since being diagnosed which came off very fast as I was heavily overweight but I've now stalled slightly and am only hitting about a 1Ib a week. Still the right direction but a long way to go.

I thought the above could be a good way to kick start the next stage of weight loss.

Any feedback from those who have done it will be greatly appreciated.

Thanks in advance

 

[grovesy]

If I remember correctly these programmes vary from area to area, and even have differnt names.

 

[Lucyr]

My GP has sent me some info as a newly diagnosed Type 2.

Was the info the GP sent you about this path to remission program? If you share more info about what it involves people might recognise it as something similar they’ve tried.

 

[Steve1984]

Was the info the GP sent you about this path to remission program? If you share more info about what it involves people might recognise it as something similar they’ve tried.

Hi Lucy yes it's called the Path to Remission Programme. I believe it's 12 weeks of eating healthy shakes and soups etc provided by the NHS along with help and advice along the way. I just wondered if anybody had any success with it. As I mentioned I've lost three stone since November but it's slowing down a little now so thought this would be a good thing to try and kick-start it again. Thanks

 

[Lucyr]

Hi Lucy yes it's called the Path to Remission Programme. I believe it's 12 weeks of eating healthy shakes and soups etc provided by the NHS along with help and advice along the way. I just wondered if anybody had any success with it. As I mentioned I've lost three stone since November but it's slowing down a little now so thought this would be a good thing to try and kick-start it again. Thanks

You could search using the term Newcastle diet and you will find experiences

 

[Cheltonian31]

Hello Steve
My experience isn't with the NHS path to remission programme because with a newly diagnosed HbA1c of 88 in Sept 2023, I was just over the threshold for acceptance onto the programme (which my GP told me was 87 in Gloucestershire). So after discussions with my GP I followed the Newcastle Diet myself. 13 weeks (with Xmas in between) of 3 Exante shakes per day plus a plate of salad or non starchy veg, or veg soup and lots of water and black tea starting in early Oct 2023. I stuck to the diet rigidly over that time and, as advised, took up no new physical exercise. By the end of week 13 I had lost 4st 7lbs which was 25% of my starting weight and my HbA1c fell from 88 to 37 and I was taken off of my diabetes meds (Metformin). I am now back to a (hopefully) more sustainable long term eating pattern. Smaller portions, not carb counting per se but in reality my daily carbs tend to be between 80g and 150g. The key focus for me being to maintain the weight loss to maintain the remission. My daily morning fasting finger prick tests are now averaging 5.4, only slightly up from 5.2 whilst I was on the diet. I have lost a further 3 lbs in the three weeks since coming off of the strict diet.
The 13 weeks on the diet were dull rather than difficult, I seldom felt really hungry or had cravings and the rapid weight loss was motivating and kept me going. Family support was also a great help.
I hope this info is useful to you in however you decide to take things forward.
All the very best.

 

[Steve1984]

Hello. Thanks so much for the info this is very helpful. I will def take this up if its offered to me after hearing your experience. Well done on your fantastic achievements. My hbac1 was 55 when diagnosed and I have my next test on the 13th March. Doc said if it had gone down then I could stay off meds and keep doing what I'm doing. I've lost three stone and tried to cut carbs as far as possible. I did a free trial with the libre sensor which was showing my hbac1 as 40 after two weeks but I understand these can be low. I've fallen off the wagon twice recently and had too much lager so I need to stop these hiccups

 

[Kreator]

Hi @Steve1984

Well done on your journey so far, keep at it😉

I was part of the original NHS Pilot scheme which is based on the programme you mention

I have a thread here;

NHS Low Calorie Diet - Type 2 Remission Programme - Oviva (aka Newcastle)

Hi All, 25/08/2021 - Link: https://www.england.nhs.uk/diabetes/treatment-care/low-calorie-diets/ - Includes links at the bottom to DiRECT Year 1, DiRECT Year 2 & DROPLET Trials ;) 25/08/2021 - Link: https://oviva.com/uk/en/programme/diabetes-remission/#join - This explains the programme...

forum.diabetes.org.uk

Approaching 3 years and counting…still in Remission 😉

 

