• Projected diabetes prevalence and related costs in three North American urban centres (2015-2040)
    February 2018 | Ulrik Haagen Panton, Malene Bagger, Simon Barquera
    To explore the future implications of diabetes for urban centres, we projected the prevalence and cost of diabetes from 2015 to 2040 in three very different North American cities: Houston, Mexico City and Vancouver through a simple demographic transition model. Unless actions are taken to decrease its incidence, diabetes is expected to increasingly contribute to the societal and financial burden, particularly for urban areas. Resources and policy actions are needed immediately to promote healthy lifestyles and to implement secondary prevention of diabetes complications.
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  • Study protocol for the Cities Changing Diabetes programme: a global mixed-methods approach
    February 2017 | A. David Napier, John J Nolan, Malene Bagger, Louise Hesseldal, Anna-Maria Volkmann
    We present a research protocol for exploring the drivers of type 2 diabetes and its complications in urban settings through the Cities Changing Diabetes (CCD) partnership programme. The protocol steers the collection of primary and secondary data across the study sites.
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  • Is the Rule of Halves framework relevant for diabetes care in Copenhagen today? A register-based cross-sectional study
    2018-09-01 | Astrid Ledgaard Holm, Gregers Stig Andersen, Marit E Jørgensen, Finn Diderichsen
    Copenhagen is doing much better than halves, when it comes to diagnosis and providing treatment, whereas the rule of halves still prevails when it comes to treatment targets. There is thus still room for improvement.
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  • Use of healthcare services among socially vulnerable diabetes patients in Copenhagen
    2017 | Christensen U Malling GMH
    Socioeconomic differences in the occurrence of diabetes exist in Copenhagen, and only 50% of those who receive diabetes care achieve the treatment targets and of these 50% achieve the desired treatment outcomes. The most vulnerable diabetics did not reach the health services available, due to other social and health issues in everyday life. Those that did reach the health services, regarded the limited time periods as obstacles in continuing practicing a healthier lifestyle.
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  • Risk perception among vulnerable diabetes patients and citizens at risk in Copenhagen
    2017 | Christensen U, Malling GMH, Kristensen EC
    With more than 95% of the daily self-management of diabetes conducted by patients themselves, patients must have the right self-care knowledge which includes a number of assessments, including perception of health risks in everyday life. Both citizens and patients knew about potential risk factors of developing diabetes and they described themselves as being at risk either due to their family history, their overweight or their lifestyle. Others did not perceive themselves at risk as they attended regular checkups at the health clinic. Being aware of one’s risk does not translate into leading a healthy lifestyle due to other social and health issues in everyday life.
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  • Understanding Social and Cultural Factors Associated with Composite Vulnerability to Better Inform Community Intervention Strategies: Part 2 of Cities Changing Diabetes in Houston
    2018-12-01 | Linder SH, Volkmann A-M, Wisniewski T, Hesseldal L, Napier AD
    We describe a novel procedure for estimating population-level vulnerability to type 2 diabetes and then demonstrate how differences in social and cultural factors among vulnerable sub-groups translate into design considerations for prevention-oriented community interventions.
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  • A population-based approach to assessing community vulnerability to diabetes: part 1 of Cities Changing Diabetes in Houston
    October 2018 | Linder SH1, Marko D, Tian Ye, Wisniewski T
    Two-thirds of current diabetics are living in urban centers and the urban concentration of individuals with diabetes is on the rise. Toward this end, we introduce the concept of composite vulnerability, which includes both group and individual-level attributes, and we provide a demonstration of its application to a large urban setting. Neighborhoods with high concentrations of residents manifesting composite vulnerability can be easily identified for targeting community-based prevention measures.
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  • Assessment of factors affecting diabetes management in the City Changing Diabetes (CCD) study in Tianjin
    2019-02-01 | Chen J1, Jing X1, Liu X, Volkmann A, Chen Y, Liu Y, Li D, Han D, Guo Y, Gao F, Han N, Wang X, Zhao H, Shi X, Dong Y, Chen L, Napier D, Ma J
    This study aimed to identify the local levels of vulnerability among patients with Type-II diabetes (T2DM) in Tianjin. The study was aimed at curbing the rise of T2DM in cities. Twelve themes involving 29 factors were associated with diabetes patients’ vulnerability. Based on our findings, specific interventions targeting individual patients, family, community and society are needed to improve diabetes control, as well as patients’ mental health care and general living conditions.
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  • Effect of a Behavioral Intervention Strategy on Sustained Change in Physical Activity and Sedentary Behavior in Patients With Type 2 Diabetes
    2019-02-01 | Stefano Balducci, MD; Valeria D’Errico, MD1; Jonida Haxhi, MD, PhD; et al
    The objective was to investigate whether a behavioral intervention strategy can produce a sustained increase in physical activity and reduction in sedentary time among individuals with T2DM.  Participants in the behavioral intervention group (n=150) received 1 individual theoretical counseling session and 8 individual biweekly theoretical and practical counseling sessions each year. Participants in the standard care group (n=150) received only general physician recommendations.  Among patients with type 2 diabetes at 3 diabetes clinics in Rome who were followed up for 3 years, a behavioral intervention strategy compared with standard care resulted in a sustained increase in physical activity and decrease in sedentary time.
