The Urban Diabetes Toolbox enables city and health leaders around the world to create their own action plan for tackling diabetes in their city. It provides new ways to setting the goal, map the challenge, understand the areas of greatest risk and vulnerability, and design interventions to halt the rise of diabetes.

The Toolbox has been developed through the Cities Changing Diabetes partnership, built on the experience of eight cities around the world. The stories of their research and actions are a resource for any city to draw on. Over time, the Toolbox will collect the experiences of more cities, offering encouragement and inspiration to everyone joining the fight against urban diabetes.

Setting the Goal

Diabetes Projection Model

The Diabetes Projection Model is a tool that plots the trajectory of diabetes in any city over time. It allows cities to forecast the impact that reducing obesity could have on both the prevalence and cost of diabetes. Using the model, it is possible to understand the scale of the challenge and set a goal for what it will take to bend the curve in a city.

Tools and downloads

    The model in Excel

Mapping the Challenge

Risk Monitor

The Risk monitor is a framework for quantifying and visualising the populations at highest risk of developing diabetes. By quantifying the number of people at highest risk of developing type 2 diabetes, cities can prioritise where action needs to be taken to push back the condition.


Tools and downloads

    How to Manual

Rule of Halves

The Rule of Halves analysis is a framework that shows where gaps need to be closed to ensure that everyone with diabetes is diagnosed, everyone diagnosed gets treated and everyone treated has better health outcomes. In the treatment of diabetes, this is critical in order to avoid complications, improve quality of life and reduce treatment costs for the health system.

Tools and downloads

    Introduction Manual

    How to Manual

Understanding Risk and Vulnerability


Diabetes Vulnerability Assessment

The Diabetes Vulnerability Assessment is a research tool for identifying city-level factors that make certain groups of people vulnerable or, conversely, resilient to diabetes and its complications. The Diabetes Vulnerability Assessment is an innovative approach for establishing a local evidence base with a special focus on the sociocultural factors that impact the health and well-being of residents.


Tools and downloads

    Introduction Manual

    How to Manual

Urban Diabetes Risk Assessment

The Urban Diabetes Risk Assessment builds on the findings of the Diabetes Vulnerability Assessments conducted in 2015. It generates valuable information about population sub-groups and their specific needs, priorities and barriers to care and health. It allows for the design of tailored city-level interventions and policies that are more effective in preventing and managing diabetes than those targeted at general populations. The approach facilitates city leaders to engage citizens around their experiences of vulnerability and shape interventions according to what will be most relevant locally.

Tools and downloads

    Introduction Manual

    How to Manual


Design Interventions

Global networks

Collaborative working supports cities to act in partnership to deliver interventions. Cities Changing Diabetes has established three new global networks to support knowledge sharing and cross-collaboration within Peer support, Community action research and Urban planning for partners engaged in the programme.


Click here to learn more

    Community Action Research Network

    Peer Support Knowledge Network (webiste)  |  Backgrounder (1-pager)

    Urban Planning Network

Action Arenas

The four Action Arenas draw on real-world examples to provide a set of inspirational cases for building city-level action plans. Click on the Action Arenas below to see how cities, including Cities Changing Diabetes cities, have developed initiatives across the four Action Arenas. The learnings from these actions can be applied by any city to build an urban diabetes action plan that is relevant to the local context and diabetes goals.



Entails increasing awareness and understanding of urban diabetes, and getting these insights incorporated into local policy. Insights gained from the Cities Changing Diabetes research provide the opportunity to develop concrete and evidence-based solutions to address the urban obesity and diabetes challenge and improve overall health.



Strives to strengthen communities around vulnerable citizens who have diabetes or increased risk of developing diabetes, so that they can build resilience and improve their quality of life, diabetes care and treatment outcomes.


Focuses on obesity and diabetes prevention by showing the importance of health-promoting aspects, such as walkability and bikeability in urban planning. Research shows that the built environment in cities plays a key role in the ability to live a healthy life, for example access to green spaces and facilities for physical activity.



Engages stakeholders at all levels to build capacity into the local healthcare system. Cities Changing Diabetes research shows that vulnerable citizens sometime struggle to access a city’s formal health systems or get the support they need to live a healthy life with diabetes. This can happen despite living in relatively close proximity to healthcare facilities.




The briefing books are central documents for the Cities Changing Diabetes programme. Together with the Urban Diabetes Toolbox they serve as strong engagement tools providing city shapers with a common understanding of the severity of urban diabetes and the crucial role cities can play in fighting diabetes.


Bending The Curve On Urban Diabetes – New research approaches and innovative interventions for tackling diabetes in your city (2017) 

This briefing book presents highlights from three years of research and diabetes action pilots in eight cities worldwide. Looking ahead, we now shine the spotlight on the single most significant driver of diabetes, namely obesity. We have modelled what it will take to hold the rise of diabetes prevalence at 10.0% globally, and what this model shows is that we must set ourselves a target of reducing obesity by 25.0% globally by 2045. Offering an Urban Diabetes Toolbox enabling every city, town and community the possibility to set a goal and take action, we ask city shapers: What will it take to bend the curve on diabetes in your city?

Urban Diabetes – Understanding the challenges and opportunities (2015)

Today, not enough is known about the dynamics of how urban development can drive diabetes, and how to deliver the potential health benefits that city living can bring. This briefing book contextualises the urban diabetes situation and offers a global overview of the challenges associated with urban diabetes, specifically focusing on the social factors and cultural determinants that impacts diabetes vulnerability.

The Impact Assessment - Programme Review 2014-2016

This review investigates the impact of the Cities Changing Diabetes partnership and relevant activities initiated in the period 2014–2016. The review aims to inform the future programme direction by documenting and understanding the impact of the Cities Changing Diabetes approach as well as capturing and sharing learnings from global and local programme activities.