[Gillimarie]

Hi
My husband has been trying to get into this for years but has had zero support from the nurse and GP at our practise. He read about the Newcastle diet and Tom Hanks and other stories years ago but has been unsuccessful in getting support.
Now he is over 65 and they continue to say no. He is getting desperate and wants to just buy the meal replacements himself and try to manage the meds on his own.
As you can imagine I’m really worried about this.
Does anyone know where you can get help and support maybe privately?
We are just really frustrated about it as he really believes it would help him and is totally committed to the twelve week initial plan. But without supervision from somebody it’s not terribly safe in my opinion.
Any suggestions gratefully received.
Gillian
PS apologies if this is in the wrong thread ‍♀️

 

[harbottle]

You don't need a doctor to do it, or their permission.
Just do it.
I had zero help/advice and just did my own low carb/calorie diet to lose weight.
The GP just said 'keep on doing what you're doing' when levels went back to normal.

 

[Leadinglights]

Hi
My husband has been trying to get into this for years but has had zero support from the nurse and GP at our practise. He read about the Newcastle diet and Tom Hanks and other stories years ago but has been unsuccessful in getting support.
Now he is over 65 and they continue to say no. He is getting desperate and wants to just buy the meal replacements himself and try to manage the meds on his own.
As you can imagine I’m really worried about this.
Does anyone know where you can get help and support maybe privately?
We are just really frustrated about it as he really believes it would help him and is totally committed to the twelve week initial plan. But without supervision from somebody it’s not terribly safe in my opinion.
Any suggestions gratefully received.
Gillian
PS apologies if this is in the wrong thread ‍♀️

Just a couple of questions, what was his latest HbA1C and what medications does he take as that may affect the suitability of the meal replacement diet, that may be why the doctor will not support it.
Does he have a lot of weight to lose as again if he hasn't then it may not be suitable.
Has he tried other dietary approaches.
The danger of going for the private support is you would need to be sure they were a good clinic.
If you check they are suitable then there is no issue about buying yourself, there a quite a few that people have tried.

 

[Gillimarie]

Just a couple of questions, what was his latest HbA1C and what medications does he take as that may affect the suitability of the meal replacement diet, that may be why the doctor will not support it.
Does he have a lot of weight to lose as again if he hasn't then it may not be suitable.
Has he tried other dietary approaches.
The danger of going for the private support is you would need to be sure they were a good clinic.
If you check they are suitable then there is no issue about buying yourself, there a quite a few that people have tried.

Yes. Lots to lose and high test results. Can’t remember exact figure but in the 70s at least. Blood glucose levels high in the morning. Anywhere between 20.4 and 17. But strangely if he tests earlier say at 6 am they are much lower. But by 8.30/9am they are higher.
We experiment with all sorts of dinners. The lowest results are something like steak and salad. Or salmon with vegetables. It’s really hard to provide interesting meals that don’t contain items that cause spikes.
Anyway. Thanks for the info. We will have to investigate further.

 

[Gillimarie]

You don't need a doctor to do it, or their permission.
Just do it.
I had zero help/advice and just did my own low carb/calorie diet to lose weight.
The GP just said 'keep on doing what you're doing' when levels went back to normal.

Thank you. I think our concern is how we adjust the meds. He takes several including slow release gliclszide plus Empagliflozin and metformin for the diabetes. Plus Enapril, and allupurinol. So hard to know how to adjust all those. But thank you for the encouragement.

 

[Lucyr]

You don't need a doctor to do it, or their permission.
Just do it.
I had zero help/advice and just did my own low carb/calorie diet to lose weight.

Well that’s dangerous advice as people do need medical advice before starting any very restrictive diet like this to make sure it’s safe for them to do, particularly if they’re on medication that might need adjusting

 

[Dragonheart]

Thank you. I think our concern is how we adjust the meds. He takes several including slow release gliclszide plus Empagliflozin and metformin for the diabetes. Plus Enapril, and allupurinol. So hard to know how to adjust all those. But thank you for the encouragement.

