The low carb program for people with type 2 diabetes and pre-diabetes – a mixed methods feasibility study of signposting from general practice

BackgroundEvidence shows type 2 diabetes mellitus (T2DM) can be effectively treated with a reduced-carbohydrate diet to support weight loss. Digital apps are increasingly used to support weight loss, yet little is known about their use as part of general practice diabetes care.AimDetermine the feasibility of signposting from routine NHS general practice to a digital weight management tool (Low Carb Program) for patients with T2DM and pre-diabetes.Design/settingMixed-methods feasibility study implemented within routine general practice consultations at four practices in the Midlands, England.MethodsGeneral practices offered signposting to eligible patients attending consultations of any type during a four-week recruitment period. Rates of offering and accepting signposting were recorded, with program registration, program completion and self-reported health outcomes (weight, HbA1c).ResultsSignposting was offered to 351 patients; 160 (45.6%) accepted, 103 (29.3%) registered with the intervention and 43 (26.9% of patients accepting signposting) completed the programme. GPs reported that signposting added between 1–4 minutes to the consultation length. Patients completing the programme reported greater weight loss (7.2 kg vs 1.6 kg, P<.001) and HbA1c improvements (–9.1 mmol/mol vs 1.7 mmol/mol, P<.001) compared to those who did not, and were more likely to reduce the number of general practice-prescribed diabetes medications.ConclusionsSignposting from real-world general practice to the Low Carb Programme is feasible and can potentially improve diabetes outcomes. Further research should explore whether the process of signposting can be enhanced to increase registration, identify whether additional practice-led support leads to increased programme completion, and confirm the intervention’s clinical and cost-effectiveness.