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Article ; Online: Diabetes care in the dispersed population of Greenland. A new model based on continued monitoring, analysis and adjustment of initiatives taken.

Pedersen, Michael Lynge

International journal of circumpolar health

2020 Volume 78, Issue sup1, Page(s) 1709257

Abstract: Diabetes used to be a rare condition among Inuit in Greenland. However, research in recent decades has shown a high prevalence of undiagnosed diabetes. Addressing diabetes in the geographically dispersed population of Greenland presents a challenge to ... ...

Abstract	Diabetes used to be a rare condition among Inuit in Greenland. However, research in recent decades has shown a high prevalence of undiagnosed diabetes. Addressing diabetes in the geographically dispersed population of Greenland presents a challenge to the health care system. In 2008, a new model of diabetes care was introduced in Greenland that included continual monitoring, analysis, and adjustment of initiatives taken. The overall aim of this review was to review the feasibility of the monitoring of an ongoing national diabetes care programme. After ten years of observation it was clear that monitoring of such a programme based on information in electronic medical records in Greenland was feasible. It was found that the majority of the population in Greenland was in contact with the health care system. Increased diagnostic activity resulted in an increased prevalence of diagnosed diabetes. The quality of diabetes care in Greenland and the testing effectiveness of gestational diabetes were improved. Microvascular complications were frequently observed among Greenlandic diabetic patients, except for retinopathy that was as an exception. In summary, this model may improve diabetes care and potentially care for other chronic conditions in Greenland, and may also be helpful in other remote settings where chronic disease care is difficult.
MeSH term(s)	Adult ; Aged ; Diabetes Complications/epidemiology ; Diabetes Complications/therapy ; Diabetes Mellitus, Type 2/epidemiology ; Diabetes Mellitus, Type 2/therapy ; Electronic Health Records/statistics & numerical data ; Female ; Glucose Tolerance Test ; Greenland/epidemiology ; Health Services Accessibility/organization & administration ; Health Services Needs and Demand/organization & administration ; Humans ; Patient Acceptance of Health Care/ethnology ; Quality of Health Care ; Social Conditions
Language	English
Publishing date	2020-01-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	1386707-6
ISSN	2242-3982 ; 1239-9736
ISSN (online)	2242-3982
ISSN	1239-9736
DOI	10.1080/22423982.2019.1709257
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Article ; Online: Low prevalence of diagnosed asthma in Greenland - a call for increased focus on diagnosing.

Nielsen, Maja Hykkelbjerg / Backe, Marie Balslev / Pedersen, Michael Lynge

International journal of circumpolar health

2023 Volume 82, Issue 1, Page(s) 2195136

Abstract: The aim of this study was to estimate prevalence of patients with asthma in Greenland according to age, gender and residence and to investigate the associated quality of care. The study was performed as a cross-sectional study with data extracted from ... ...

Abstract	The aim of this study was to estimate prevalence of patients with asthma in Greenland according to age, gender and residence and to investigate the associated quality of care. The study was performed as a cross-sectional study with data extracted from the Greenlandic electronical medical record. A total of 870 patients aged 12 years or above were diagnosed with asthma at the end of 2022, corresponding to a prevalence of 1.9%. In 2020, the total prevalence was 0.2%. The prevalence of patients aged 12 years or above with asthma was highest among patients in Nuuk (3.3%) compared with patients in the remaining parts of Greenland (1.1%). More women than men were diagnosed with asthma, and the prevalence increased with age from 20 to 59 years. The prevalence of current smokers was high among the asthma population. The quality of care was significantly higher among patients living in Nuuk for all process indicators compared with patients from the remaining parts of Greenland. The prevalence of asthma in Greenland is low compared to other comparable populations and might be underestimated. Initiatives supporting increased focus on diagnosing asthma are thus warranted.
MeSH term(s)	Male ; Humans ; Female ; Greenland/epidemiology ; Cross-Sectional Studies ; Prevalence ; Medical Records ; Asthma/diagnosis ; Asthma/epidemiology
Language	English
Publishing date	2023-03-29
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1386707-6
ISSN	2242-3982 ; 1239-9736
ISSN (online)	2242-3982
ISSN	1239-9736
DOI	10.1080/22423982.2023.2195136
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Article ; Online: High burden of symptoms reported among patients diagnosed with chronic obstructive pulmonary disease (COPD) in Greenland after introducing the COPD Assessment Test in clinical practice.

