Philadelphia ranks fourth among large cities in prevalence of Type 2 diabetes. That’s one of the reasons Novo Nordisk chose the home of the Liberty Bell as the second U.S. city in its localized initiative to prevent Type 2 diabetes.
Called “Cities Changing Diabetes,” the effort has now spread to 25 cities around the world. Novo Nordisk studies each city for about a year in advance to figure out the unique challenges each one faces, said Dr. Todd Hobbs, chief medical officer for Novo Nordisk in North America. The goal is to partner with 50 cities by the end of 2023.
In the case of Philadelphia, that meant sponsoring research conducted by public health organizations, which found that the characteristics of the city’s neighborhoods may make people more or less prone to diabetes. The research identified three types of neighborhoods where developing diabetes is more likely. Those are areas that are “socially cohesive” with strong community structures in place, “polarized by change” in areas where disruptive change affects trust and civic engagement, and “less anchored” places where there is less of a sense of community.
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“At the kickoff, we pulled together public and private stakeholders who want to be engaged, but maybe don’t have the overall resources and coordination needed to make these things successful,” Hobbs said, noting that the next step will be an advisory council meeting and deciding what will be the major effects moving forward.
“What we don’t do is come in and just drop a bunch of money or resources and hope that something sticks or helps," he added.
Philadelphia represents an ongoing thematic expansion as well. As Hobbs said, "It’s not just diabetes. In Philadelphia we’re also talking about obesity which is a driver of much of the diabetes epidemic. Over the five or six years we’ve been involved in the cities program globally, now we’re really speaking to both of them. Because diabetes is not just about glucose and sugar, it’s about obesity and all the other associated co-morbidities."
While this effort is a social health initiative, Novo Nordisk commercial treatments target diabetes with semaglutide, a compound already approved in two forms as Ozempic and Rybelsus.
Houston was one of the original Cities Changing Diabetes launched five years ago. Today, it has six initiatives that reach 75,000 people in the city on diabetes prevention and resource management. The approach in Houston focused on individual behavioral characteristics of people, versus the neighborhood approach in Philadelphia to find those who are more vulnerable to developing diabetes.
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“It’s a problem in cities because that’s where people with diabetes live. Two-thirds of the growing number of people with diabetes are living in cities. But every city’s challenges to address this major problem are very unique and very different,” Hobbs said.