37 Reimagining type 2 diabetes care: culturally adapted lifestyle medicine for underserved populations

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Background North Lewisham Primary Care Network (NLPCN) serves over 92,000 residents, with significant health inequalities; 67% fall within CORE20PLUS populations. Diabetes prevalence in NLPCN is 6.1% (QOF adjusted). We developed a community co-designed Lifestyle Medicine Service delivering interventions across the six pillars for individuals experiencing health inequalities and living with diabetes or pre-diabetes. We aimed to improve glycaemic control, wellbeing, and self-management.Methods NLPCN patients with type 2 diabetes and pre-diabetes were invited to join the programme, alongside usual medical care. Health and Wellbeing coaches (hired via ARRS funding) used culturally tailored, personalised approaches to each of the six pillars of lifestyle medicine via one-to-one and group sessions over 12 weeks. HbA1c was repeated at 3 and 6 months.Results Consecutive patients completed the programme (n=74); 30 (41%) female, mean (SD) age 55 (15) years. Ethnically, 64% self-identified as Black, 19% Asian, 16% White, and 1% Mixed. Median (IQR) HbA1c improved from 61 (46–88)mmol/mol at baseline to 47 (41–61)mmol/mol at 3 months (n=74), and 48 (41–58)mmol/mol at 6 months (n=21) (all p<0.001) ( figure 1). The median (IQR) reduction in HbA1c between baseline and 3 months was 10 (4-25)mmol/mol, and 6 months was 11 (3-37)mmol/mol. The number of patients without diabetes (HbA1c <48) increased from 22 (30%) at baseline to 38 (51%) at 3 months (p<0.001), and 10 (48%) at 6 months.Conclusions Culturally tailored, person-centred lifestyle medicine approaches are effective at improving glycaemic control and achieving diabetes remission in patients with significant health inequalities. Lifestyle medicine interventions should be considered in the care of all patients with diabetes.Abstract 37 Figure 1

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