Annual Report

Steno DiabeteS Center

AnnuAl report 2011

3

From the Director4

Education26

Clinical Activities10

Outreach and Consultation Activities 30

Biomedical Research14

Administration34

Health Promotion Center20

Awards, Dissertations, Publications40

Table of contents

Table of contents

From the Director

From the Director

5

By John J. Nolan

6

The past year has been a period of strategic

transition and development for Steno. The

organization is focused around the activities of the

four centers who are working closely together on

translational research, treatment, and prevention:

Patient Care, Research, Health Promotion, and

Education. This configuration allows Steno to

focus on the complete spectrum of diabetes from

earliest risk through to long-standing diabetes

with complications, while ensuring that results are

directly implemented to improve patient care and

management as well as targeting new approaches

to disease prevention.

An important milestone in 2011 was the development

and launch of the Steno 2020 Aspiration Strategy.

The strategy actively contributes to the fulfilment

of Steno’s vision which is characterised by Superior

quality of care, Full-cycle care and prevention,

Global presence and recognition, and People and

organisational development. These cornerstones

anchor our overall focus, while also ensuring that

we are creating an inspiring, productive work

environment.

In late 2011, the EU Seventh Framework Programme

(FP7) awarded Steno Diabetes Center with two

major research consortium grants totalling 11

million Euros. The grants (DEXLIFE and PRIORITY)

will run over the next 3-5 years and involve a wide

range of European partners. This was an important

milestone for research at Steno. Each project is

focused on prevention (prevention of progression

to type 2 diabetes; prevention of progression

of the earliest stages of renal complications of

diabetes) directly in line with our strategic focus.

The coming year will not be without challenges,

but we will strive to maintain our status as a world-

leader within diabetes treatment and prevention

and aim to strengthen further our national and

international partnerships and collaborations.

I would like to extend my appreciation to all the

staff at Steno, to our collaborating partners, to

the Steno Management team, and to our Board of

Directors for their support. Finally, I would also

like to extend my thanks to our Patient Panel and

to all the patients at Steno who have been and will

continue to be the focus of our efforts and goals

for the future.

From the Director

John J. NolanJohn J. Nolan, MD FRCPI FRCP(Ed)

Director and CEO

From the Director

7

From the Director

aspiration strategy 2020

Superior quality of care

We will excel in clinical care

through our clinics, the use

of modern technologies, and

improved methods for patient

education.

Global presence and recognition

We will extend Steno’s

educational message through

local Steno hubs in high-

prevalence countries, as well as

through web-based approaches

and through international

research partnerships.

Full-cycle care and prevention

We will develop solutions for both

care and prevention of diabetes

through research in health

promotion, understanding of early

disease, complications and novel

approaches to clinical care.

People and organisational development

We will develop Steno’s

organisation through leadership,

attraction and retention of talent

and a culture marked by the joy of

high performance.

Clinical Activities

Clinical Activities

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10

The Patient Care Center at Steno was established

in 1932 and was dedicated to the treatment of

patients with diabetes and to investigate and gain

knowledge on diabetes treatment. This is still the

case and Steno has developed into a large out-

patient clinic with expert knowledge on diabetes

patient management and care.

The patient base is primarily from the Capital

region of Copenhagen (90%). The center serves as

an integrated part of the public health care system

and is under contract with the Capital region. The

remaining 10% of patients seen at the center are

referred from other regions of Denmark.

The clinical staff of 90 in the center includes

doctors, nurses, dieticians, secretaries, podiatrists,

and lab technicians. The clinical services

offered include eye screening, which is closely

linked with the Capital Regions Department of

Ophthalmology, and a podiatry services including

an external orthopedic consultant. These expertise

areas, together with dieticians and lab technicians,

ensure optimal treatment and consultation for all

patient management issues.

Patient care at Steno includes both type 1 and

type 2 diabetes patients. Type 1 patients are

followed lifelong at Steno. Patients with type 2

diabetes are referred from general practitioners

for work-up including screening for complications,

diabetes education, and optimizing of the medical

treatment. This usually lasts from 6–8 months and

if the treatment goals are met, the patients are

referred to their own doctor.

