Management for Type 2 Diabetes Mellitus (T2DM) is connected with urbanization because 2/3 of T2DM-patients live in towns, that is reflected in the term «urban diabetes». The T2DM-onset and T2DM-progression are depended not only on complex interaction of modified and non-modified risk factors, but also and sociodemographic determinants (and its modification at municipal level allowed to neutralize the unfavorable risk factors of T2DM&obesity. The urban non-rational food, disturbance of circadian rhythm, low T2DM-pths compliance stimulate onset of obesity, deterioration of glycemic control, high postprandial hyperglycemia, glucolipotoxicity, epigenetic changes and negative metabolic memory. Meanwhile the city politics may affect to the non-modified T2DM-risk factors at carrying the municipal policy directed to the rational catering, mass sports, organization of recreational zones, decrease of excessive urban traffic, improvement of ecology. The paper considers the features of migration to urban, religious fasting, COVID at the urban T2DM. The «urban diabetes» must be considered at therapeutic education and affected to form the active T2DM-pts-management.