Weight management in diabetes
DGRefHelp - NHS Dumfries & Galloway
Weight management should be discussed early and revisited regularly for people with Type 2 Diabetes or pre-diabetes. This section summarises local options and national diabetes remission routes.
At Type 2 Diabetes diagnosis
- Provide Diabetes UK Type 2 Diabetes Remission information to everyone newly diagnosed with Type 2 Diabetes.
- Refer to DESMOND and/or weight management via SCI Gateway as part of first-year management.
- DESMOND in Dumfries & Galloway includes newly diagnosed and established Type 2 Diabetes modules, MyDESMOND, and Let's Prevent Diabetes for people at high risk of Type 2 Diabetes.
Local options
Option
Who is it for?
Format
Comments
Tier 2 Weight Management (Second Nature)
BMI >25 kg/m2
App-based habit change programme with 12 weeks coaching and lifetime app access.
Refer out service
Check the patient can use WhatsApp.
Written materials available in 12 languages.
Technology will include scales and activity monitor.
Type 2 Diabetes Remission programme (Counterweight Plus)
BMI >27 kg/m2
Age 18-65 years.
Type 2 Diabetes diagnosed within 6 years.
ANIA national remission programme is first line. Local remission referrals only for those HbA1c > 87 mmol/mol and/or on insulin
Total diet replacement for 12 weeks, two-weekly appointments, food reintroduction for 12 weeks, then weight maintenance for further 6-18 months. Face-to-face assessment, dietician-led virtual group delivery.
Aims to achieve remission of Type 2 Diabetes.
Tier 3 Weight Management
BMI ≥40 kg/m2 with Type 2 Diabetes, or BMI ≥60 kg/m2.
Assessment with dietitian, 12 weeks weekly coaching, then 9 months monthly support. Clinical psychology support if required. One-to-one or virtual group delivery.
Refer out service.
Aim 10-15% weight loss.
Tier 4 Weight Management - Bariatric surgery pathway
Age 18-44, Type 2 Diabetes diagnosed within 5 years, BMI 35-50 kg/m2.
Triaged by NHS Ayrshire & Arran bariatric surgery MDT. Pre-operative group and local follow-up for 2 years post-op.
Aim 30-40% weight loss and remission of Type 2 Diabetes.
ANIA National Digital Type 2 Diabetes Remission Programme
The Accelerated National Innovation Adoption (ANIA) pathway is supporting a National Digital Type 2 Diabetes Remission Programme across NHS Scotland. The programme has been developed with NHS Scotland partners and specialist input from weight management and primary care clinicians.
For more details see the dedicated page
- National provider: Counterweight Limited.
- ANIA implementation information describes eligible patients being referred by Primary Care directly to the national provider, with national availability across NHS Scotland Health Boards from January 2026.
- The programme is expected to support 3000 patients nationally, with anticipated remission in 35-45% of participants using a digital application.
- Refer using SCI-Gateway Special Health Boards...National Diabetes Programmes...National Type 2 Diabetes remission programme
- Inclusion/exclusion criteria here.
Pre-diabetes and diabetes prevention
- People with pre-diabetes can be referred for Type 2 Diabetes prevention and pre-diabetes education.
- In Dumfries & Galloway, Let's Prevent Diabetes is available for people at high risk of Type 2 Diabetes and may be delivered face-to-face or virtually.
How to refer / signpost
- Refer to DESMOND via SCI Gateway DGRI...Diabetes...Desmond and/or weight management via SCI Gateway DGRI...Clinical Biochemisty...Weight management.
- Consider GP practice referral for DESMOND / MyDESMOND / Let's Prevent Diabetes where appropriate. Let's Prevent also by SCI-Gateway referral DGRI...Diabetes...Lets prevent.
- Patients may be signposted to Diabetes UK remission information for shared decision-making before referral.