International study prompts rethink on the rise of diabetes in cities

The findings suggest that in cities around the world, social and cultural factors play a far more important role in the spread of the epidemic than previously thought.

More than two thirds of the world’s 400 million people with diabetes live in urban areas. The year-long study for Cities Changing Diabetes, a unique public-private-academic partnership, sought to better understand what makes people vulnerable to type 2 diabetes in cities in order to inform solutions for one of the most pressing modern-day public health challenges. To explore this complex issue, more than 550 interviews were undertaken with at-risk and diagnosed people in five major cities – Copenhagen, Houston, Mexico City, Shanghai and Tianjin.

“By largely focusing on biomedical risk factors for diabetes, traditional research has not adequately accounted for the impact of social and cultural drivers of disease,” says David Napier, Professor of Medical Anthropology, UCL. “Our pioneering research will enable cities worldwide to help populations adapt to lifestyles that make them less vulnerable to diabetes.”

The study found that diabetes vulnerability in cities is linked to a complex mix of social and cultural factors – responsible for both putting people at greater initial risk and subsequently making them less likely to be diagnosed, receive treatment and maintain good health. The identified social factors included financial, geographical, resource and time constraints while cultural determinants included the perception of body size and health and deep-seated traditions.

Prompted by the findings, Novo Nordisk has pledged to support the fight against urban diabetes via the investment of 20 million USD of expert resource and research funds by 2020. Commenting on the promise, Lars Rebien Sørensen, president and chief executive, Novo Nordisk said: “We have a longstanding commitment to provide more than just pharmaceuticals to the fight against diabetes. Research of this nature illustrates precisely why we initiated Cities Changing Diabetes – to fundamentally change the trajectory of the disease through targeted actions informed by new understanding.”

The Cities Changing Diabetes partnership has three distinct but interconnecting phases – mapping, sharing and action. With the initial mapping phase now complete, the Copenhagen Summit meeting will see 250 expert delegates from around the world come together to discuss the learnings and discuss solutions to tackle diabetes in cities. In the longer-term, the partnership aims to tackle the rise of diabetes in cities around the world via the sharing of insights and knowledge of participants. In 2016, Vancouver and Johannesburg will become the latest cities to join the programme and contribute to the international pool of evidence