Cities work to curb urban diabetes epidemic

As diabetes rates skyrocket, Vancouver teams up with other cities to share prevention strategies.

November is diabetes awareness month. But as diabetes rates climb, researchers say any awareness must be backed up with better prevention. In Vancouver, seven percent of the population has diabetes. If current trends continue, that will increase to 10 percent in the next three years and keep climbing. This increase is a global trend and many cities are teaming up to share the best prevention strategies. 

Vancouver Coastal Health Research Institute (VCHRI) investigator Maylene Fong is part of Vancouver’s contingent in the Cities Changing Diabetes programme. Fong says Vancouver researchers are learning about strategies that work in cities like Houston, Rome, Copenhagen and Shanghai and adapting them to local needs. 

“Knowing that diabetes is a global issue is empowering. We can look at cities like Houston—where the diabetes rates are even higher— and see how they are tackling the issue.  We see proof of tremendous cost savings when cities get serious about prevention.”

Maylene Fong is a diabetes researcher and manager of the Healthy Living Program at Vancouver Coastal Health

Preventing diabetes also means preventing all the additional health issues associated with it, including increased rates of cardiovascular disease, stroke, blindness, lower limb amputation and kidney disease. Adopting a healthier lifestyle is the key approach. 

Fong highlights two global approaches that produce results. The first is better urban planning to encourage more physical activity. Fong says the City of Vancouver is on the right track with its implementation of more bike paths and its focus on neighbourhood parks. “More bike lanes mean more people bike, more parks equal more people walking and safer neighbourhoods mean people move around.” Yet, despite its healthy West Coast image, less than 60 percent of Vancouverites are physically active on a regular basis.

The second successful approach is targeting high-risk communities with awareness and prevention strategies. In Vancouver, this means reaching out to the South Asian and Chinese communities, who both have a higher genetic risk for the disease. Fong’s own research showed many younger people in these communities were pre-diabetic or diabetic and unaware of it.

To respond to this need, Fong and her colleagues at Vancouver Coastal Health have created targeted outreach for South Asian and Chinese communities under The Healthy Living Program.  One of these is a prevention program offered in Punjabi, Cantonese and Mandarin called the “First Steps to Prevention.”  The program offers evening and weekend sessions to accommodate new immigrants, who are often working multiple jobs. 

Fong says the courses show participants that a healthier lifestyle does not need to cost more or take up a lot of time. “We teach people simple strategies for eating healthier and getting more exercise. In the Chinese community for example that can mean cutting back on white rice and using more brown rice.”

As for exercise, you don’t have to join a gym or get a trainer. Even going for a walk after dinner makes a huge difference.”

Self-Assessment and Cost-savings

Fong’s team was instrumental in testing out a diabetes risk assessment tool that people can access online or at any Shopper’s Drug Mart locations. The tool will show people if they are high-risk and should take action to manage diabetes. 

But Fong admits she often feels she’s up against an overwhelming challenge. Her community-based programs can only service a fraction of the urgent need for healthy-living education and awareness.

“We don’t have enough prevention strategies in place in BC. We need the provincial government to make prevention a priority and devote more resources to it. For too long our health care approach has been reactive, not pro-active. With diabetes, being reactive means being too late. Once you have diabetes, it affects all your organs and you are at risk for so many other problems. ” 

Better prevention will also save money. It’s estimated that diabetes will cost BC almost $2 billion annually by 2020, in direct and indirect costs. By making diabetes prevention a priority, Fong says many other chronic diseases—like stroke and cardiovascular disease—will be prevented too. It’s a win-win for health care costs and for quality of life. 

Visit the Canadian Diabetes Association website for more information.


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