Joined the programme in 2017

In Xiamen, Cities Changing Diabetes is supporting the city’s integrated approach to the healthcare system that has enabled Xiamen to maintain its relatively low diabetes prevalence. The city’s approach begins at the grassroots level and goes beyond primary care to prevent diabetes-related complications.

gulangyu island with xiamen skyline in daytime

At 4.8%1, the prevalence of diabetes in the city of Xiamen is lower than the national average in China (10.9)2. However, still more than half of the people living with diabetes in Xiamen are unaware of their condition.1 The longer diabetes goes undetected and unmanaged, the more likely an individual with the condition will develop diabetes-related complications that are difficult and costly to treat.

Key facts and figures



of adults in Xiamen are living with diabetes1



> 1/2


of people with diabetes are unaware of their condition1



In 2015, the city of Xiamen introduced a system known as the Three-Division Co-management Model to create a more integrated healthcare system with better coordination and communication between primary and tertiary care levels. Cities Changing Diabetes in Xiamen has been supporting the implementation of this model since the city joined the network in 2017.


By strengthening the care at the primary level through community health centres, Xiamen hopes to reduce the number of people requiring tertiary care in large hospitals for diabetes-related complications.


Creating and implementing the Three-Division Co-management Model has required improving and standardising skills related to diagnosing and treating diabetes at the grassroots level. Xiamen has set up additional health clinics in vulnerable communities and trained almost 1,000 health managers to support community-based general practitioners.


Under this model of care, people living with diabetes are cared for by a team of specialists that provides comprehensive, multidisciplinary and holistic healthcare within the community.


" The Cities Changing Diabetes project can help the high-risk diabetes population to carry out early prevention, not only by expanding the primary prevention of diabetes, but also by improving the tertiary prevention of diabetes."

— Yao Guanhua, director of Xiamen Municipal Health Commission

Download Tianjin case study

Xiamen Municipal Health Commission 

Xiamen Medical Association 

Xiamen Diabetes Institute


He W, Xu Q, Han L, et al. Using real-world data to estimate the changing trends in the prevalence and incidence of type 2 diabetes mellitus in Xiamen of China from 2014 to 2019. BMC Endocr Disord. May 1 2021;21(1):92. doi:10.1186/s12902-021-00759-w


International Diabetes Federation. IDF Diabetes Atlas, 9th ed. 2019.