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Cost fears made ministers scrap obesity clinics plan

The Government scrapped standards on insulin resistance in the national service framework for diabetes because of the huge resource implications, Pulse can reveal.

Proposals were for GPs to refer patients with suspected insulin resistance to obesity clinics either in the surgery or set up as a specialist service.

The clinics would have offered patients 30-minute consultations with a trained health care professional to give advice on losing weight and lifestyle changes to prevent the onset of type 2 diabetes.

Diabetes experts warned failing to tackle insulin resistance now could lead to a surge in new cases of type 2

diabetes, especially in younger patients.

Dr Azhar Farooqi, a member of the diabetes NSF external reference group, said the Government probably rejected the proposals because of the costs of implementation.

Dr Farooqi, a GP in Leicester, said: 'I don't think you can deal with insulin resistance effectively by an off-the-cuff remark about losing weight to someone who comes in with a cold. Weight reduction and lifestyle changes require a systematic approach involving a trained health care professional and lots of time. It is difficult to do this in a 10-minute consultation.'

He added: 'Smoking cessation clinics have advisers and half-hour appointments. You have to have the same rigour to deal with obesity.

'It hasn't been well addressed in the framework, partly down to implementation. But one can assume the Department of Health might not have included it because it is very resource intensive.'

Professor Giancarlo Viberti, professor of diabetes and metabolic medicine at Guy's, King's and St Thomas' Medical School, London, said the framework should have dedicated some resources to insulin resistance. He said it affected one in four adults in the UK and was the 'root cause of diabetes' as well as a strong independent predictor of cardiovascular disease.

He added: 'We are now seeing more and more younger people and even children diagnosed with type 2 diabetes, which is a real concern.'

Professor Viberti said insulin resistance was classified as a separate condition in the US.

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