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Is this programme safe to follow?

Yes, this programme is safe to follow. It is supported by research and experience. During the programme, your health and your medications will be monitored by your healthcare team. Your Diabetes Practitioner will be working closely with you, and your healthcare team, to provide support at every step. There are strict medical criteria that you must meet in order to participate in this programme. There are some medical conditions that might mean you are not able to take part, however this is something you will be screened for before getting started. If there is any cause for concern, or any changes to your health, please update your Diabetes Practitioner or your GP as soon as possible.

What will I be eating/drinking on this plan?

During the stage 1 of the programme, you will be on a ‘Total Diet Replacement’ (also called TDR). You will consume specially designed products in the form of shakes or soups, instead of your usual meals (for breakfast, lunch and dinner). The TDR products will provide you with the vitamins and minerals your body needs whilst also causing weight loss. Your drinks must be calorie free, which means no sugar containing drinks, no milk in tea or coffee and no alcohol. In the second stage of the programme, you will be gradually reintroducing balanced meals back into your diet.

What is Remission?

Diabetes remission in people with Type 2 Diabetes means that your blood sugar levels are health (A HbA1C less than 44mmol/mol) without needing to take any diabetes medication. Diabetes UK (2000)

Will I feel hungry on the TDR?

One of the more common side effects of being on a TDR is hunger. This happens more so in the beginning; however, your body does adapt. Appetite and hunger levels tend to decline as your progress through the programme. This is because of a process called ketosis. One of the side effects of ketosis can be a suppressed appetite and hunger levels. People only tend to feel genuine hunger on TDR if they snack on foods that are not advised.

What will my energy levels be like whilst on the TDR?

In the beginning, many people find that they feel slightly more tired than usual, however as your body adjusts to a lower calorie intake, many find that their energy levels increase. A lot of people tell us that their energy levels increase once they have adapted to TDR.

Can I increase my activity levels on the TDR?

We recommend that you maintain your existing activity levels whilst taking part in the TDR. It is important to listen to your body and only do what you are able to. You may find that there are some days when you are unable to be as you would like to be – especially in the beginning when you may be experiencing side effects. A lot of people report having “extra energy” once they have adapted to TDR. If you feel like this, do an activity that you feel that you are able to.

Will I achieve remission from type 2 diabetes by joining this programme?

The programme is based on research. Research shows that the more weight you lose the more chance you have of achieving remission of type 2 diabetes. It is important to know that remission of type 2 diabetes may not be possible for everyone. However, even losing 5% of your weight can have health benefits including fewer medications, improved blood glucose levels and reduced risk of complications of type 2 diabetes.

Is there a cost to access the programme?

The Low Calorie Diet programme is free of charge. You will be provided a free code to order your TDR products (soups and shakes) required to complete the programme including a sample pack. Whilst the sessions are being delivered remotely, you will also receive a self- monitoring kit free of charge including scales, glucometer and BP Monitor if you are (required to monitor you BP). You will be required to take these measurements before each session and report them to your Diabetes Practitioner.

Should I be taking supplements whilst on this plan?

If you have been prescribed supplements, we recommend that you follow the advice of your healthcare team. You will be provided with a fibre supplement that you are encouraged to use to minimise any potential side effects whilst on the programme e.g. constipation.

What happens if I miss the first or second session?

The first and second sessions are important because they give you lots of information about the programme. If you miss these sessions, then you will miss a lot of information. The programme is also set out in a very specific way to support you at key points. If you miss the first or second session, then we recommend that you start the programme again. If you are on a group-based programme we will try and offer you another group, however because this is a pilot places are limited.

What happens if I miss sessions later on?

If you are unable to make a session please contact us on 0333 577 3561. If you miss any session after session 2 then you reduce your chances of long-term success. These sessions are vital in helping to build healthy habits and learn new skills. If you do miss a later session then we will try and offer you another session, but this may not always be possible (as this is a pilot, places are limited). If you miss a number of sessions and have not advised us of this in advance, we may be required to discharge you back to your GP.

My circumstances have changed and I can no longer attend the sessions I am booked onto, what can I do?

Please contact the patient support team on 0333 577 3561, we will try and find another suitable option for you.

Can we try the Total Diet Replacement products before we commit?

Yes, you will receive a free sample pack before you start the programme. The sample pack will include 2 soup flavours and 4 shake flavours.

What flavours soups and shakes are available?

Shakes are available in 4 different flavours- banana, chocolate, strawberry and vanilla. Soups are available in 2 flavours- chicken and vegetable

Can I combine my TDR products e.g. banana and strawberry shake, or double up e.g. two soups?

Yes, you can. Make sure that you have 4 TDR products per day during stage 1 of the programme.

How do I order the Total Diet Replacement Products?

Once you are booked into session you will receive an email with a unique code which will allow you to order your products from Altralife via their website or by calling them. Full order instructions are provided in the email but can also be found here https://xyla.fra1.cdn.digitaloceanspaces.com/wp/wp-content/uploads/2021/01/altralife-order-guide.pdf

How to I mix the Soups/shakes
What if I have lactose intolerance or do not want to consume dairy, can I still take part in the programme?

The TDR products are not suitable for people with a lactose intolerance or dairy intolerance. We are in the process of developing the TDR products range. For more information on the TDR products contact Altralife on 0118 453 2853.

I have a problem with my Total Diet Replacement (TDR) products, what should I do?

Please contact Altralife directly on 0118 453 2853 or email support@altralife.co.uk

Are the TDR halal/ kosher/ gluten free/ nut-free etc.?

For the most up to date information on the TDR products contact Altralife on 0118 453 2853.

I don’t know how to work my scales/glucometer/blood pressure machine

Please watch the instructional video that can be found here: https://xylahealthandwellbeing.com/nhs-low-calorie-diet/ If you have any ongoing issues please contact Diabetic Supply directly on 01473 845453.

How long is the programme and what does it involve?

The programme last for 12 months. For more detailed information on what the programme entails please visit https://xylahealthandwellbeing.com/our-services/diabetes-remission/nhs-low-calorie-diet/

How often should I take my measurements?

Please take your measurements before each session and have these ready to report to your Diabetes Practitioner.

My sessions are on Microsoft teams- what is this and how do I access it?
Do I have to complete all the online modules on the app?

Try to think of your online modules as the pieces of a puzzle, having all the pieces makes for a much clearer picture! We recommend you work through all modules; they have been created with you in mind and are your steppingstones to success.

Where can I get app support?

Please see the Wellbeing way Help/FAQ’s (Frequently asked questions) in the ‘More’ section of your Wellbeing Way app or click on this link: https://xylahealthandwellbeing.com/wellbeing-way-app-faq/