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  2. Prevent the progress of diabetes
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  4. I have been diagnosed with prediabetes
  5. Managing my weight
Important: please update your RDS app to version 4.7.3

Welcome to the March 2025 update from the RDS team

1.     RDS issues - resolutions

1.1 Stability issues - Tactuum implemented a fix on 24th March which we believe has finally addressed the stability issues experienced over recent weeks.  The issue seems to have been related to the new “Tool export” function making repeated calls for content when new toolkit nodes were opened in Umbraco. No outages have been reported since then, and no performance issues in the logs, so fingers crossed this is now resolved.

1.2 Toolkit URL redirects failing– these were restored manually for the antimicrobial calculators on the 13th March when the issue occurred, and by 15th March for the remainder. The root cause was traced to adding a new hostname for an app migrated from another health board and made live that day. This led to the content management system automatically creating internal duplicate redirects, reaching the maximum number of permitted redirects and most redirects therefore ceasing to function.

This issue should not happen again because:

  • All old apps are now fully migrated to RDS. The large number of migrations has contributed to the high number of automated redirects.
  • If there is any need to change hostnames in future, Tactuum will immediately check for duplicates.

1.3 Gentamicin calculators – Incidents have been reported incidents of people accessing the wrong gentamicin calculator for their health board.  This occurs when clinicians are searching for the gentamicin calculator via an online search engine - e.g. Google - rather than via the health board directed policy route. When accessed via an external search engine, the calculator results are not listed by health board, and the start page for the calculator does not make it clearly visible which health board calculator has been selected.

The Scottish Antimicrobial Prescribing Group has asked health boards to provide targeted communication and education to ensure that clinicians know how to access their health board antimicrobial calculators via the RDS, local Intranet or other local policy route. In terms of RDS amendments, it is not currently possible to change the internet search output, so the following changes are now in progress:

  • The health board name will now be displayed within the calculator and it will be made clear which boards are using the ‘Hartford’ (7mg/kg) higher dose calculator
  • Warning text will be added to the calculator to advise that more than one calculator is in use in NHS Scotland and that clinicians should ensure they access the correct one for their health board. A link to the Right Decision Service list of health board antimicrobial prescribing toolkits will be included with the warning text. Users can then access the correct calculator for their Board via the appropriate toolkit.

We would encourage all editors and users to use the Help and Support standard operating procedure and the Editors’ Teams channel to highlight issues, even if you think they may be temporary or already noted. This helps the RDS team to get a full picture of concerns and issues across the service.

 

2.     New RDS presentation – RDS supporting the patient journey

A new presentation illustrating how RDS supports all partners in the patient journey – multiple disciplines across secondary, primary, community and social care settings – as well as patients and carers through self-management and shared decision-making tools – is now available. You will find it in the Promotion and presentation resources for editors section of the Learning and support toolkit.

3.     User guides

A new user guide is now available in the Guidance and tips section of Resources for providers within the Learning and Support area, explaining how to embed content from Google Calendar, Google Maps, Daily Motion, Twitter feeds, Microsoft Stream and Jotforms into RDS pages. A webinar for editors on using this new functionality is scheduled for 1 May 3-4 pm (booking information below.)

A new checklist to support editors in making all the checks required before making a new toolkit live is now available at the foot of the “Request a new toolkit” standard operating procedure. Completing this checklist is not a mandatory part of the governance process, but we would encourage you to use it to make sure all the critical issues are covered at point of launch – including organisational tags, use of Alias URLs and editorial information.

4.Training sessions for RDS editors

Introductory webinars for RDS editors will take place on:

  • Tuesday 29th April 4-5 pm
  • Thursday 1st May 4-5 pm

Special webinar for RDS editors – 1 May 3-4 pm

This webinar will cover:

  1. a) Use of the new left hand navigation option for RDS toolkits.
  2. b) Integration into RDS pages of content from external sources, including Google Calendar, Google Maps and simple Jotforms calculators.

Running usage statistics reports using Google analytics

  • Wednesday 23rd April 2pm-3pm
  • Thursday 22nd May 2pm-3pm

To book a place on any of these webinars, please contact Olivia.graham@nhs.scot providing your name, role, organisation, title and date of the webinar you wish to attend.

5.New RDS toolkits

The following toolkits were launched during March 2025:

SIGN guideline - Prevention and remission of type 2 diabetes

Valproate – easy read version for people with learning disabilities (Scottish Government Medicines Division)

Obstetrics and gynaecology induction toolkit (NHS Lothian) – password-protected, in pilot stage.

Oral care for care home and care at home services (Public Health Scotland)

Postural care in care homes (NHS Lothian)

Quit Your Way Pregnancy Service (NHS GGC)

 

6.New RDS developments

Release of the redesign of RDS search and browse, archiving and version control functionality, and editing capability for shared content, is now provisionally scheduled for early June.

