‘The obesity and diabetes epidemic is unsustainable’: how a team of academics aims to halt the trend

Earlier this year, the University of Toronto announced a significant donation from Novo Nordisk, a major global healthcare company, to explore new ways to support healthier urban lifestyles. The University of Toronto’s Novo Nordisk Network for Healthy Populations will bring together a range of interdisciplinary experts to tackle the root causes of type 2 diabetes and other chronic diseases.

This is not the first time these two powerhouses have worked together. In 1921, a team of researchers at the Canadian university discovered insulin and its role in treating those with type 1 diabetes. Novo Nordisk’s predecessors, Nordisk Insulin Laboratorium and Novo Terapeutisk Laboratorium, were among the first to mass-produce this new product and distribute it across the world.

This latest partnership represents a potential new era of hope for improving the lives of people living with diabetes. To facilitate this, Novo Nordisk has donated C$20m (£11.5m), which has been matched by the University of Toronto with C$20m worth of financial and related contributions. These investments will fund innovative interdisciplinary research that strengthens existing partnerships in healthcare and public health activities while encouraging new community engagement and outreach opportunities.

News of this exciting development comes at a critical time. Despite it being a century since insulin’s discovery, cases of chronic disease, especially type 2 diabetes, have been on the rise across the world for several decades. “We are reaching an unsustainable obesity and diabetes epidemic,” says Dr Lorraine Lipscombe, the director of the new network, who is also an associate professor of endocrinology and metabolism at the University of Toronto and senior scientist in the Women’s College Research Institute. Such a challenge demands new and more wide-ranging approaches to public health that look beyond innovations in medicine alone. According to Lipscombe, “a lot has already been done within various fields, but this research remains siloed. In order to move the evidence into action, we need to have integration with other disciplines as well as key community stakeholders.”

Based at the University of Toronto’s Mississauga campus, the network is a partnership between the Temerty Faculty of Medicine, the Dalla Lana School of Public Health and the University of Toronto Mississauga. It will provide access to the insights and leading research of an interdisciplinary team, allowing for a multi-pronged approach that looks at the many different settings where diabetes risk factors are present and where intervention can take place.

The interdisciplinary effort will explore the nature and extent to which chronic disease, wellbeing and health more generally are influenced by social and cultural determinants, such as lifestyle, transportation usage, mobility, retail management and the built environment. There is also an emphasis on how data science and engineering can create new risk prediction algorithms that inform novel technologies and apps that help people better engage with healthier lifestyles.

The network will also benefit from having its base at the University of Toronto’s campus in Mississauga, a large city close to Toronto on Lake Ontario. This city has a diverse population of roughly 830,000 and serves as a landing place for many newcomers to the country. According to Prof Kathi Wilson, a health geographer at the university’s department of geography, geometrics and environment who is also involved in the network, there is a clear connection between immigration and increased stress, and an overall decrease in health and wellbeing soon after immigrants arrive in their host countries.

The city is also home to a large number of Canada’s indigenous peoples who have, says Dr Tracey Galloway, an associate professor in the department of anthropology, “a higher risk profile for diabetes than the general Canadian or global population”. According to Galloway, this is “largely the result of social factors, like poverty, food insecurity, and the experience of discrimination in healthcare and other public settings”.

By addressing these issues, the researchers will gain new insights that have relevance for other cities and organisations across the world. The partnership in Mississauga provides a unique opportunity to engage with key stakeholders and communities who have a fundamental role to play in shaping the nature of the research taking place in the partnership. “Research can become its own engine, and we want to make sure we are not driving this train,” says Galloway. “We want to ensure we are working with and really listening to these key partners.”

The network, which began its research in September, presents a crucial opportunity to improve the lives of those living with chronic disease; and prevent it from occurring in future generations.

Dr Russell Moul holds a PhD in the history of colonial science and medicine and medical ethics