A unique feature at the Patient Care Center

is that they have been on the forefront for

implementing electronic medical records

for patients and have over 10 years of data

collected.

Clinical activities

Clinical Activities

Fig. 1 - Patient population at Steno

In 2011, Steno had around 6000 patients in total and of

these, 740 were new patients.

Type 1 diabetes Type 2 diabetes

3600

2200

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Clinical Activities

Fig. 2 - Outpatients at Steno

Steno Diabetes Center has team-based patient care where patients can receive care of feet and eyes, get dietary advice,

and a general check-up in one visit. Steno conducts over 20.000 outpatient visits a year including.

Table 1 - Steno’s performance over the last 3 years

In order to ensure a high quality of patient treatment and management, Steno uses the

National Committee of Quality Assurance (NCQA) system. The below table outlines

Steno’s performance over the last 3 years and compared to the NCQA standard.

NCQA Standard 2009 2010 2011

HbA1c > 9,0 % ≤ 15% 20,8 21,1 22,2 21,6 20,8 19,9

HbA1c < 7,0 % > 40% 14,3 23,9 14,2 23,9 15,5 25,4

HbA1c < 8,0 % > 60% 46,3 54,3 45,5 55,3 49,0 56,7

BP > 140/90 ≤ 35% 7,9 9,1 6,6 8,4 7,2 8,5

BP < 130/80 > 25% 29,2 28,5 29,5 26,0 30,4 25,5

Eyes screenings > 60% 69,9 74,1 67,1 68,7 66,0 68,4

Smoking status assessed > 80% 46,9 50,3 52,2 53,9 93,7 93,1

LDL chol > 3,3 mmol/l ≤ 37% 10,2 6,8 13,6 8,6 15,3 9,4

LDL chol < 2,6 mmol/l > 36% 64,2 80,9 57,8 74,0 52,1 73,2

Renal assessment > 80% 90,9 96,0 91,3 95,2 91,9 96,5

Feet examined > 80% 68,4 71,7 80,0 83,3 84,2 85,7

Type 1 diabetes

Type 2 diabetes

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Fig. 3 - Standard of Accrediation

The activity in the biochemistry department totaled 360,000 paragraphs. The graph contains an overview of the analysis

performed in 2011, including the consulting activity provided by the lab.

The Patient Care Center includes a Clinical

Biochemical and Physiology Lab which provides

biochemistry service to the outpatient clinic

as well as diabetes relevant clinical physiology

investigations.

The lab is accredited under the Danish DANAK

organization (Standard of Accrediation: DS/

EN ISO 15189:2008) and the iLAC (International

quality example).

As an integrated part of the lab, lab technicians train

patients in using blood glucose measurements.

Patients can also have their devices checked as

well as to take their own blood pressure at home

with standardized equipment from the lab.

Clinical biochemical and

Physiology Lab

Clinical Activities

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Table 2 - Active projects in 2011

Patients seen in the outpatient clinic are also offered participation in various clinical research projects.

The active projects in 2011 included:.

The research run directly by the staff of the

outpatient clinic is closely related to improvement

of treatment quality. In 2010 and 2011 these

projects focused on ways and methods of reducing

HbA1c among patients with HbA1c above 75

mmol/mol (9 %). Additionally, staff from the clinic

are collaborating on other projects addressing

education and treatment of type 2 diabetes and

research aiming to optimize the use of social

networks for patients with type 1 diabetes.

research in the

Patient Care Center

Clinical Activities

Title Number of patients enrolled

Improvement of poorly controlled diabetes in younger adults through Guided Self Determination

200

Does use of periodical Continous Glucose Measurement (CGM) improve HbA1c in pooly regulated type1 diabetes patients (Adult and Adolescent)

160 Adult

20 Adolescent

Improvement of blood glucose control in patient with foot ulcers 60

Biomedical Research

Biomedical Research

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A. Complications Research group

It is our ambition that diabetic patients will live

longer lives without complications. Over the past

year, the group has worked to combine our interest

in new biomarkers for early detection of diabetic

complications, such as renal and cardiovascular

complications, with our experience in preventing

and treating diabetic renal disease.