You really do need the dr to support him on medication reduction. Insist they must help otherwise you risk hypos because of the gliclizide and possibly Euglycemic DKA with the empagliflozin (as sglt2 medications and low carb are not a good mix and should be advised against. Although this is a low calorie plan by its very nature it’s also low carb too.) No idea about the others.

Try taking this document with you to the appointment https://bjgp.org/content/69/684/360.
“Adapting diabetes medication for low carbohydrate management of type 2 diabetes: a practical guide”

 

[Leadinglights]

Yes. Lots to lose and high test results. Can’t remember exact figure but in the 70s at least. Blood glucose levels high in the morning. Anywhere between 20.4 and 17. But strangely if he tests earlier say at 6 am they are much lower. But by 8.30/9am they are higher.
We experiment with all sorts of dinners. The lowest results are something like steak and salad. Or salmon with vegetables. It’s really hard to provide interesting meals that don’t contain items that cause spikes.
Anyway. Thanks for the info. We will have to investigate further.

It would be unwise to start a meal replacement regime with all those medications but if his levels are still that high despite them it certainly needs some better advise from the GP. Even people need to be cautious with going too low on carbohydrates.
Those meals you mention are pretty low carb but there are plenty of other options for tasty meals whilst still keeping blood glucose increases to an acceptable level.
It would be worth while testing before and 2 hours after meals so you can identify any problem meals which increase blood glucose by more than 2-3mmol/l and then you could look to reducing the amount of carbs in those.
There may be some recipes and meal ideas in this link https://lowcarbfreshwell.com/. It is low carb but with the aid of the monitor you could select the more suitable ones.
Many people find blood glucose will increase as soon as they get up and move around as the liver releases glucose to give energy for the day in the absence of food. Testing in bed will give a more consistent morning /fasting reading.
It certainly sounds as if something need adjusting in terms of medication. I can see why the GP wouldn't support the meal replacement regime with all those diabetic medications.

 

[Gillimarie]

You really do need the dr to support him on medication reduction. Insist they must help otherwise you risk hypos because of the gliclizide and possibly Euglycemic DKA with the empagliflozin (as sglt2 medications and low carb are not a good mix and should be advised against. Although this is a low calorie plan by its very nature it’s also low carb too.) No idea about the others.

Try taking this document with you to the appointment https://bjgp.org/content/69/684/360.
“Adapting diabetes medication for low carbohydrate management of type 2 diabetes: a practical guide”

Thank you. That’s really helpful.

 

[Gillimarie]

Thank you. That’s really helpful.

You really do need the dr to support him on medication reduction. Insist they must help otherwise you risk hypos because of the gliclizide and possibly Euglycemic DKA with the empagliflozin (as sglt2 medications and low carb are not a good mix and should be advised against. Although this is a low calorie plan by its very nature it’s also low carb too.) No idea about the others.

Try taking this document with you to the appointment https://bjgp.org/content/69/684/360.
“Adapting diabetes medication for low carbohydrate management of type 2 diabetes: a practical guide”

I’ve read this through and it’s super helpful in explaining the risks of inadequate medication adjustment. Really straightforward explanations.

 

[Drummer]

Hi
My husband has been trying to get into this for years but has had zero support from the nurse and GP at our practise. He read about the Newcastle diet and Tom Hanks and other stories years ago but has been unsuccessful in getting support.
Now he is over 65 and they continue to say no. He is getting desperate and wants to just buy the meal replacements himself and try to manage the meds on his own.
As you can imagine I’m really worried about this.
Does anyone know where you can get help and support maybe privately?
We are just really frustrated about it as he really believes it would help him and is totally committed to the twelve week initial plan. But without supervision from somebody it’s not terribly safe in my opinion.
Any suggestions gratefully received.
Gillian
PS apologies if this is in the wrong thread ‍♀️

Sorry if this sounds daft but has your husband 'failed' eating a low carb diet?
The meal replacements are actually higher in carbs than I eat to stay in remission, from what I can gather.
They seem to require some will power to stick to that regime, but I'm eating all I want, having meals I enjoy regaining a waistline and feeling great.

 

[Lucyr]

Sorry if this sounds daft but has your husband 'failed' eating a low carb diet?

He takes empagliflozin, you can’t low carb on that