Promoting national diabetes treatment
in Shanghai community health centres

Understanding that one of the most effective ways of combatting diabetes is the ability of community health professionals to recognise and respond to the disease in their patients, the CCD, alongside Shanghai’s Diabetes Intervention Programme, trained over 1,500 healthcare professionals from 241 community health centres. The emphasis of this programme is placed on community-based health promotion for controlling diabetes risk factors, early detection of diabetes and education on health management in the 5 districts and is a positive start in the reduction of diabetes in one of the world’s largest and fastest growing urban areas, now and in the future. 

Local Partners: Shanghai Medical Association

01

Background

China has one of the highest rates of diabetes in the world, affecting over 121 million people. More than half of the people with diabetes live in cities, and Shanghai ranks among the largest urban areas in China with a population of 25 million people1. The Diabetes Projection Model shows that, today, 11.3% of the adult population has diabetes. If measures to stem this aren’t taken now, the prevalence of diabetes is projected to reach 18.2% by 2045, increasing the total number of patients from 2.3 million today to 4.3 million people. As the second city in China joining the Cities Changing Diabetes partnership, Shanghai has already established a strong foundation for action alongside CCD partners. Their concerted and impactful response to the rising NCD challenge taken now, will help stem the escalation in diabetes cases, with an estimated 800,000 cases of type-2 diabetes avoided, and 353 million dollars in healthcare expenditure saved, by 20452. Realising this challenge, the Shanghai Municipal Government has launched an action plan on diabetes, the Diabetes Intervention Programme. 

02

What the city did

Research collected by the CCD program alongside the Diabetes Intervention Programme identified that a major barrier to effective treatment was an inability of people with the condition from controlling their diabetes adequately, despite data showing that 60% of people with a diagnosis of diabetes receive treatment. Providing the necessary support to these individuals means having a well-qualified and adept organisation of local, first-response health professionals1. Recognising this, CCD engaged with the Shanghai Medical Association to train local health care professionals from 5 out of Shanghai’s 18 districts.

03

Outcome

In May 2018, more than 2000 healthcare professionals, including primary care physicians and nurses, have received training at 240 community health centres in Shanghai. In addition, standard diabetes treatment and referral guidelines were created, promoted and dispersed amongst the health centres, enabling community healthcare professionals to communicate a unified approach to caring for their diabetes patients, giving patients greater comfort and understanding of their condition. Shanghai has also strengthened it diabetes awareness through risk assents and screenings. Until March 2018 more the 1 mio had conducted a risk assessment and the city identified 325,000 people in high risk of developing diabetes. People that now can get support from the Community Health Center for changing their lifestyle and preventing them from developing diabetes in the future. Out of the 325,000 people that were identified to be high risk, 48,000 people had prediabetes and 37,000 people was diagnose with diabetes. 37,000 diagnosed can now get the care that they need and hopefully live a long and good life with diabetes. This is a great achievement for cities prevention and control of diabetes This helps to build better understanding within the community, but also relationships between the community health professional and their patients, aiding in the provision of active and dynamic medical care. 

04

What’s next

Continued strong collaboration with and among local city stakeholders to ensure continued commitment to create change. The National Office for Diabetes Primary Care located in Shanghai has created a network of directors of community health centres and primary care physicians that meet regularly to collaborate on further strengthen prevention and control of diabetes in Community health centres in Shanghai. 

 

References

1. Zhang W, Kang L. (2012). State of Urban Community Health Centers in China: Nursing and Patient Perspectives (Observations on Challenges and Implications of Reform).

2. Cities Changing Diabetes. (2017). Diabetes Projection Model, Tianjin. Data on file. Novo Nordisk. In: Incentive, ed. Holte, Denmark.

3. Ibid.