Together with an international collaboration of

15 European partners, the group has developed

a study where patients with an elevated risk for

future renal disease are identified with a new

urinary proteomic analysis, developed by one of

the partners, and are randomized to aldosterone

blockade or placebo in addition to usual treatment.

The study, called PRIORITY (eu-priority.org) was

funded by the European Commission in December

2011 and will be coordinated by Steno.

Studies with biomarkers such as vitamin D and

uric acid have suggested that these markers are

also of relevance and may provide new targets for

optimized treatment which the group is exploring

further in current and future studies. Although one

single marker may provide insight into disease

pathophysiology, the combination of many

markers may provide even better information for

greater understanding and prognostic impact.

The group is also partnering on another EU-

funded project, SYSKID (Systems Biology in

Kidney disease). The objective of this project is to

study different new techniques for measurement

of genetic and non-genetic markers and see if

combining them provides an overview of the

mechanisms leading to chronic kidney diseases,

the dominating cause of renal failure in the

Western world.

Even the right clinical treatment will not work

if patients are not taking their medication.

Therefore, in collaboration with the epidemiology

group and the Health Promotion Center at Steno,

the complications group is trying to unravel the

challenges related to improving patient adherence.

biomedical research

Biomedical Research

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B. Epidemiology Research

The main achievement for the Epidemiology

group in 2011 was the conclusion of the clinical

examinations in the ADDITION-PRO study. This

study follows participants who were found to

have elevated diabetes risk or impaired glucose

regulation between 2001 and 2006. The follow-

up examination allowed us to assess how many

had progressed to diabetes in the meantime, and

what their diabetes and cardiovascular risk status

was. Between 2009 and 2011, 2143 participants

were seen at Steno and in 3 different centres in

Jutland. There are four ongoing PhD projects

based on ADDITION-PRO, focusing on central fat

distribution, arterial stiffness, physical activity and

proteomics.

A second research line in the Epidemiology group

is register-based research. A clear highlight in this

area in 2011 was the publication in Diabetologia

of a paper describing the occurrence of different

types of cancer among patients with diabetes

according to their insulin use status. This study was

based on linkage of the Danish diabetes register

and the Danish cancer register and showed that

the association between insulin use and cancer

is strongest at the point of therapy initiation and

tapers off in the subsequent years. The project

continues and will look more precisely into dosage

and insulin subtypes.

The group worked in close collaboration with Novo

Nordisk and the Steno Patient Care Center on the

Biomedical Research

Priority Study - European Commission in December 2011 at Steno Diabetes Center

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Diabetes World Tour project, which evaluated

the occurrence of undiagnosed diabetes and

undetected cardiovascular risk and retinopathy

among over 8,000 individuals in the United Arab

Emirates, Saudi Arabia, Algeria, and Portugal.

In 2011 the Epidemiology group contributed to 50

publications, with 7 of those in journals with an

impact factor greater than 7. Fifteen of the articles

included a group member as first or last author.

Group members taught different audiences,

ranging from undergraduate students in Denmark

to diabetologists in India. Teaching occurred at 16

sites in 6 countries. The group supervised ongoing

projects from 8 Masters and PhD students. There

were 28 poster and oral presentations at 16

conferences and meetings.

C. Clinical Research

The vision for the Clinical Research Unit (CRU)

is to facilitate collaboration between internal

research groups at Steno and external research

collaborators. We strive to create and maintain

an infrastructure based on superior quality

and efficiency – in patient care, in our working

environment, and in research data collection and

analysis. Our ultimate goal is to promote and

expand the expertise around patient oriented

clinical research at Steno Diabetes Center and in

Denmark.

