On 1 October, locals and visitors gathered in the Greenlandic capital Nuuk to celebrate the official opening of a new building. The building houses Steno Diabetes Center Greenland, a state-of-the-art outpatient centre and knowledge-sharing hub with the ambitious goal of improving the quality of life of every person in the country with diabetes and related lifestyle-associated diseases.
The building houses an outpatient clinic where patients can have routine consultations, meet with a physiotherapist or dietician, or get eye and foot examinations. There are also research facilities, meeting rooms, and an exercise room.
Many of the people who joined the celebrations on 1 October are already patients at Steno Greenland – that’s because the centre has been running since 2020, using existing healthcare facilities to treat and educate patients, train healthcare professionals, and carry out research.
This year alone, the centre is providing treatment and care for around 9,500 people – around 17% of the country’s population – up from 6,600 in the year it opened.
Now, with a 2,500 square meter building designed for Steno Greenland’s unique needs, the work can be expanded, enabling the centre to become an even stronger force in preventing and treating chronic disease, with ripple effects across Greenland’s health system and wider community.
An obligation to be more open
Marit Eika Jørgensen, Chief Medical Officer at Steno Diabetes Center Greenland, is delighted that the centre’s researchers and clinicians will now be working under the same roof.
“Simply being together physically means that findings from research can much more easily be implemented in the clinic, and vice versa – some of the important clinical questions coming up are more easily transferred to research questions.”
She’s also excited about the community activities made possible by the building, such as a lifestyle café where people can come and have their blood pressure or blood sugar measured and get information about lifestyle-associated diseases.
“I think the building will give us an opportunity, and I think also an obligation, to be more open towards the surrounding society,” explains Jørgensen.
Challenges in diagnosis and treatment
The centre is one of seven Steno Diabetes Centers across Denmark, Greenland and the Faroe Islands, all funded by the Novo Nordisk Foundation. They aim to provide world-class care and generate new knowledge and innovative ways to prevent, detect and treat diabetes, with differences in focus and operation depending on each region’s needs. The centre in Greenland is the result of a long-term collaboration between the Government of Greenland and the Foundation.
Similar to many other parts of the world, the number of people in Greenland with diabetes and related lifestyle diseases such as chronic lung disease (COPD) and hypertension is rising rapidly – many of them undiagnosed and many of them with more than one condition. The problem is particularly severe in Greenland, partly due to the genetic predisposition of the native population to develop type 2 diabetes.
There are also significant challenges when it comes to diagnosis and treatment. Frequent bad weather and a lack of transport links make it difficult for many people outside Nuuk to access healthcare. This is compounded by the long-term challenge of recruiting and retaining healthcare professionals in Greenland.
Increasing access to care
The challenges remain huge, but Steno Greenland is making inroads.
Tina Amondsen, Director of the Greenlandic Health Service, welcomes the focus the centre has brought to the prevention and management of chronic diseases.
“That focus has lifted the quality of the treatment,” she explains. “And having a strong force like the Steno Diabetes Center is also raising awareness about these diseases, which is good for everybody.”
She is particularly inspired by the centre’s telemedicine initiatives that are making care available to people living far from Nuuk and the other large towns.
For example, a new app called Puisa enables patients to have initial consultations or routine appointments with a healthcare professional via a secure online connection.
A second telemedicine initiative focuses on eye screenings that are used to detect diabetic retinopathy (DR), a late complication of diabetes responsible for around 80% of vision loss in persons with diabetes worldwide.
Until recently, there were just nine cameras in Greenland that could screen for DR, with patients often travelling for days to reach one for a routine eye examination. As a solution, the centre purchased three much smaller cameras that are easy to transport and operate, allowing care to be taken much closer to the patients and saving significantly on travel time and costs.
A boost for research and training
Steno Greenland is also boosting local research. In 2020, the country had one senior scientist doing part-time research in diabetes – now there’s an active and growing research environment focused on generating the knowledge and tools needed to meet the country’s specific needs.
“Until now, research has to a large extent been something that took place in Denmark,” explains Jørgensen. “Researchers were sent to Greenland, collecting data and bringing it back to Denmark. But with a centre like this, we actually have a fair chance to be part of building a local research environment, with better facilities for storing data in Greenland, freezers for biological samples and so on.”
The effects of all these interventions are already spilling over into the rest of the healthcare system. For example, healthcare workers in areas such as paediatrics are also using Puisa for remote consultations.
Nurses and health workers across the country are also benefitting from the centre’s educational programmes. To date, around 400 have received training to ensure they have up-to-date knowledge about diabetes and related conditions.
In the coming years, the centre will expand current initiatives and launch new ones. More patients will be able to access video consultations, and training for healthcare professionals will continue.
Jørgensen also hopes Steno Greenland will inspire other similar initiatives, for example for heart disease or osteoporosis.
“Hopefully we can inspire other parts of the healthcare system with this model for delivering chronic care,” she says.
Further information
Novo Nordisk Foundation, Judith Vonberg, Communications Manager, +45 4172 7925, jvo@novo.dk
Photo: Jytte Lindskov Jacobsen, nurse at Steno Diabetes Center Greenland (right) talks with Karen Naamansen, a patient at the centre