Completing the National Health Service Diabetes Prevention Programme (NHS DPP) is associated with a lower incidence of not only type 2 diabetes (T2D) but also multiple other long-term conditions (LTCs), according to a new retrospective observational study published in Nature Medicine.¹

This study analysed data from adults in England with non-diabetic hyperglycaemia (NDH) who were referred to the NHS DPP between April 2016 and February 2020. The intervention group consisted of individuals who completed the programme (defined as attending >60% of sessions), which involves 9 months of behavioural support focused on weight loss, increased physical activity, and improved diet.² This group was compared to a matched control group of individuals who were referred but did not attend any sessions.

The primary outcomes were the incidence of T2D and 31 other LTCs, which were categorised as either etiologically linked (LTC-L) or possibly linked (LTC-PL) to the programme's lifestyle goals. The incidence of developing multiple long-term conditions (MLTCs), defined as having two or more chronic conditions, was also assessed. Outcomes were measured at 6, 12, 18, and 24 months post-programme initiation.

Compared to the control group of non-attenders, individuals who completed the NHS DPP had a significantly lower incidence of T2D and other LTCs. Although the magnitude of the association decreased over time, it remained significant at the 24-month follow-up.

At 24 months, the adjusted odds ratio for incident T2D in the intervention group was 0.53 (95% CI: 0.48–0.59). The adjusted rate ratios for developing new conditions were 0.79 (95% CI: 0.74–0.84) for LTC-L and 0.80 (95% CI: 0.74–0.88) for LTC-PL. Furthermore, the incidence of developing MLTCs was significantly lower among programme completers at all follow-up points.

The findings suggest that a real-world, at-scale lifestyle intervention aimed at preventing T2D may have broader benefits in reducing the burden of multimorbidity. The study authors concluded, "We found that completers of the NHS DPP had lower incidences of T2D, LTC-L and LTC-PL compared to non-attenders."¹

However, they also highlighted the study's limitations, stating, "we were not able to directly conclude whether lower incidence rates were a direct result of completing the NHS DPP or due to residual bias stemming from unmeasured confounding and imprecision in the estimation of diagnosis."¹ The observational nature of the study means causality cannot be definitively established.

The authors suggest that further high-quality research, including randomised controlled trials, is needed to confirm these associations and to better understand the causal pathways through which such lifestyle interventions may reduce the risk of developing LTCs and MLTCs.

This study was supported by multiple sources, including the National Institute for Health Research (NIHR), CW+, and Research Ireland.

References

1. Barron E, Chappell P, Hatfield I, et al. Association between the English National Health Service Diabetes Prevention Programme and incident multiple long-term conditions. Nat Med 2025. https://doi.org/10.1038/s41591-025-03922-1

2. Valabhji J, Barron E, Bradley D, et al. Early outcomes from the English National Health Service Diabetes Prevention Programme. Diabetes Care 2020;43:152–60. https://doi.org/10.2337/dc19-1425

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