Our collaborators include Danish and International

diabetes researchers, 14 pharmaceutical industries,

Good Clinical Practice units at the surrounding

Universities, several national and international

Clinical Research Organisations (CROs), and

external laboratories and pharmacies.

Fig. 4 - Patient population at Steno

Our activities are divided into three areas: Investigator

initiated intervention studies, Pharmaceutical initiated

intervention studies, and observational studies. We have

the expertise in-house to coordinate every aspect of

single and multi-center trials from concept development

to protocol design, execution, close-out, and data

analysis.

Biomedical Research

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The realm of studies executed include all

aspects of diabetes treatment and prevention

with focus areas such as: Treatment of

glycaemia in type 1 and type 2 diabetes;

Understanding and preventing hypoglycaemia;

Cardiovascular disease and risk factors;

Neuropathy; and, Obstructive sleep apnea.

Our next steps, together with the Patient Care

Center and Steno researchers, will take us further

into exploring the interaction between artery

and bone mineralisation and the major challenge

of obstructive sleep apnea, which seems to be

present in every third patient with type 2 diabetes

referred to Steno Diabetes Center.

The Clinical Research Unit at Steno is consists of 3 medical doctors, 6 nurses, 6 lab technicians, and 2 study coordinators.

Biomedical Research

Health Promotion Center


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Steno Health Promotion Center, launched in

June 2009, has three overall focus areas: Patient

education, prevention, and health promotion.

The center aims at establishing cross-disciplinary

cooperation with partners at Steno as well as with

external institutions in Denmark and abroad. The

focus is on research with a potential to influence

“real life” practices.

Research at the Steno Health Promotion

Center is based on five principles:

1. ACTIvE INvOLvEMENT of the target group

as a basis for development of ownership and

sustainable health promoting change

2. A POSITIvE AND BROAD CONCEPT OF

HEALTH, which focuses on the person as a

whole instead of just the disease

3. Development of people’s COMPETENCE TO

TAKE ACTION and control their own life as

well as their living conditions

4. Acknowledging the CONTEXT IN WHICH

PEOPLE LIvE and to include this in the

intervention carried out

5. INCREASING EQUITY in health by paying

attention also to the least resourceful

members of the community

During 2011 more than 15 different projects have

been initiated. Due to this increase of activity

and substantial external funding during 2011, the

number of overall staff is now at 35, covering a

broad range of academic fields such as public

health, anthropology, psychology, pedagogy,

social science and design.



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A. Health Promotion

Research regarding this focus area included

the following activities in 2011:

• Pre-diabetes – prevention among people at

risk

• Gestational diabetes

• Schools and families as health promoters

The research field of pre-diabetes is focused on

finding real-life diet and exercise interventions

to prevent type 2 diabetes. In collaboration

with colleagues at University of Aarhus, Steno

conducted a pilot project among general

practitioners in Denmark. The results identified

a number of limitations to this approach which

will allow us to explore alternative approaches in

settings such as municipality prevention centers

and local communities.

Steno plays an active role in the World Diabetes

Foundation funded vida Nueva project on

gestational diabetes in Barranquilla, Colombia.

Collaborating together with local health authorities

and three local universities, along with the HJELT

Institute at the University of Finland, the project

aims to detect and manage gestational diabetes

and develop compatible research projects.

The health promotion projects on young

people, families and schools are centered

around the following approaches:

1. use of innovative technologies and aesthetic

learning processes;

2. use of cultural meetings

3. collaboration between schools and

communities

Project ”PULSE”

In 2011, the Novo Nordisk Foundation funded a

new collaborative project between Steno and

the Experimentarium museum in Copenhagen.

The project, called PULSE, focuses on family

interaction and education as a key component

for improved health. The activities will focus on

children and young people as being the catalyst

for change in the family and community at large.

The project collaborators include Kenyatta

University, Roskilde University Center, and the

Municipalities of Copenhagen and Gentofte,

as well as the University of Southern Denmark

and University of Copenhagen.