Nielsen, Maja Hykkelbjerg / Lynge, Anna Rask / Pedersen, Michael Lynge

International journal of circumpolar health

2023 Volume 82, Issue 1, Page(s) 2220476

Abstract: The aim was to test the internal consistency of the Greenlandic version of the COPD Assessment Test (CAT) questionnaire and to estimate the symptom burden in patients with chronic obstructive pulmonary disease (COPD) in Greenland using the CAT ... ...

Abstract	The aim was to test the internal consistency of the Greenlandic version of the COPD Assessment Test (CAT) questionnaire and to estimate the symptom burden in patients with chronic obstructive pulmonary disease (COPD) in Greenland using the CAT questionnaire. A Greenlandic version of the CAT questionnaire was developed including forward translation, reconciliation, backwards translation, and pilot test. Afterwards, a cross-sectional study of patients with COPD was conducted. The internal consistency assessed by the Cronbach α coefficient was 0.823 for the Greenlandic version of the questionnaire (
MeSH term(s)	Humans ; Greenland/epidemiology ; Cross-Sectional Studies ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Forced Expiratory Volume ; Smoking/epidemiology ; Surveys and Questionnaires
Language	English
Publishing date	2023-01-17
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1386707-6
ISSN	2242-3982 ; 1239-9736
ISSN (online)	2242-3982
ISSN	1239-9736
DOI	10.1080/22423982.2023.2220476
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Article ; Online: High quality of diabetes care in Greenland since the launch of Steno Diabetes Center Greenland 2020 - geographical disparities need attention.

Backe, Marie Balslev / Jørgensen, Marit Eika / Pedersen, Michael Lynge

International journal of circumpolar health

2023 Volume 82, Issue 1, Page(s) 2290305

Abstract: The aim of this study was to estimate the prevalence of diagnosed diabetes in Greenland and evaluate quality of care according to sex, region and healthcare unit within regions. Data on all inhabitants registered with diabetes were extracted from the ... ...

Abstract	The aim of this study was to estimate the prevalence of diagnosed diabetes in Greenland and evaluate quality of care according to sex, region and healthcare unit within regions. Data on all inhabitants registered with diabetes were extracted from the electronic medical record. We found a crude prevalence of diagnosed diabetes in the population aged ≥ 20 years to be 4.7%, and the prevalence of diabetes standardised to the WHO world population was 4.0%. Compared to males, a significantly higher proportion of females had mean glycated haemoglobin (HbA
MeSH term(s)	Male ; Female ; Humans ; Greenland/epidemiology ; Diabetes Mellitus, Type 2/epidemiology ; Electronic Health Records ; Healthcare Disparities ; Prevalence ; Attention
Language	English
Publishing date	2023-12-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	1386707-6
ISSN	2242-3982 ; 1239-9736
ISSN (online)	2242-3982
ISSN	1239-9736
DOI	10.1080/22423982.2023.2290305
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Article ; Online: Microvascular complications in Nuuk, Greenland, among Greenlanders and non-Greenlanders diagnosed with type 2 diabetes.

Pedersen, Michael Lynge

Diabetes research and clinical practice

2018 Volume 136, Page(s) 1–6

Abstract: Aim: The objective of this study was to estimate and compare between Greenlanders and non-Greenlanders living in Nuuk the proportion of patients with type 2 diabetes with microvascular complications.: Methods: This study was performed as a cross- ... ...

