An Investigation Into the Use of the Complete Health Improvement Programme (CHIP) for Reversing Type 2 Diabetes Mellitus: A Multimethod Approach

Abstract

The incidence and prevalence of Type 2 Diabetes Mellitus (T2DM) are increasing dramatically on a global level. Other than bariatric surgery, there is no known medical cure for T2DM, however, several lifestyle modifications reverse symptoms, most frequently in conjunction with a reduction in BMI. The purpose of this thesis was to discover the effectiveness of the CHIP as an intervention for reversing T2DM, by conducting two studies. The aim of Study 1 was to assess the effectiveness of the CHIP in reversing abnormal fasting blood sugar levels in T2DM clients. The aim of Study 2 was to obtain an understanding of participants’ knowledge of diabetes reversal and their experience of the CHIP and adherence to lifestyle recommendations. A multimethod approach was used. Study 1 consisted of a parallel open-label randomised control trial (RCT) where the intervention was participation in the CHIP for 12 weeks followed by nine months of monthly follow-up. The control group participated in usual diabetes care. A descriptive qualitative design supported by illustrative case studies was used in Study 2 using participants from the intervention and control groups in Study 1. The results of the RCT demonstrated positive changes in measured outcomes. Most of these improvements remained significant at 12-months. Diabetes reversal was not demonstrated. No significant change in outcomes were demonstrated in the control group. Data from Study 2 suggest that 25 percent of the study cohort did not understand diabetes reversal and most participants believed they could not achieve diabetes reversal. All participants acknowledged a degree of recidivism. The synthesis of findings suggests that adherence to lifestyle recommendations is better fostered where the relevance of change is understood and where health-care providers partner with clients to educate and manage care for improved levels of self-responsibility. Better support for clients may improve resilience, and focusing on lifestyle choices that are enjoyable and rewarding may promote long-term adherence.