Innovative health promotion exhibitions engaging families:

A cross-disciplinary development and research project

PULSE

A pulse is rhythmical, a beat of the heart, a movement. PULSE is an innovative research-based exhibition concept combining state-of-the-art exhibition methodologies and health promotion. The name PULSE reflects the exhibition’s goals of learning, fun and improving health.

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B. Patient Education

Research on patient preferences, psychosocial

health, social network, social support and

diabetes related behaviors inform all other areas

of research for patient education. The focus in

2011 has been on participation, dialogue and the

development of competences among diabetes

patients. Research has also been conducted on the

learning processes, theories and methods among

health care professionals engaged in participatory

patient education.

In 2011 the Patient Education research

activities included:

• Survey on patients’ preferences, social

network, activation and perceptions of

perceived care

• Development of health educational

interventions in the Type 2 Clinic at the Steno

Patient Care Center

• Use of innovative and participatory methods

in consultations concerning medical

compliance among type 2 patients with poor

glycemic control

• Psychosocial health and diabetes

• Educational activities for HCPs, policy makers,

decision makers and others working within

the field of diabetes

NEXT STEPS: During 2012 the focus will be to

test and further revise the tools developed for

participatory patient education and to establish

and consolidate the research area of psycho-

social dimensions of diabetes.


Tools for patient education

Tools developed in 2011 for implementation in clinical settings, available online at www.steno.dk

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C. Prevention

In 2011 research in prevention included the

following areas:

• Work place and work force health promotion

• Supersettings as a new prevention approach

in local communities

In the area of workplace one focus point has

been on a literature review, exploring the main

literature for the last 30 years with a specific focus

on technology and health promotion, behavior

approaches and leadership and health promotion.

The review was one of the cornerstones in

the international seminar “Workplace Health

Promotion – do we need an upgrade” organized

in collaboration with the National Research

Centre for the Working Environment. One of

the outcomes of this seminar was to establish an

international workforce health promotion research

network which is a collaboration between Steno,

the National Research Centre for the Working

Environment, and Copenhagen Business School.

Steno is also collaborating with selected

communities in developing new and innovative

solutions that are referred to as supersetting-

approaches. A supersetting implies broad, cross-

sectoral collaboration and ownership as well as

long-term commitment, context-sensitivity, and

evidence-based decision making.

This approach received external funding from

the Nordea Foundation for implementation on

the Danish island of Bornholm. The objective of

the 4-year project will be to facilitate a healthy

life among families with small children through

a synergetic partnership between media (Tv2

Bornholm), local supermarkets, schools, and

daycares. The project is a collaboration with the

Capital Region’s Research Centre for Health and

Prevention, the research group MENU at Aalborg

University, the municipality of Bornholm, local

NGO’s and Steno.

During 2012 the focus for the group will be to

develop and test the intervention approach within

the Bornholm supersetting project and to initiate

similar projects in two other Danish municipalities

(Odsherred and vejle).


Education

Education

27

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Through education of endocrinologists, diabetes

teams, and other health care professionals (HCP)

Steno Education Center is disseminating the

clinical competencies, front-line research results,

and patient focused treatment and care practices

from Steno.

Performed through state-of-the-art knowledge

sharing at seminars, symposiums, and workshops,

the teaching faculty is a multidisciplinary diabetes

team from Steno Diabetes Center, ensuring that

all key core competencies necessary for optimal

treatment of diabetes are covered.

Steno Education Center conducts educational

programs on:

• Team based diabetes management drawing

on Steno Diabetes Center’s expertise and

experience

• Updates and symposiums on diabetes

management and frontline diabetes research

• Nurse-led practical diabetes course for HCP

• Clinical quality assurance programs for

diabetes clinics using the unique Steno

Quality Assurance Tool (SQAT)

Activities in 2011 included:

International courses:

• Frontiers symposium in Copenhagen (170

participants).

• Eight Steno training and Application of

resources (STAR) courses for education

in developing countries. The courses were

held in China, India, and Instanbul (600

participants).

