Joined the programme in 2014
Shanghai was already working on bending the curve on diabetes when it joined the Cities Changing Diabetes network in 2014. Since then, a wide range of local stakeholders has collaborated through the Cities Changing Diabetes programme to ensure that diabetes is diagnosed early and managed properly in the city.
One of the world’s largest and fastest growing megacities, Shanghai is the first city in China to be categorised as an ageing society, with residents living to an average age of 841. Population ageing is accompanied by an increase in the prevalence of non-communicable diseases (NCDs), including type 2 diabetes2.
When Shanghai joined the Cities Changing Diabetes network, almost a third (29.5%)3 of schoolchildren and 20% of adults were living with obesity4. Other challenges identified in the city included a high proportion of people with undiagnosed diabetes and gaps in healthcare provider knowledge related to the provision of standardised diagnosis and treatment of diabetes.
of adults were living with obesity in Shanghai in 20134
of school children were living with obesity in Shanghai in 20143
Cities Changing Diabetes in Shanghai is collaborating with local city stakeholders to strengthen the capacity of the city’s health system to prevent, diagnose and manage diabetes.
Standardising diabetes management
Shanghai Sixth People’s Hospital was designated as the city’s official diabetes prevention and treatment centre under Shanghai’s three-year action plan (2015 – 2017). The hospital collaborated with Shanghai CDC, Shanghai Eye Disease and Treatment Center and Shanghai Laboratory Center to carry out its mandate.
The system was put in place to ensure that all residents had access to a comprehensive system of diabetes prevention, intervention and treatment and covers 240 community health centres in the city’s 16 districts.
A model for managing NCDs
Between 2016 and 2017, the number of people living with diabetes under standardised management rose from 685,000 to 749,000. By March 2018, the city had completed a diabetes risk assessment for one million people. During this process:
The model used to transform diabetes management in Shanghai could potentially be used as a model for the management of other chronic diseases in urban communities across China. It has ensured the upskilling of healthcare professionals at the primary care level, made large-scale diabetes screening possible and improved the referral system in Shanghai.
" The dynamics driving diabetes in Shanghai are complex:
growing wealth, changing lifestyles and an ageing population,
alongside a rising number of younger people getting the disease.
Also, fast-paced working lives can stand in the way of diabetes
management. Through in-depth learning and connecting our knowledge,
Cities Changing Diabetes can help us to improve even further the
effectiveness of taking on diabetes in our city."
— Professor Jia Weiping, Shanghai Institute of Diabetes
Shanghai Municipal Centre for Disease Control and Prevention
Shanghai Municipal Commission of Health and Family Planning
Global Times. Residents’ average life expectancy reaches 84.11, Shanghai in line with advanced countries in health indexes. Global Times; 2022. 16 February 2022. Accessed 5 July 2022. https://www.globaltimes.cn/page/202202/1252385.shtml
International Diabetes Federation (IDF). IDF Diabetes Atlas 10th edition. 2021. Accessed March 2022
Martinson ML, Chang YL, Han WJ, Wen J. Child Overweight and Obesity in Shanghai, China: Contextualizing Chinese Socioeconomic and Gender Differences. Int J Behav Med. Feb 2018;25(1):141-149. doi:10.1007/s12529-017-9688-6
Wu J, Xu H, He X, et al. Six-year changes in the prevalence of obesity and obesity-related diseases in Northeastern China from 2007 to 2013. Article. Scientific Reports. 01/27/online 2017;7:41518. doi:10.1038/srep41518