A community-led diabetes prevention programme in rural Bangladesh slashed new diabetes cases by nearly 60% in a controlled trial, and researchers now want to see if that success holds when rolled out to 215,000 people. Diabetes is exploding in low- and middle-income countries, where healthcare systems are often too weak or expensive to manage the disease. Most prevention efforts rely on costly medical interventions or individual behaviour change, which are hard to sustain. This project tests a radically different approach: training ordinary villagers to identify local health threats and organise their own solutions—such as group exercise, dietary swaps, or peer support—without outside doctors or clinics. If the scaled-up programme works, it could offer a cheap, replicable blueprint for diabetes prevention across South Asia and beyond. The intervention costs little and may save health systems money by preventing expensive complications like kidney failure or blindness. The researchers are also tracking whether the health gains persist after external support ends, and they are actively briefing governments and global health agencies to push for wider adoption.
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We recently completed a population health experiment in rural Bangladesh where we found that a diabetes-focused participatory community mobilisation intervention whereby ordinary community members themselves identify, prioritise and address threats to their health reduced the burden of diabetes and the risk of diabetes (known as 'intermediate hyperglycaemia') in these villages by more than 60% relative to villages where no intervention took place. Furthermore, among individuals who were at higher risk of developing diabetes, those living in community mobilisation villages were almost 60% less likely to develop the disease over two years compared to those who lived in villages where no intervention took place. These findings and our robust methods of evaluation give us confidence that exposure to the community mobilisation intervention caused this reduction in the burden of intermediate hyperglycaemia and diabetes. Furthermore, the low-cost, social intervention is cost-effective and can lead to savings in health care expenditure. Based on these findings, we wish to scale-up our intervention to cover a much larger population. Working with the Diabetic Association of Bangladesh, who will implement the intervention across a population of 215,000 people, UCL will apply epidemiological, economic, social and implementation science methods to better understand the processes, costs and impact of implementation at such a large scale. Further, we will evaluate the sustainability of groups when direct intervention from the Diabetic Association of Bangladesh is withdrawn and evaluate whether observed improvements in health last over a period of three years. Finally, a core component of our project will be engagement with governmental and non-governmental stakeholders in Bangladesh and globally to share our findings and to explore opportunities for longer-term, larger-scale implementation of the intervention.
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