Turning the tide on diabetes starts with prevention

Diabetes, a disease that has been growing steadily over the last 30 years, is a catastrophe in slow motion. Today, more than 400 million people have diabetes. If action isn’t taken, that figure is projected to rise to more than 700 million by 2045 – that’s one in every nine adults. And as people with diabetes are at higher risk of severe illness or complications from COVID-19, the pandemic has brought the scale of diabetes into sharp relief. In short, diabetes, obesity and COVID-19 are a perfect storm for public health.

While Novo Nordisk has been developing treatments for diabetes for nearly 100 years, it has never been clearer that treating the disease is no longer enough. Yes, demand for our medicines may grow, but the complex needs of diabetes patients, particularly as the disease progresses, and the growing volume of people with diabetes means this trajectory is ultimately unsustainable.

Pressure on health systems, and the deterioration in quality of life, makes the prevention of diabetes one of the most pressing health challenges of our time. Alongside innovation to develop cutting-edge treatments and access to ensure that those who need it can obtain treatments, is why Novo Nordisk is using its expertise to focus on prevention to tackle the problem from getting bigger and bigger.

The combination of all three – Innovation, Access and Prevention – forms the basis of our strategy to Defeat Diabetes, launched in May this year – a name that is synonymous with our purpose. And measuring the impact of our efforts to fulfil our purpose is now a central part of how we do business and how we are building a strong, sustainable business that is fit for our second century as a company.

Ninety percent of all diabetes cases are type 2, a complex chronic disease that occurs when the body cannot make enough insulin or use it effectively. People living with type 2 diabetes need treatment in order to keep their insulin and blood sugar levels under control, and they have a two to four times increased risk of developing cardiovascular disease.

But to prevent people from developing diabetes in the first place, we have to look at who is most at risk – and why.

Today, 650 million adults and 120 million children live with obesity – a disease that makes people seven times more likely to develop type 2 diabetes. Our modelling shows that in order to cap the number of people living with diabetes at one in 10 by 2045, global obesity levels must be reduced by 25%. With obesity growing at a significant rate, turning the tide is essential.

Losing weight is not just a question of eating less and moving more. Obesity is complex. It can be influenced by genetics, physiology, environment, job, education and social status, and what is going on in the brain. Its causes are multiple, from genetic disposition to brain chemistry, and it is not an easy disease to treat.

This is why tackling obesity and diabetes together is central to our prevention work within Defeat Diabetes.

Over the last six years, we have developed numerous partnerships and initiatives that are focused on the broader context for diabetes and involve multiple stakeholders from different disciplines.

Back in 2014, we co-founded Cities Changing Diabetes with University College London and Steno Diabetes Centre in Copenhagen. It is now an established network of more than 35 cities around the world that are home to over 175 million people. Its mission is simple: to lead a global fight against urban diabetes.

Cities are the front line of the diabetes challenge. They are where more than half of the world’s population lives and are home to two-thirds of people with diabetes. Although cities are engines of economic growth and innovation, some of the drivers of their prosperity can also lead to widening health inequalities. They significantly impact how people live, travel, play, work and eat — factors that, in combination, impact the rise in diabetes.

The Cities Changing Diabetes programme is designed to address the social and cultural factors that can increase type 2 diabetes vulnerability among certain people. Built on three interconnected elements – Map, Share, and Act – the programme enables cities to understand their own urban diabetes challenge, to set goals for halting the rise of type 2 diabetes in their city, and to work across sectors and disciplines to unite stakeholders behind a common cause, to learn from others and trial new solutions.

As the programme continues apace, in 2021 we will be taking our learnings to launch an open Innovation Challenge that seeks to discover new types of interventions. In the same year that will see the United Nations convene a Food Systems Summit, our focus will be on food and food systems, with the aim of surfacing and scaling interventions that advance healthier, sustainable food environments for people who are disproportionately vulnerable.

Food is one of the strongest levers to optimise health and environmental sustainability on our planet. However, more than 820 million people still lack sufficient food, and many more consume either low-quality diets or too much food.

Some citizens have easy and convenient access to fresh, healthy, and affordable food; others do not. Creating equal opportunities for all will make the healthier choice the easier choice.

So, the big question on our minds for 2021 is: how can we shape food environments to make healthy food choice the easy and default behaviour for all?

We look forward to sharing with you and the rest of the world the answers we find.