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Gold, incentives and meh

GPs urged to prescribe 'lifestyle medicine' instead of drugs for type 2 diabetes

Experts are urging GPs to prescribe ‘lifestyle medicine’ – including dietary changes, exercise and stress management – instead of medications to tackle diseases like type 2 diabetes and obesity.

The message is being pushed out by leading cardiologist Dr Aseem Malhotra with the launch of a new documentary and has received backing from leading health academics and the BMA.

The film describes how lifestyle changes – such as eating more nuts, olive oil and vegetables and taking specific types of exercise – can reduce the need for medication and even reverse type 2 diabetes.

Dr Malhotra advocates the benefits of the Mediterranean ‘diet’ – which he says come from much more than foods, encompassing a whole lifestyle approach including habitual movement, sunshine, sleep and the absence of sugar in the diet.

New BMA president Dr Pali Hungin, professor of primary care and general practice at Durham University, said he supported the initiative.

Dr Hungin said: ‘We do seriously need to move away from drugs alone to more selected, positive health habits - these can be extremely effective in improving diabetic control. It is fitting that we should examine this important topic during this epidemic of type 2 diabetes.’

Professor Sir Muir Gray, director of Better Value Healthcare, from the University of Oxford, said: ’The documentary emphasises the benefits of exercise not just for weight control but to prevent inflammation which is caused by stress and inactivity and the programme explores the contribution of stress, for so long ignored because of the difficulty in measuring stress.’

Sir Muir added that the ’primary focus is not on any single risk factor but as the programme emphasises, on all the factors that combine to increase the risk of heart disease, stroke and vascular dementia’.

It comes after Dr David Unwin, RCGP clinical expert in diabetes and a GP in Southport, was awarded a prestigious NHS innovator of the year award for his work combining a low-carbohydrate diet with psychological support, which saw his practice spend some £45,000 less than average on drugs for type 2 diabetes.



Readers' comments (6)

  • Sorry, cannot be done in 10min with all the other tick boxes and problems presented.

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  • Really? Really? What more can we do than say loose weight do more exercise and eat better? We have no time and no resources to do any more. This is pie in the sky mumbo jumbo.

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  • If you are not keen to suck up to the drug companies then prescribe bariatric surgery in addition, or the small bowel sleeve as this area of the bowel is obviously implicated in the development of type 2 DM.
    Remove high sugar content and refined food from supermarket and food shop shelves.

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  • |Anonymous | GP Partner|22 Jul 2016 11:20pm - wise words and evidence based.

    Show me one RCT that has showed lifestyle is more effective than medication/surgery in T2DM !

    Most of my patients would need either TKR/THR and/or heart/lung transplants before contemplating any form of exercise.

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  • Sorry but what in the name that is good and holy possessed dr unwind to be presented with an award for proven retro information. Maybe because he is old enough.... I am not but still posses a reasonable long term memory.
    Anyone who has any basic knowledge of diabetes and its treatment would know that the treatment for anyone with type 1 dm prior to insulin HAD to be low carb diet. Otherwise they died. Funny that it has resurfaced, despite all the "diabetic experts"
    I was fortunate enough to be taught about diabetes by the person responsible for inventing the insulin pen a true innovator not a plagiarist.
    Bariatric surgery and small bowel sleeve is the answer to dm2, explore then shaft the redicullous drug company medication management.

    Incidenta if you really want to shaft them do away with inhaled therapy in respiratory medicine. I know I will be dead and buried before the 'experts" realise that one too.

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  • So we should tell our patients to improve their diet, lose weight and do more exercise. Utter genius, why didn't we think of this ourselves??
    Here on Planet Earth every T2DM patient knows exactly what lifestyle choices they should make, and choose to ignore them. Refuse to prescribe metformin at your peril.

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