Social and economic factors in urban areas play a much larger role in dictating the risk of diabetes than previously thought, according to new research.
The study, conducted at University College London in association with the Cities Changing Diabetes programme (CCD), suggests that traditional ways of understanding diabetes risk are flawed. Everything, from financial constraints to geographical factors, can affect diabetes risk, according to the findings.
“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,” said David Napier, Professor of Medical Anthropology at CCD programme partner University College London. “Our pioneering research will enable cities worldwide to help populations adapt to lifestyles that make them less vulnerable to diabetes.”
Cities Changing Diabetes is an initiative that focuses on the diabetes risk factors associated with urban environments. Diabetes is largely an urban problem, with 65 per cent of people with diabetes living in urban areas. Although the programme focuses primarily on type 2 diabetes, rates of type 1 diabetes are also higher in cities.
Five large cities signed up to the programme: Copenhage, Housto, Mexico City, Shanghai and Tianjin. The programme aims to raise awareness for the problem of urban diabetes, fund studies looking into urban risk factors and encourage local governments to take action once the problems have been identified. CCD’s website describes the initiative as being “built on public-private partnerships between businesses, city leaders and planners, architects, healthcare professionals, academics, community leaders and others with a stake in the outcome.”
So far, the initiative has been successful, and the research has identified several uniquely urban problems that increase the risk of diabetes.
“The insight we have gained from the Cities Changing Diabetes research have fundamentally changed the way we think about diabetes in our city,” said Dr. Armando Ahued Ortega, minister of health in Mexico City. “This new understanding of sociocultural risk factors will guide the development of increasingly efficient and targeted public health policies to support the health and wellbeing of our citizens.”
The study was conducted using 550 face-to-face interviews with people living in one of the five cities signed up the program. The researchers used the responses to identify certain factors that make people living in urban areas more likely to develop diabetes.
Pharmaceutical company Novo Nordisk will financially support the continued CCD programmen, with an investment of $20m by 2020.
“We have a longstanding commitment to provide more than just pharmaceuticals to the fight against diabetes,” said CEO Lars Rebien Sorensen.
“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.”

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