Notable Outcomes of the Audit Report 2025
Clinically meaningful improvements in a range of health markers were again observed in participants of X-PERT programmes, including significant improvements in blood glucose control. Other benefits of attending a programme include a reduced need for diabetes medication in a significant proportion of participants, improvements in participant empowerment, and meaningful reductions in body weight and cardiovascular disease risk. These findings suggest participants of X-PERT programmes are likely to have improved health and wellbeing, and a significantly reduced risk of health complications.
Importantly, the results of the 2025 annual audit met or exceeded all the X-PERT audit standards (derived from the original X-PERT clinical trial) against which programme performance is benchmarked.
HbA1c was reduced by a clinically meaningful amount at both 6 months (-9.3mmol/mol) and 12 months (-7.3mmol/mol). Importantly, the improvements in HbA1c in the current audit exceed the targets set out in the X-PERT Audit Standards.
Further, and again as with previous audits, there were also improvements in a wide range of markers of CVD risk at both 6 months and 12 months. This includes reductions in TC to HDL ratio and TG to HDL ratio, which are useful indicators of the general health and balance of lipids and lipoproteins in the blood.
In the current audit, 578 participants (46.5% of those with relevant data available) were able to reduce or omit the amount of diabetes medication they were taking at 6 months compared to baseline. There was no change in medication requirements for a further 487 participants (39.2% of those with available data), thus the total percentage who did not increase their medication requirements (85.7%) was significantly above the 50% target outlined in the X-PERT Audit Standards
The mean age of participants was 61 years, and the majority of participants (88.7%) were between the ages of 45 and 84 years. There were a similar number of male and female participants (48.7% versus 50.8%).
The mean evaluation score for the 2025 audit was very similar to the excellent outcome for this metric achieved in the 2024 audit (95.4% in 2025, compared to 95.2% in 2024), whilst the observed improvement in empowerment (+20.5%) exceeded the 2024 results (+19.9%). Importantly, the targets set in the X-PERT Audit Standards (a mean evaluation score of at least 90% and an increase in empowerment of at least 10%) were again exceeded for both of these outcomes.
Expanding Reach and Equity
With 1,194 programmes delivered during the audit period, attendance and completion rates remained strong (78.8% and 85% respectively). The findings also highlight X-PERT’s increasing success in engaging underserved communities.
The Reaching Underserved Communities Award was presented to the Pembrokeshire Community Diabetes Team at Hywel Dda University Health Board for pioneering a culturally sensitive, community-embedded approach to diabetes education.