Abstract	Aim: The objective of this study was to estimate and compare between Greenlanders and non-Greenlanders living in Nuuk the proportion of patients with type 2 diabetes with microvascular complications. Methods: This study was performed as a cross-sectional register study based on information in the Electronic Medical Record (EMR). All patients diagnosed with type 2 diabetes and with permanent addresses in Nuuk were included. Patients born in Greenland were considered to be Greenlanders, while patients born outside Greenland were considered as non-Greenlanders. Proportions of patients with retinopathy, microalbuminuria, nephropathy and neuropathy were estimated based on information from the EMR. Results: A total of 393 patients (295 Greenlanders and 98 non-Greenlanders) were included. In total 83.0% of all patients have been screened for retinopathy, while 66.4% were screened for microalbuminuria and 64.6% for neuropathy within a two year period. The most frequent microvascular complication was neuropathy, which was observed among half (49.6%) of all patients followed by microalbuminuria (28.4%), retinopathy (10.7%) and nephropathy (7.3%). Retinopathy was observed among 21.4% of the non-Greenlanders compared to only 7.0% of the Greenlanders (p = .001). Microalbuminuria was also observed more frequently (p = .047) among non-Greenlanders (37.5%) than among Greenlanders (24.9%). Conclusion: Greenlanders seem to be less prone to especially retinopathy than are non-Greenlanders.
MeSH term(s)	Adult ; Aged ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/complications ; Female ; Greenland ; Humans ; Male ; Microvessels/pathology ; Middle Aged
Language	English
Publishing date	2018-02
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	632523-3
ISSN	1872-8227 ; 0168-8227
ISSN (online)	1872-8227
ISSN	0168-8227
DOI	10.1016/j.diabres.2017.11.030
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Article ; Online: Schizophrenia in Greenland.

Jakobsen, Ane Storch / Pedersen, Michael Lynge

Danish medical journal

2021 Volume 68, Issue 2

Abstract: Introduction: The present prevalence of schizophrenia in Greenland is unknown. The aim of this study was to estimate the prevalence of schizophrenia in Nuuk and the rest of Greenland.: Methods: The study was designed as an observational, cross- ... ...

Abstract	Introduction: The present prevalence of schizophrenia in Greenland is unknown. The aim of this study was to estimate the prevalence of schizophrenia in Nuuk and the rest of Greenland. Methods: The study was designed as an observational, cross-sectional study based on statistical extractions and review of medical records for psychiatric patients in Greenland, aiming to determine the prevalence of schizophrenia. Results: The prevalence of schizophrenia was estimated to 1.0% in Nuuk and 0.7% in the rest of Greenland. More males than females were affected (male/female ratio 2.5). Poor socio-economic conditions were revealed for the majority of patients. Cardiovascular risk factors were monitored suboptimally. Conclusions: An increased focus on socio-psychological rehabilitation and monitoring and control of cardiovascular risk factors is warranted. Funding: The study was funded by a grant from The Greenlandic Research Council (Sundhedspuljen). Trial registration: not relevant.
MeSH term(s)	Cross-Sectional Studies ; Female ; Greenland/epidemiology ; Humans ; Male ; Prevalence ; Schizophrenia/epidemiology
Language	English
Publishing date	2021-01-07
Publishing country	Denmark
Document type	Journal Article ; Observational Study
ZDB-ID	2648771-8
ISSN	2245-1919 ; 2245-1919
ISSN (online)	2245-1919
ISSN	2245-1919
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Article ; Online: Burden of selected chronic non-communicable diseases in a primary healthcare setting in Nuuk, Greenland, compared to a Danish suburb.

Backe, Marie Balslev / Kallestrup, Per / Rasmussen, Kurt / Jørgensen, Marit Eika / Pedersen, Michael Lynge

Scandinavian journal of primary health care

2024 , Page(s) 1–7

Abstract: Introduction: Noncommunicable diseases (NCDs) constitute a massive global burden and are the leading cause of death and disability worldwide. In Greenland, the prevalence of NCDs has historically been low. However, during the past approximately 70 years, ...

