Finding Type 2 Diabetes Where People Already Are: Inside the T2D Network’s Community Screening Clinics
Many people living with, or at risk of, type 2 diabetes (T2D) don’t have a regular family doctor. Others have one but face language barriers, long waits, or clinical settings that don’t feel safe or welcoming. For these people, the usual route to early detection (book an appointment, get a referral, follow up) can break down at the first step.
The T2D Network’s community screening clinics were built for exactly these gaps.
Rana Madani Civi (T2D Network) and K Jin Lee (Shoppers Drug Mart South Surrey) partner for a community T2D screening event
Meeting people where they are
Our clinics run through pharmacies, community organizations, cultural spaces and community events. Instead of asking people to find their way into a fragmented system, we bring risk screening to places they already trust and visit. This matters most for communities with elevated T2D risk and less access to care, including South Asian and East Asian communities, Métis and First Nations peoples, newcomers, and people in rural and remote parts of BC.
What we’re seeing
Across the first five screening sessions in Surrey and White Rock, we reached 523 attendees. Of those:
19% were identified as being at higher risk based on elevated blood glucose
30% were not attached to a primary care provider
Nearly a third of the people we screened had no regular provider to turn to if their results were concerning. For them, a screening result alone isn’t enough. They need a next step. That is why navigation is built into every clinic: people who are unattached are connected to care through a primary care attachment mechanism, so a high-risk result leads to follow-up rather than a dead end.
What the research says about T2D screening
Our approach follows a growing body of evidence. Diabetes often goes undetected, and some groups are at risk earlier. Evidence suggests that one-third to one-half of diabetes cases in industrialized settings are undiagnosed, and Canada has no formal diabetes screening program. The risk is higher and starts earlier for South Asian communities. An Ontario cohort study found South Asian adults were far more likely to develop diabetes than white adults (hazard ratio 3.40), at lower weights.
The BMI at which risk matched a BMI of 30 in white adults was 24 in South Asian adults. A 2024 study in Nature Medicine linked earlier onset to genetic signatures for lower insulin production and less favourable fat distribution. People with the most extreme profiles developed type 2 diabetes about eight years earlier, at lower body mass index. A person can look healthy by conventional measures and still be at risk, so screening shouldn’t wait for visible warning signs.
Pharmacies and community venues reach people the system misses. A systematic review and meta-analysis of pharmacy screening describes it as a chance to engage groups less likely to use GP-based care, including people with lower incomes and those from minority ethnic groups. The strongest recent evidence is Australia’s Pharmacy Diabetes Screening Trial (2023), which involved 14,089 participants at 339 pharmacies and found 145 newly diagnosed cases of type 2 diabetes and 338 new cases of prediabetes.
The researchers concluded that screening during routine pharmacy visits fostered positive engagement with consumers and GPs. Trusted community spaces work too. A feasibility study in faith centres screened 252 people at four events, found most had a high diabetes risk score, and achieved high uptake of a follow-up group education program.
It works in Canada. Researchers at the University of Toronto Mississauga offered community-based screening at two wellness fairs in Peel Region, home to one of Canada’s largest South Asian communities. About one in four people screened had diabetes or prediabetes. The team found that screening and education alone weren’t enough, so they worked with community partners to speed access to care. They are now exploring pop-up screening in community centres, faith-based centres and workplaces, with the same principle we follow: go into the community rather than waiting for the community to come to the system.
Screening alone isn’t enough, which is why navigation matters. The same pharmacy review that supports screening also contains a warning: all the included studies had high rates of attrition between screening and follow-up. A result that never leads to care doesn’t help anyone. Navigation can close that gap. In a 2025 study of a health check service in Zimbabwe, 72% of people who were referred for diabetes and could be reached later said they had seen a health professional within 30 to 60 days, and follow-up phone calls to support linkage were added during the program. That setting differs from BC’s, but the lesson carries over.
The US Community Preventive Services Task Force also found economic evidence that interventions engaging community health workers for diabetes management are cost-effective. This is why the 30% of people at our clinics without a primary care provider matter so much. Connecting them to care is part of the work, not an extra.
Culturally and linguistically tailored support gets better results. An updated Cochrane review of 28 trials found culturally appropriate diabetes education improved blood sugar control (HbA1c) and diabetes knowledge for up to 24 months compared with conventional care. A 2026 meta-analysis for Asian American and Pacific Islander adults found an average HbA1c reduction of 0.39 percentage points, particularly when interventions were culturally and linguistically tailored. A review of lifestyle programs for migrants and ethnic minorities found smaller but still statistically significant gains and described the evidence as promising for culturally appropriate, cost-effective approaches.
Culturally grounded by design
That evidence is why cultural relevance is part of how we build, not an afterthought. Our resources are available in Punjabi, Hindi, Bengali and Urdu, with Mandarin, Cantonese and Indigenous languages in development. Our tools are co-developed with patient advisors and diabetes educators.
A platform that extends the reach
The clinics work alongside our website, t2dnetwork.ca, which draws more than 5,000 visits per month. In the past year it reached 36,196 unique visitors, a 1,369% increase. Someone who meets us at a clinic can keep learning online in their own language, and someone who finds us online can be pointed to a clinic or to care.
What’s next
We plan to expand clinic delivery into rural and remote BC communities, where geography is a major barrier to early detection. We’ll do this in partnership with Indigenous and settlement organizations, and we’ll strengthen navigation support so every person identified at risk has a clear path to follow-up.
Early detection changes outcomes. If you’d like to host a clinic, partner with us, or learn more, visit t2dnetwork.ca.
