Looking forward to the American Diabetes Association in our hometown of San Francisco.

It’s time again for the 74th Scientific Sessions of the American Diabetes Association (ADA)  – and this year it’s right in our hometown of San Francisco! ADA begins in just a few weeks, and all of us at diaTribe will be headed to the conference to get the very latest insights into diabetes and obesity, not to mention the therapies and devices that could improve the health and happiness of those living with these diseases. We’ll be reporting back to you next issue with all the biggest takeaways from this year’s ADA, but while we’re on the topic San Francisco, I wanted to focus on the bigger picture: the relationship between cities, their citizens, and diabetes.

The modern city is a major under-examined part of the type 2 diabetes story, as a disproportionate percentage of the global diabetes population is found in urban environments, an effect that will just get worse as more and more people move to cities over the coming decades. If you haven’t had a chance yet, please read our piece on how cities can change diabetes, and make your voice heard on which city deserves the most help in our reader poll. We’ve had a terrific response so far from our readers; all your stories have been even more thoughtful and compelling than I could have hoped! If you haven’t yet responded, would you take two minutes to do so?

I’d like to share some illuminating reader comments. Many respondents stressed the importance of education and empowering people with diabetes to more effectively manage their health. YES. What else would be on my wish list? Many wrote about the importance of changing the food culture, and suggested simple tweaks like having all restaurant menus display nutritional info, provide lower-carb options, and display nutritional information for alcoholic drinks like beer and wine. Another wanted employers to take a more active role in motivating their employees to exercise and eat healthier and giving workers the opportunity to take “exercise lunches” to get physical activity in during the workday.

It’s a powerful idea to reimagine and revitalize cities to make them places that naturally promote healthy lifestyles. It's on my mind for ADA, because this year the conference is coming to us in our hometown of San Francisco. Our city is well known as a center for immigration and cultural exchange, the home of iconic sites like Alcatraz and the Golden Gate Bridge, and a place of progressive thought and civil rights activism. Now I hope that San Francisco will take a leading role in reshaping itself to address one of the great public health crises of our time.

After all, this is a city that has always evolved and grown to solve unique challenges. San Francisco wasn’t just built – it was rebuilt after the earthquake of 1906. San Francisco reshaped itself into a city better prepared to withstand the next great disaster. Now it must change again to face the public health challenges of the present. The type 2 diabetes epidemic that currently affects San Francisco and cities throughout the world is not the same as an earthquake; at least, it won’t cause damage all at once. We’ll see the problems occur in slow-motion, as an ever-growing percentage of the population are asked to cope physically, emotionally, and financially with a complicated chronic disease. But the good news is that we can prevent the onset of type 2 diabetes whenever possible and make sure those already living with it have all the resources they need to remain happy and healthy.

We’re starting to see changes already. San Francisco is considering a soda tax, making it more expensive to buy sugary, high-calorie soft drinks. We think it’s a good idea to show we mean business – especially because the funds would all go toward making it easy to live more healthily by improving school nutrition and physical activity programs. In the last year, we saw the introduction of a bike-sharing program similar to those already in place in London and New York. In this month’s issue, Adam Brown gives his top ten tips for surviving in a food environment where it’s hard to make healthy choices. The kind of progress we’ve seen here, and in other cities from Seattle to Birmingham, is inspiring, and now it’s time to push further by thinking about how we can change our environment to be happier and healthier. I’m looking forward to hearing what the experts have to tell us at ADA – and this year, I can finally walk there!

Very best,

Kelly L. Close

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