Reversing Diabetes Case Study: ProCare partners with PREKURE to ‘Beat Diabetes Together’

ProCare is a leading healthcare provider that aims to deliver the most progressive, pro-active, and equitable health and wellbeing services in Aotearoa. ProCare serves over 830,000 patients through their network of general practices and healthcare providers. These practices serve the largest Pacific and South Asian populations enrolled in general practice and the largest Māori population in Tāmaki Makaurau.

The team at ProCare is passionate about working collaboratively with other healthcare providers and organisations to find innovative solutions to health challenges facing their community. They recently joined forces with PREKURE, a social enterprise that focuses on using the latest science in lifestyle medicine, combined with the power of behaviour change and coaching, to prevent, manage and reverse chronic disease. The “Beating Diabetes Together” pilot project was launched at Papatoetoe Family Doctors in South Auckland in late 2022 and has achieved remarkable results in helping their patients manage and in some cases reverse their type 2 diabetes.

The need for a fresh approach

The prevalence of type 2 diabetes (T2D) is astounding and continues to grow in New Zealand (NZ) with an alarming 253,480 people affected in 2018, and Māori and Pacific populations disproportionately affected [1, 2]. T2D is the leading risk factor for several non-communicable diseases including cardiovascular disease [3], cerebrovascular disease [4], selected cancers [5], and dementia [6]. The mortality, morbidity, and economic burden of T2D is significant in NZ, Australia and globally [7]. It has long been believed that this non-communicable disease is irreversible; however, recent advances in lifestyle medicine, particularly regarding whole food carbohydrate-restricted diets, suggest that this is not the case, and that type 2 diabetes can in fact be reversed [10,11,12].

The numbers highlight the undeniable need for new solutions to address this growing problem. The challenge however is how to provide not just the health education that the latest science points to, but also culturally responsive support that is on the client’s agenda, to truly empower lasting results and drive meaningful change in our society.

 

PREKURE brings innovative solutions to this growing problem

ProCare and PREKURE collaborated to develop and implement a pioneering initiative called “Beating Diabetes Together”, with the aim of empowering individuals with type 2 diabetes to achieve better health outcomes. This novel community-based approach equipped participants with the knowledge, skills, and support needed to effectively manage their health and diabetes.

We know that ‘no man is an island’ and lasting solutions come from creating an environment with a robust support network.

The “Beating Diabetes Together” pilot brought this quote to life by working with a local healthcare team of nurses, GPs, social workers and Health Coaches who live and work in the community, ensuring that the program was culturally responsive and tailored to the community’s specific needs. By combining health literacy with health coaching and culturally relevant, community-based peer support, the program achieved powerful outcomes, empowering participants to take control of their own health.

Lifestyle medicine works when everyone is paddling in the same direction toward a shared goal, in this instance the goal is to rid the community of type 2 diabetes, for good.

The program, which was developed based on PREKURE’s Diabetes Lifestyle Education Protocol (LEP), featured a unique combination of engaging, short online lessons and health coaching delivered by PREKURE’s trained and certified Health Coaches. These Health Coaches utilise the latest scientific evidence and approaches in type 2 diabetes management and leverage the power of health coaching to drive sustainable behaviour change and lasting results.

 

The results show that type 2 diabetes reversal is possible

The pilot program ran for 12 weeks in late 2022 with 30 participants at Papatoetoe Family Doctors at the Health Hub. The results, for many, have been life changing, with two participants reversing their type 2 diabetes, four participants seeing reductions of between 12-25 mmol/L in HbA1c and two participants changing classification from ‘diabetic’ to ‘pre-diabetic.’

All participants experienced health improvements, some significantly so, including improvements to HbA1C, weight, waist circumference, and systolic blood pressure. Those who attended at least 2 health coaching sessions showed an even greater improvement in their HbA1C levels.

 

What program participants had to say

Participants reported improvements in both health and energy levels, finding the changes easy to sustain day-to-day, with lots of small changes making a big difference. Fiona, a participant in the program, is one of many success stories, having reversed her type 2 diabetes and gaining a new lease on life. Her commitment to the program is a testament to what is possible with early intervention.

The results of the program have proven that with adequate support and education, individuals can take charge of their health and experience positive changes in both physical and mental wellbeing. And that incorporating culturally competent and technically trained Health Coaches with health literacy and a high-quality diet can positively impact clinical measures of diabetes management and even reverse type 2 diabetes.

The success of the program is a testament to the effectiveness of PREKURE’s Diabetes innovations and ProCare’s commitment to bringing new solutions to their patients. Long-term programs in the UK and US demonstrate the potential for achieving similar success in Aotearoa.

PREKURE are leading the T2D revolution in New Zealand

PREKURE’s innovations in health coaching combined with nutritional science is changing the way diabetes is treated across Australia and New Zealand, empowering people to take ownership and control of their journey to success.