• A newly-developed course in quality

assurance of clinical data in diabetes was held

in India (60 participants).

• Two international courses in Practical

Diabetology hosted in Denmark (100

participants).

• One international course on nursing in the

near east (80 participants).

National courses:

• A course for general practitioners held

in collaboration with the Danish medical

association

• Two nurse-led courses in collaboration with

the University College of Sjælland.

• Several nurse courses for Danish nurses in

primary health care.

NEXT STEPS: The future focus areas for the Steno

Education Center will be building international

HUBs for teaching locally, developing e-learning

programs to ease accessibility, as well as continuing

our collaboration with local partners on quality

assurance of clinical care to enhance patient care

and management of diabetes globally.

Education

education

Outreach and Consultation Activities


31

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outreach and Consultation activities

Activities in 2011 Responsible

The Danish Society for Endocriniology, Chairman Peter Rossing, MD, DMSc

Danish National Indicator Project, Chairman Peter Rossing, MD, DMSc

Advisory Board on Health Promotion, Danish Prevention Foundation Bjarne Bruun Jensen, PhD

Danish Guidelines for Treatment of Type II Diabetes, Member Peter Rossing, MD, DMSc

World Health Organization, Development of “Health 2020,” Advisor Bjarne Bruun Jensen, PhD

University College Metropol, Copenhagen, Board of Directors Bjarne Bruun Jensen, PhD

Capital Region Advisory Board for Diabetes, Member Thomas Almdal, MD, DMSc

Capital Region advisory Board for Endocrinology, Member Thomas Almdal, MD, DMSc

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Steno Symposium May 2011

160 doctors from 26 countries attended the

Steno Symposium from 25th-27th of May 2011,

which focused on the latest research within early

detection, prevention, and treatment of diabetes

complications.

The symposium, which ran over 2 days, had a

program focusing on clinical research that can

be easily applied in daily practice. The theme

throughout the program was prevention and

detection of complications, as early as possible,

with the use of existing and new methods.

EUPHA meeting with Copenhagen School of

Global Health

On 10 November Steno Health Promotion Center

and Copenhagen School of Global Health,

University of Copenhagen, hosted a pre-conference

session in connection with the European Public

Health Conference (EUPHA). The themes focused

on the social determinants influencing prevention

and control of non-communicable diseases and

the research needed to support these.

Participation and dialogue in patient

education

On 29th November, Steno Health Promotion Center

and the Danish Association for Nurses hosted

a conference focused on patient education and

communication around chronic diseases such as

diabetes. More than 300 researchers and other

health professionals attended the conference

in Copenhagen to share knowledge and best

practices on ways to improve participation and

dialogue in patient education.

Theatre and Health Promotion among

Children

A two-day international symposium on “Theatre

as a Setting for Health Promotion among Children”

was hosted by Steno in December 2011. The

symposium brought together 30 researchers and

practitioners in order to explore the potential of

this new field and to plan for future collaboration.


Administration

Administration

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36

Funding

In 2011, Steno Diabetes Center’s total funding

was DKK 176 million (EUR 23.7 million) stemming

from three major sources: The Capital Region

of Copenhagen, The Novo Nordisk Foundation,

and Novo Nordisk A/S. The majority of funding

from these three sources is governed by fixed

contracts ensuring the operation of patient care,

educational activities, research activities, as well

as administrative support functions.

Focus on Quality

Quality is a key focus area at Steno and as a

consequence we highly prioritise developing and

anchoring our Quality Management System. We

are committed to continuously measure, evaluate

and adjust our performance in our ambition to

meet the highest standards. This not only relates

to meeting end-points in standards for diabetes

care but that quality is part of everything we do.

As recognition of our efforts, we are proud

to announce that in November 2011, we were

awarded an accreditation according to the Danish

Health Care Quality Programme (DDKM) by IKAS.

administration

Fig. 5 - External funding 2011

Steno has been extremely successful in 2011 to attract

external funding to support research activities. This

funding has been obtained from public and private

grant awards based on applications for research

projects and network and collaborations.