Abstract	Introduction: Noncommunicable diseases (NCDs) constitute a massive global burden and are the leading cause of death and disability worldwide. In Greenland, the prevalence of NCDs has historically been low. However, during the past approximately 70 years, life circumstances have changed dramatically resulting in increased life expectancy. Today, the proportion of inhabitants in Greenland ≥65 years has nearly tripled since the 1980s, and the prevalence of obesity and diabetes has increased rapidly within the past decades. The aim of this study was to describe the burden of selected NCDs in a primary care setting in Nuuk and compare it to a modern westernized suburban general practice in Denmark. Methods: The study was performed as a cross sectional register-based study using data extracted from the electronic medical records (EMR) based on diagnosis codes from inhabitants living in Nuuk, Greenland, and a suburb in Denmark. Estimates of prevalence were age-standardized to the WHO world standard population. Results: In both Nuuk and the Danish suburb, the highest prevalence was observed for hypertension (13.2% for both populations), followed by asthma (4.4 and 9.5%, respectively) and diabetes (4.3 and 2.9%, respectively). The age-standardized prevalences of diabetes, COPD, atrial fibrillation, and heart failure, were significantly higher in Nuuk, while seven NCDs including asthma, ischemic heart disease, arthritis urica, psoriasis, hyperthyreosis, hypothyreosis and osteoporosis were significantly higher in the Danish suburb. Conclusion: In contrast to the disease pattern observed in Greenland in the last century, the prevalence of diagnosed NCDs in Nuuk is no longer rare. Thus, the overall prevalence of NCDs in the population of Nuuk is now comparable to or even higher than in the suburb in Denmark. This calls for increased focus on all NCDs in the primary healthcare system in Greenland and adaption of the primary healthcare services to a changed disease spectrum.
Language	English
Publishing date	2024-04-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	605763-9
ISSN	1502-7724 ; 0281-3432 ; 0284-6020
ISSN (online)	1502-7724
ISSN	0281-3432 ; 0284-6020
DOI	10.1080/02813432.2024.2334746
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Article ; Online: Living with chronic obstructive pulmonary disease or type 2 diabetes in Greenland - a qualitative interpretive description study.

Nielsen, Maja Hykkelbjerg / Jensen, Annesofie Lunde / Pedersen, Michael Lynge / Seibæk, Lene

International journal of circumpolar health

2023 Volume 83, Issue 1, Page(s) 2296706

Abstract: Non-communicable diseases such as chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (T2D) represent major challenges for health systems all over the world. In an interview study, we explored patient experiences and perspectives of ...

Abstract	Non-communicable diseases such as chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (T2D) represent major challenges for health systems all over the world. In an interview study, we explored patient experiences and perspectives of being diagnosed and living with COPD or T2D in Greenland. Participants (
MeSH term(s)	Humans ; Diabetes Mellitus, Type 2 ; Greenland/epidemiology ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Qualitative Research ; Coping Skills
Language	English
Publishing date	2023-12-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	1386707-6
ISSN	2242-3982 ; 1239-9736
ISSN (online)	2242-3982
ISSN	1239-9736
DOI	10.1080/22423982.2023.2296706
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Article: High awareness of diabetes in the health care system in Greenland measured as a proportion of population tested with glycated haemoglobin within 2 years.

Pedersen, Michael Lynge

Diabetology & metabolic syndrome

2017 Volume 9, Page(s) 30

Abstract: Background: Sixty years ago diabetes was almost non-existent in Greenland and until the beginning of this century awareness of diabetes was quite minimal. A high prevalence of undiagnosed diabetes has been reported in repeated population surveys. ... ...