 

The leading experts in Type 2 Diabetes reversal in Australia and New Zealand

PREKURE bring the latest science and evidence, by world leading experts including:

  • Prof Grant Schofield, Prof Public Health Director of The Centre for Human Potential at AUT University and professor of public health.
  • Dr Glen Davies, General Practice Medical doctor focused on offering LCHF and Keto active management diets for chronic illness and disease. Nominated as NZ GP of the Year 2021 for his work in reversing T2D.
  • Dr Catherine Crofts, Pharmacist Catherine has a PhD in the early diagnosis of metabolic disease, and is experienced in the deprescribing of medications.
  • Sonya English, Health Coach Faculty Lead & Registered Nurse Sonya has a masters of health practice and is highly experienced as a critical care nurse in the acute treatment of people suffering from ill-health.
  • Dr Lily Fraser, General Practice GP and Clinical Director at Turuki Healthcare in Mangere, South Auckland with a passion for low-carb nutrition and improving their health and wellbeing through lifestyle changes. Dr Fraser has been using this approach in her practice for a number of years with favourable results

 

Are you keen to join the revolution?

We’re looking for more partners looking to achieve remarkable results for their patients and help reduce some of the chronic disease burden in New Zealand and Australia.

 

For partnership enquiries please contact Louise Schofield.

ProCare’s pilot program data

ProCare Beating Diabetes Together pilot program data: 59% of participants achieved a clinically significant reduction in HbA1c (≥3 mmol/L), and 82% experienced a reduction of at least 1 mmol/L in HbA1c. Moreover, two participants were able to reverse their type 2 diabetes and are now classified within the normal range for HbA1c. Four participants saw reductions between 12-25 mmol/L in HbA1c, and two participants changed classification from ‘diabetic’ to ‘pre-diabetic.’ In terms of weight loss, the average change in weight for all participants was 2.8 kgs, with 13% (2 participants) achieving a clinically significant reduction in weight (≥5% body weight). Moreover, 73% (11 participants) experienced a reduction in body weight.

 

References

  1. Ministry of Health. Diabetes Virtual Register: Ministry of Health; 2019 [cited 2020 8 March]. Available from: https://www.health.govt.nz/our-work/diseases-and-conditions/diabetes/aboutdiabetes/virtual-diabetes-register-vdr.
  2. Huxley R, Barzi F, Woodward M. Excess risk of fatal coronary heart disease associated with diabetes in men and women: meta-analysis of 37 prospective cohort studies. BMJ. 2006;332(7533):73-8
  3. Kruyt ND, Biessels GJ, Devries JH, Roos YB. Hyperglycemia in acute ischemic stroke: pathophysiology and clinical management. Nat Rev Neurol. 2010;6(3):145-55.
  4. Giovannucci E, Harlan DM, Archer MC, Bergenstal RM, Gapstur SM, Habel LA, et al. Diabetes and cancer: a consensus report. Diabetes Care. 2010;33(7):1674-85.
  5. de la Monte SM, Wands JR. Alzheimer’s disease is type 3 diabetes-evidence reviewed. J Diabetes Sci Technol. 2008 2(6):1101-13
  6. Gounder ST, Wijayanayaka DR, Murphy R, Armstrong D, Cutfield RG, Kim DD, et al. Costs of bariatric surgery in a randomised control trial (RCT) comparing Roux en Y gastric bypass vs sleeve gastrectomy in morbidly obese diabetic patients. N Z Med J. 2016;129(1443):43-52.
  7. Ministry of Health. Living Well with Diabetes: 2015-2020: Ministry of Health; 2019 [cited 2020 8 March]. Available from: https://www.health.govt.nz/our-work/diseases-andconditions/diabetes/living-well-diabetes-2015-2020.
  8. New Zealand Guidelines Group. New Zealand Primary Care Handbook 2012. Wellington: New Zealand Guidelines Group for the Ministry of Health; 2012. Available from: https://www.health.govt.nz/publication/new-zealand-primary-care-handbook-2012
  9. American Diabetes Association (2019). 5. Lifestyle Management: Standards of Medical Care in Diabetes-2019. Diabetes care, 42(Suppl 1), S46–S60. https://doi.org/10.2337/dc19-S005
  10. Virta Health Corp. Virta 2020 [cited 2020 6 March]. Available from: https://www.virtahealth.com/.
  11. Saslow LR, Summers C, Aikens JE, Unwin DJ Outcomes of a Digitally Delivered LowCarbohydrate Type 2 Diabetes Self-Management Program: 1-Year Results of a Single-Arm Longitudinal Study, JMIR Diabetes. doi:10.2196/diabetes.9333
  12. Hallberg et al. Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year. Diabetes Ther. Doi: 10.1007/s13300-018-0373-9

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