Cities Changing Diabetes: a global fight against urban diabetes

Cities Changing Diabetes: a global fight against urban diabetes

Cities Changing Diabetes brings together businesses, researchers, policymakers and urban planners to tackle the worrying rise of diabetes and obesity in cities – the new battleground for public health.

You might think that for Novo Nordisk, the world’s biggest producer of insulin, the alarming rise of diabetes across the globe is good news. This could not be further from the truth because the rapid growth of this disease is completely unmanageable for society.

Today, more than 400 million adults around the world have diabetes,1 but if action is not taken, this is set to rise to 736 million by 2045. The disease is shortening the lives of millions of citizens and constraining economic growth – and it risks stifling health systems as well as the global economy.

Medicine plays a critical role in the treatment of diabetes and in slowing its progression, but if we are to stop this epidemic from crippling our world, we must look beyond medicine to tackle the disease. Adequate treatment and prevention must work hand in hand.

Can we bend the curve on diabetes?

Cities Changing Diabetes, initiated by Novo Nordisk in partnership with University College London, UK, and Steno Diabetes Center, Denmark, in 2014, is a global fight against urban diabetes. It is now a growing global partnership consisting of 19 cities – home to over 130 million people – and well over 100 expert partners who are united in the fight against diabetes.

Our ambition is to bend the curve on diabetes – which means holding the rise of diabetes at a ceiling of one in ten adults living with the condition. To do this, ambitious action is needed on the single biggest modifiable risk factor for diabetes: obesity.

To bend the curve on diabetes, obesity must be reduced by 25% globally between now and 2045. Achieving this would halt the continuing rise of diabetes and prevent more than 100 million people from developing the disease.

If action is not taken, there will be a very different picture, with the prevalence of diabetes set to continue to rise from 9.1% in 2017 to 11.7% in 2045. This demonstrates how urgent the action required is.

These projections were done using the Diabetes Projection Model which plots the trajectory of diabetes over time. Part of the Urban Diabetes Toolbox,2 the tool helps countries and cities to forecast the impact that reducing obesity could have on both the prevalence and cost of diabetes. The model gives two scenarios:

  1. Illustrating how the diabetes prevalence will continue to increase if the obesity rate continues to rise along the current trend
  2. Illustrating how the diabetes prevalence will bend if the obesity rate is decreased by 25% by 2045 compared to 2017.

Cities are the front line of the diabetes challenge

But why are Novo Nordisk and the Cities Changing Diabetes programme so concerned with tackling diabetes at the city level? Despite half of the world’s population now living in urban areas, their populations make up two thirds of the world’s cases of diabetes. The way cities are designed, built, and run creates health benefits and job opportunities for citizens. But cities also concentrate risks and hazards that can promote the development of diabetes. More sedentary lifestyles, insufficient physical activity and a higher intake of unhealthy foods all play a part.

To tackle the challenge, cities must understand how their communities live and work in order to develop the best interventions and start to engender a shift in attitude and culture in how we look at our own health and the health of those around us.

The programme welcomes a wide range of partners – researchers, businesses, city governments, non-governmental organisations, faith-based groups, employers and health providers. Their knowledge and commitment are key to driving change. Cities Changing Diabetes depends on new partnerships that are forging new ways of working, trialling interventions and new ideas, sharing what does and does not work.

How does the programme work?

A critical first step is to understand the connection between rising diabetes and the drivers of obesity, to realise the outlook if the city does not intervene – and to use that knowledge to drive change…

Intrigued to know about how the programme works? Curious about partnerships around Cities Changing Diabetes? Want to learn more about the mission for the future?

Stay tuned for more, as the rest of this article will appear in issue 8 of Health Europa Quarterly, which will be published in February 2019.


  1. Source:
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Cities Changing Diabetes
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