The Scottish Government Realistic Medicine Policy team is leading development of a national approach to implementation of Patient-Reported Outcome Measures (PROMs) as a key objective within the Value Based Health and Care Action Plan. The Right Decision Service has been commissioned to deliver an initial version of a platform for issuing PROMs questionnaires to patients, making the PROMs reports available from patient record systems, and providing an analytics dashboard to compare outcomes across services.  This work is now underway and we will keep you updated on progress.

The RDS team has supported Scottish Government Effective Prescribing and Therapeutics Division, in partnership with Northern Ireland and Republic of Ireland, in a successful bid for EU funding to test develop, implement and assess new integrated care pathways for polypharmacy, including pharmacogenomics. As part of this project, the RDS will be working with NHS Tayside to test extending the current polypharmacy RDS decision support in the Vision primary care electronic health record system to include pharmacogenomics decision support.

7. Implementation projects

We have just completed a series of three workshops consulting on proposed improvements to the Being a partner in my care: Realistic Medicine together app, following piloting on 10 sites in late 2024. This app has been commissioned by Scottish Government Realistic Medicine to support patients and citizens to become active partners in shared decision-making and encouraging personalised care based on outcomes that matter to the person. We are keen to gather more feedback on this app. Please forward any feedback to ann.wales3@nhs.scot

 

 

Managing my weight

Your weight plays a large role in  your risk of developing  type 2 diabetes, especially if your extra weight is around your waist. 

Bathroom scales    tape measure

What is a healthy weight to aim for?

This is about working out your Body Mass Index (BMI).  BMI uses your height and weight to work out if you're a healthy weight.  You can work your BMI out for yourself using this NHS tool  – it will show you your target range.

For many people living with obesity, aiming for a healthy BMI may not be realistic. Research shows that  even losing just 5% of extra weight will improve your health. The more weight you lose, the greater the health benefits.

What is a healthy waist size?

BMI  doesn’t look at how much fat you have around the middle. That is why you need to measure your waist too.

Healthy weight size all depends on your gender and ethnicity. For a healthy measurement you need to aim to be less than:

  • 80cm (31.5in) for all women
  • 94cm (37in) for most men
  • 90cm (35in) for South Asian men.

This video from Diabetes UK shows you how to measure your waist size.

 

Diet plan options to lose weight

There are a lot of different ways to lose weight – but there’s no one-size-fits-all diet.

It starts with finding a way to eat fewer calories than you use. A calorie (or kcal) is a unit of energy, which is in the food and drink we consume. Your body uses energy for everything we do – from breathing and sleeping to exercising. When you eat, you’re replacing the energy you’ve used, which helps you to maintain a healthy weight.

As a general guide, government recommendations are that men need around 2,500kcal a day to maintain a healthy weight, and women need around 2,000kcal a day. But most people need different amounts of calories based on how their bodies work, how active they are and any weight management goals.

A range of diet options is listed below, with links to menu plans from Diabetes UK. Research suggests that the best type of diet is one that you can maintain in the long term, so it's important to talk to your healthcare professional about what will work for you. 

With any weight loss diet it is important to speak to your healthcare team first as it may impact on your health conditions or medication.

Researchers have examined all the evidence on which diets help people with type 2 diabetes to lose weight. They found that low-calorie meal replacement diets helped people to lose more weight than other types of diets and gave people with type 2 diabetes the best chance of going into remission. 

The research showed that people with type 2 diabetes who went on a very low-calorie diet of around 400-500 calories a day for 8-12 weeks  lost the most weight. This type of diet involves swapping your usual meals for a short period with total diet replacement products, often soups, bars and shakes, that are carefully designed to provide the vital nutrients your body needs. Normal foods are then gradually introduced

This type of diet on average helped people lose 6.6kg more weight compared to food-based low-calorie diets of around 1000-1500 calories a day. This is because very low-calorie meal replacement diets provide fewer calories. 

The evidence also showed that low carbohydrate diets did not lead to greater weight loss than higher carbohydrate, low-fat diets.

High-protein and Mediterranean, diets all led to only a small amount (between 0.3-2 kg) or no weight loss compared to other diets tested, but the researchers found the evidence on these diets was of poor quality.

Support from healthcare professionals

The people who took part in the study were supported through their behaviour change and to stay on the trial diet. If you want to follow a similar diet, it's very important to get support from your healthcare team to make sure it's safe and suitable for you.

You can read this research online.

A healthy diet is all about variety and choosing different foods from each of the main food groups every day. This variety is essential, as no single food contains all the essential nutrients your body needs.

The main food groups are listed below, with links to more information from Diabetes UK:

Eating a low-carb diet means cutting down on the amount of carbohydrates (carbs) you eat to less than 130g a day.

