In March earlier this year Novo Nordisk, the world’s biggest producer of insulin, announced that it would team up with some of the world’s biggest cities to develop initiatives to help combat what their CEO described as “a global diabetes epidemic that is an emergency in slow motion”.

There are 320 million diabetics in the world and two in three of them live in cities according to the International Diabetes Federation with the number forecast to rise to half a billion over the next twenty years. Living in the city it seems is a diabetes trap. Chinese cities are reported to have seven times the level of obesity as rural villages and in India ten years after moving from the countryside to the city you can expect to be 11 percent fatter. As urbanization the world over explodes the thought is that by making our cities more diabetic friendly with walkways and bike paths, we can reduce the incidence of diabetes most effectively by reaching the most diabetics to affect that change. The irony is that as the concentration of diabetic care is to be found in the city, it could be argued that diabetics move to the city for care thus exacerbating the incidence of diabetes in urban areas. But it’s the prevalence of the convenient and cheap fast food that leads to poor dietary decisions being made which is the root cause and keeps insulin manufacturers in business.

The International Diabetes Federation Africa region describes diabetes as the disease of the poor where it predicted that within 15 years diabetes will overtake the death toll from infectious diseases such as malaria and HIV as urbanization takes hold even in rural areas. In Kenya they call it the “Coca –Colaisation” with billboards showcasing bottles of sugary drinks with the slogan “Open Happiness”. An increasingly sedentary lifestyle and a diet richer in starch and fried fatty snacks in school see diabetes in children on the rise.

Whether you are living in the city or the countryside, the predominant reasons for diabetes remain the same -poor diet and lack of exercise.

This past week Copenhagen joined Mexico City as the two first cities to sign up for Novo Nordisk’s “Cities Changing Diabetes -A global fight against Urban Diabetes” . It’s a great idea and one to be applauded, with American cities reported to be lined up to join the cause. You can join the “fight” by registering at http://www.citieschangingdiabetes.com/#contact and share your ideas how urban diabetes can be defeated.

Cities with more bike paths is a great idea and a good start. But if we are really going to try to tackle diabetes in America and the world over, then the emphasis can’t just be on exercise for those diabetics that live in the city.

There needs to be a national campaign for diabetes education that reaches the masses. Public health announcements to combat the marketing campaigns of the fast food industry would be a good start. Obamacare discounts on health insurance premiums for those that participate in a monitored health tracking program would be another. The technology is there or thereabouts. It’s only a couple of years away where a wearable device will sync with your laptop to record your key indicators and let you know where you need to focus your healthcare efforts. Too much sugar in your blood, too much fat in your diet, too much alcohol in one week, your device will beat you into submission to get you on track and as a reward for your effort, you’ll get a discount on your health premiums the following month.

In July, India’s new Prime Minister, Nerendra Modi, in his first budget, took on the soft drink industry by levying a 5% excise duty on carbonated beverages, classifying carbonated soft drinks with other traditional sin items – cigars, cigarettes, Indian chewing paan and other tobaccos products. This was followed up this week by the Indian Minister of Food Processing Industries who met with PepsiCo’s Indian born chief executive to request that “the sugar content of soft drinks be brought down so that the health aspects of such products are duly taken care of.” Both Pepsi and Coke plans to invest $5 billion in India over the next five years to cater to the demand from increasingly affluent consumers of soft drinks and snacks. As sales to increasingly health conscious western consumers decline, India represents a relatively virgin market. Quite rightly so, New Delhi seems ambivalent about Pepsi’s plans for investment and growth as it fights a worsening incidence of diabetes and cardiovascular disease among the affluent coupled with pervasive malnutrition of the poor.

If Novo Nordisk really wants to fight diabetes, then it needs to challenge the Burger Kings, McDonalds, Coca Cola and PepsiCo’s of the world to do the same.