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  • Rome as a walkable city for reduce the impact of the Obesity, T2DM and CDV risks
    2018-11-01 | F Serra, M Damilano, D Ponchio, C pinato, A Gaudioso, A Nicolucci, S Frontoni, L Morviducci, F Dotta, A Lenzi
    This project aims to map and realize acts on the burden of and risk factors for T2DM in the metropolitan area of Rome, which in 2017 joined the “Cities Changing Diabetes” (CCD) initiative. Huge discrepancies between the centre and the suburban areas have been shown for age, socio-economic status, immigration, eating habits and physical activity, as well as for diabetes process and outcome indicators. CCD realized in Rome, in collaboration with the Roma City Mayor, 50 walking routes for a total of 320 Km to prevent obesity, T2DM and CDV risk. Aims the project will be to involve about 100.000 diabetics people and about 1 million of citizens in a year.
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  • Urban health in Italy: health outcomes and sustainable living
    2018-11-01 | S Da Empoli, M Fadda, E Mazzoni, A Gaudioso, F Serra, C Spinato, A Cosimi, K Vaccaro, F Dotta, A Lenzi
    37% of Italy's population lives in the 14 Metropolitan cities, making urban health a priority for local policies. An independent think tank called Health City Institute was created to coordinate the work of professionals aiming to improve urban health. The main project is a permanent observatory on health in cities. To implement this project, a macroeconomic analysis has been carried out to understand the state of the art.
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  • Urban diabetes: the case of the metropolitan area of Rome
    2018-11-01 | A Nicolucci, MC Rossi, F Dotta, K Vaccaro, R Crialesi, S Frontoni, L Morviducci, F Serra, A Lenzi
    CCD Rome has three core elements; mapping the problem, sharing the learnings and taking action. Data and scientific reports were reviewed and used to map diabetes and risk factors in Rome. The prevalence of T2D was mapped and the correlation between prevalence and social and cultural determinants was assessed. A wide variation exists in the prevalence of T2D among the districts of Rome, associated with social and cultural determinants.
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  • The map of diabetes and its determinants within the metropolitan area of Rome
    2017 | Poscia A, Nicolucci A Vaccaro K Crialesi R, Corsaro L, Dotta F, Lenzi A, Ricciardi W, Poscia A, Nicolucci A, Vaccaro K, Crialesi R, Corsaro L, Dotta F, Lenzi A, Ricciardi W
    The 37% of the population in Italy lives in the 14 Metropolitan cities and the urban health issue is becoming a priority for local policy design. To give a civic response to the urgent need to study the health in cities, an independent think tank named Health City Institute was created with the aim of coordinating the work of professionals with different backgrounds, targeted on the promotion of urban health in Italy. As a first step towards the development of this project a macroeconomic analysis of the 14 Metropolitan cities in Italy has been carried out to photograph the state of the art in terms of urban context sustainability and urban health related outcomes.
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  • Nuovi scenari epidemiologici e assistenziali: dall’Urban Health all’Urban Diabetes
    2017 | Medea G, Nati G, Lenzi A, Cricelli C1Medea G, Nati G, Lenzi A, Cricelli C
    Urbanization is rising around the world and is a major contributor to T2DM, which leads to a rise in health care costs. To stem this, cities need to identify stratefies to promote the health of citizens. This can be done by improving the health determinants in cities. The study used the quantitative and qualitative assessments proposed by CCD to measure diabetes prevalence in Rome.
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  • Il progetto Cities Changing Diabetes
    2017 | Lenzi A, Dotta F, Frontoni S, Crialesi R, Nicolucci A, Vaccaro K, Lenzi A, Dotta F, Frontoni S, Crialesi R, Nicolucci A, Vaccaro K
    Urbanization is one of the main contributors to diabetes. As urbanization increases, it is important to promote healthy living in cities as a strategy to prevent the increase of T2DM. CCD underlines the necessity to tackle the growing number of T2DM. Rome has been included in 2017. 
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  • Dietary Inflammatory Index and Type 2 Diabetes Mellitus in Adults: The Diabetes Mellitus Survey of Mexico City.
    2018 | Denova-Gutiérrez E, Muñoz-Aguirre P, Shivappa N, Hébert JR, Tolentino-Mayo L, Batis C, Barquera S
    Diet and inflammation are both associated with T2DM. The study examined the relation between dietary inflammatory index (DII) and the presence of T2DM in Mexican Adults. The results suggest that a pro-inflammatory diet is associated with significantly higher odds of T2DM among adult Mexicans.
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  • Evidence of increasing sedentarism in Mexico City during the last decade: Sitting time prevalence, trends, and associations with obesity and diabetes
    2017-12-01 | Medina C, Tolentino-Mayo L, López-Ridaura R, Barquera S
    Sedentary behavior is associated with obesity and diabetes independently of total reported physical activity. This study aimed to report the current sitting time per day in Mexico City. Sitting time/day prevalence increased 8%, and average daily sitting minutes significantly increased by 8.2% (18 minutes) in the nine-year study period (2006±2015). Current public health policies should consider strategies not only for increasing physical activity levels, but also for reducing sitting time/day among the population as a measure to fight the growing epidemic of obesity and diabetes in Mexico.
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