But low-carb eating shouldn’t be no-carb eating. Some carbohydrate foods contain essential vitamins, minerals and fibre, which form an important part of a healthy diet. 

It’s really important to first reduce your carb intake from unhealthy sources such as sugary drinks, pizzas, cakes, biscuits, chips, white bread, fruit juices and smoothies.

And it is a good idea to get your limited carbs from healthy high-fibre carb foods, such as pulses, nuts, vegetables, whole fruits and whole grains.

Benefits and risks

One of the main benefits of following a low-carb diet is weight loss. This helps to reduce HbA1c and blood fats such as cholesterol. For people with prediabetes, losing weight can reduce your risk of developing type 2 diabetes, and a low-carb diet is one option to help you do this.

However, there’s no evidence that following a low-carb diet is any more beneficial in managing diabetes than other approaches in the long term, including a healthy, balanced diet.

Depending on the approach, following a low-carb diet may also lead to  side effects, such as constipation or bad breath. Although these can be unpleasant, they are usually temporary and shouldn’t be harmful in the long term. Speak to your healthcare professional if you’re concerned about any of these.

You can help make sure you're getting the calcium you need by including unsweetened milk and yoghurt in your diet too. 

Meal plan 

Diabetes UK provides a 7-day low-carb meal plan that you can try.

Mediterranean diets have been associated with reduced risk of high blood pressure and cholesterol which are risk factors for heart disease. A Mediterranean style diet can therefore provide a great option for people at risk of diabetes, as it could help reduce the risk of heart-related diabetes complications.

There’s also evidence to show that the Mediterranean-style diet can promote weight loss and improve blood glucose management.

A Mediterranean diet includes a lot of fruits and vegetables, beans and pulses, nuts and seeds, wholegrains and olive oil. It also includes some dairy (milk and yogurts), lean protein like chicken, eggs and fish, in moderation. Red meat and processed foods are included in much smaller amounts, and wine is included in moderation.

Diabetes UK provide a 7-day Mediterranean diet meal plan that you can try.

Diabetes UK provide a range of low calorie meal plans for men and women, Including vegetarian options.

 

A low-calorie diet is made up of between 800 to 1200 calories a day. A very low-calorie diet means having less than 800 calories a day. 

Most people who follow these diets use special meal replacement products, likes soups and shakes, which are nutritionally complete. If you chose to try a low-calorie diet, speak to your GP, nurse or dietitian first.

These are short-term diets. You would usually have the soups or shakes for about 12 weeks, then gradually reintroduce normal, healthy food again.

This type of diet isn't right for everyone. You need to talk to your doctor before starting a low-calorie diet, so you can be sure that it's safe and could work for you.

It may sound obvious, but this diet isn’t easy. You'll need a lot of support from your doctor and other healthcare professionals, as well as the people around you.

Benefits and risks of a low-calorie diet

Your doctor can talk to you about the benefits and risks of a low-calorie diet.

A low-calorie diet can have side effects, including:

  • constipation
  • dizziness
  • headaches.

These side effects often go away after a while, but it's important to talk to your doctor if you have any of these, so they can keep a close eye on you.

Information on portion sizes from British Nutrition Foundation

Information on portion sizes from the British Dietetics Association

The British Dietetics Association provides useful information on carbohydrates and the glycaemic index - a rating system for foods containing carbohydrates.

By putting a weight loss plan in place and noting down your progress, you'll be able to see the positive changes you're making. 

NHS Weight Loss Plan

This is a free NHS weight loss app for IOS and Android. The plan is broken down into 12 weeks, and helps you to:

    • set weight loss goals, plan your meals
    • make healthier food choices
    • get more active and burn more calories
    • record your activity and progress.

 

Diabetes UK: My weight-loss planner

If you don't want to use a mobile app, you can download this PDF document from Diabetes UK to help you set weight loss goals, track your progress, and keep motivated (PDF download).

 

Healthy Helpings

  • An online weight management programme for NHS Grampian, designed to be done as 12 weekly sessions. Please note that this program is not appropriate for people who are under 18 years of age, pregnant, or in a healthy weight range.

 

 

Healthy Weight Grampian

  • This website aims to provide a range of information which will be useful to anyone who is looking to adopt or promote a healthier lifestyle with the aim of achieving better health and a healthier weight. Resources cover physical activity, eating and drinking, healthy habits and routines, and psychological support.

Diabetes UK Healthy Eating

  • Advice and tips on a healthy, balanced diet. Includes  healthy swaps, understanding food labels, how to cook healthier meals, meal planning and shopping on a budget and a recipe finder.

Diabetes UK Learning Zone

  • The Learning Zone includes various diabetes resources, including a course on losing weight. This online course is designed to be completed over 6 weekly 10-minute sessions. You will need to give some personal information to register for the learning zone, including your name, email, and postcode.