A free online NHS program is delivering meaningful health improvements for adults living with type 2 diabetes (T2D) across England, a new study by University of Manchester researchers has shown. The NHS program called “Healthy Living for people with type 2 diabetes” is a website containing written articles, videos, self-assessment quizzes and tools.
It supports people to live well with T2D by providing information and advice about eating well, becoming more active, living with diabetes, and emotional well-being.
The study is published in PLOS One.
The research team analyzed data from people with T2D who activated a Healthy Living account and found they experienced better health outcomes at one year than those who did not take part.
They examined who was most likely to use the program (uptake) and how engagement related to changes in HbA1c—a blood test used to measure average blood sugar levels—blood pressure, body mass index, insulin use, and completion of essential diabetes care processes.
The findings show, uptake of the program was highest among women, people from least deprived areas (vs. most deprived areas), and people of white ethnicity, and current smokers (vs. never smokers).
To assess clinical outcomes, the study compared 4,940 Healthy Living users with 24,685 similar individuals who did not register for the program. After a year, Healthy Living users saw an average HbA1c drop of 1.3 mmol/mol, alongside small but steady dips in BMI and blood pressure, all pointing to better day?to?day control of their diabetes.
They were also 1.6 times more likely to complete the routine yearly MOT that helps spot problems early, keeping on top of the vital checks that protect the eyes, feet, heart and kidneys in the long run.
However, the study highlights that even small average improvements can translate into meaningful reductions in T2D?related complications when applied across large populations.
It also underscores the need to address inequalities in uptake, with notably lower participation among Asian and Black communities despite higher T2D prevalence.
Lead author Dr. Salwa Zghebi said, “What this study shows, in the plainest possible terms, is that a free, nationally available NHS educational program can help people with T2D make measurable improvements to their health, even when used in the complex reality of everyday life.
“It’s not a silver bullet, but it is a practical tool that works—and the challenge now is ensuring that everyone who could benefit has the opportunity to do so.”
“We feel Healthy Living offers a scalable, accessible option for supporting type 2 diabetes self?management, particularly for people who face barriers to attending in?person diabetes education programs.
“Improving uptake among underserved groups will be essential to ensuring the program reduces existing health inequalities.”
Co-author Dr. Sarah Cotterill, Principal Investigator and an Honorary Reader at The University of Manchester said, “People’s outcomes were better for those who attended more of the Healthy Living program, so it would be worthwhile for the NHS to find ways to encourage people to attend for longer, such as improved signposting and motivational messages.”
Publication details
Salwa S. Zghebi et al, Examining the uptake, retention, and effectiveness of a national online type 2 diabetes self-management intervention in England (Healthy Living): A retrospective cohort study, PLOS One (2026). DOI: 10.1371/journal.pone.0348266
Journal information:
PLoS ONE
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