Abstract	Background: Sixty years ago diabetes was almost non-existent in Greenland and until the beginning of this century awareness of diabetes was quite minimal. A high prevalence of undiagnosed diabetes has been reported in repeated population surveys. Increased focus on diabetes has been made a priority within the health care system since 2008, and in 2010 glycated haemoglobin was introduced as a diagnostic tool to further facilitate the diagnosis of diabetes. Objective: The aim of this study was to estimate the age and gender specific use of glycated haemoglobin in 2014 and 2015, as an indicator of diagnostic activity and awareness of diabetes, and to estimate the prevalence of diagnosed pre-diabetes and diabetes among adults in Greenland aged 20-79 years of age. Methods: The study was performed as an observational, cross sectional register study based on information gleaned from the electronically laboratory system used in Greenland including all patients tested with glycated haemoglobin at least once in 2014 or 2015. Results: A total of 10,127 patients were tested with glycated haemoglobin in 2014 or 2015 corresponding to 18.1% of the whole population. Among adults aged 20-79 years 9506 patients were tested corresponding to 24.0% of the total adult population. More females (32.5%) than males (16.5%) aged 20-79 years old were tested (p < 0.001). The prevalence of diagnosed diabetes and high risk pre-diabetes among adults aged 20-79 years was 4.3 and 6.8% respectively. Conclusion: In conclusion use of glycated haemoglobin is widely used in the health care system in Greenland indicating a high awareness of diabetes in the population and by the health care system. Still, awareness of undiagnosed diabetes remains an important issue and additional strategies targeting males under 70 years old must be considered.
Language	English
Publishing date	2017-05-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2518786-7
ISSN	1758-5996
ISSN	1758-5996
DOI	10.1186/s13098-017-0230-4
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Article ; Online: Prevalence of patients using antihypertensive medication in Greenland, and an assessment of the importance of diagnosis for the associated quality of care - a cross-sectional study.

Nielsen, Maja Hykkelbjerg / Backe, Marie Balslev / Pedersen, Michael Lynge

International journal of circumpolar health

2022 Volume 81, Issue 1, Page(s) 2110675

Abstract: This study aimed to estimate the age- and sex specific prevalence of patients using antihypertensive medication in Greenland, and compared the quality of care between patients with and without a diagnosis for hypertension. The study was a cross-sectional ...

Abstract	This study aimed to estimate the age- and sex specific prevalence of patients using antihypertensive medication in Greenland, and compared the quality of care between patients with and without a diagnosis for hypertension. The study was a cross-sectional study comparing patients using antihypertensive medication in 2020 (6,629 patients) and 2021 (7,008 patients), respectively. For data from 2021, patients with a medical diagnosis code were identified. Data was obtained from the Greenlandic electronic medical record. The population of Greenland was used as background population. Quality of care was evaluated based on suggested indicators by international guidelines and goals from Steno Diabetes Centre Greenland. The prevalence of patients aged ≥20 years using antihypertensive medication had increased from 16.7% in 2020 to 17.5% in 2021. The prevalence increased by age and was higher among women compared to men. In 2021, the prevalence of patients aged ≥20 years with a medical diagnosis code for hypertension was 7.9%. The use of antihypertensive medication in Greenland is common. The associated quality of care was low. However, process indicators were significantly improved when patients had a medical diagnosis code. Future focus must be on initiating initiatives ensuring that more patients are registered with a medical diagnosis code.
MeSH term(s)	Antihypertensive Agents/therapeutic use ; Cross-Sectional Studies ; Female ; Greenland/epidemiology ; Humans ; Hypertension/diagnosis ; Hypertension/drug therapy ; Hypertension/epidemiology ; Male ; Prevalence
Chemical Substances	Antihypertensive Agents
Language	English
Publishing date	2022-09-14
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1386707-6
ISSN	2242-3982 ; 1239-9736
ISSN (online)	2242-3982
ISSN	1239-9736
DOI	10.1080/22423982.2022.2110675
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