Administration

37

Administration

Grant Title Role Duration

EU FP7DEXLIFE Mechanisms of prevention of type 2 diabe-tes by lifestyle intervention in subjects with pre-dia-betes of at high-risk for progression,

Coordinator 2012-2015

EU FP7

PRIORITY Proteomic prediction and Renin angioten-sin aldosterone system Inhibition prevention Of early diabetic nephRopathy In TYpe 2 diabetic patients with normoalbuminuria,

Coordinator 2012-2017

EU FP7SysKID, Cellular and molecular mechanisms of the development of chronic kidney disease,

Partner 2009-2014

The Danish Government (Southern Region)

Developing methods for patient education across diagnosis and in development of competence of health professionals,

Principal

Investigator2010-2012

The Danish Ministry of Health

Self-management and care for young adults with poorly regulated type 1 diabetes,

Principal


Danish Heart Association

Researching methods for communicating healthy lifestyles to children and adults,

Principal

Investigator2010-11

Danish Heart Association

Researching insights on young people’s understand-ing of health and risk factors,

Principal

Investigator2010-11

The City of Copenhagen

Evaluation of the city’s prevention efforts focused on the health of over-weight children,

Principal


Lundbeck Foundation

LUCAMP, Centre for Applied Medical Genomics in personalised disease prediction, prevention and care,

Partner 2009-2013

Novo Nordisk Foundation

PULSE: ”Innovative health promotion exhibitions engaging families: A cross-disciplinary development and research project,”

Partner 2012-2016

Nordea Foundation Supersetting project, Bornholm Coordinator 2011-2015

Table 3 - Major foundings sources 2011

Overview of major funding sources and type of projects at Steno in 2011:

38

People

Steno Diabetes Center currently has 272

employees, of which 57 (21%) are externally

affiliated. There was an overall growth in 2011 of

7,5% (within all employee groups) and this was

generally attributed to expanding the qualitative

research areas and the introduction of new core

functions.

Steno Diabetes Center is a stable organization with

very low employee turnover (average unwanted

separation equals 0,8% of average permanent

staff) and a high degree of employee engagement.

In 2011, the average score on the annual employee

satisfaction survey (evoice) was 4,23 on a five-

point scale, which indicates a strong commitment.

A large number of employees join Steno on a

limited-time basis, typically to write PhD theses or

for clinical or project rotations. To a large extent,

this employee group has been and will continue to

be a talent pipeline for Steno.

Administration

Fig 6 - Headcount 2011, by contract type

Awards, Dissertations, Publications


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42

Awards

Steno ranked as 39th best research institution

in the world

Steno Diabetes Center was ranked as the 39th

best research institution in the world and the

second best in Denmark by the world-renowned

Scimago Institutions Rankings (SIR). The report,

made public in December 2011, is the most

comprehensive ranking of research institutions.

It covers institutions with more than 100

publications and includes in total 3042 institutions

that together are responsible for more than 80%

of worldwide scientific output. The Excellence

Rate indicates which percentage of an institution’s

scientific output is included into the set formed by

the 10% of the most cited papers in their respective

scientific fields. The ranking documents the high

quality of research performed at Steno.

awards, Dissertations,

Publications


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PhD theses

1. Louise Lundby Christensen, MD: Carotid

intima-media thickness in type 2 diabetes –

metholdological considerations and effects of

interventions. University of Copenhagen, June

2011.

2. Kasper Ascanius Pilgaard, MD: Developmental

Programming of Type 2 Diabetes. Novel

Epidemiological and Mechanistic Insights

from Danish cohort Studies. University of

Copenhagen, June 2011.

3. Martin Friedrichsen: Is insulin resistance

related to molecular events in skeletal muscle?

– Integrative analyses of insulin signaling and

inflammation. University of Copenhagen,

June 2011. Professor Jørn Nerup, DMSc, Steno

Diabetes Center, Gentofte, Denmark. 2011

4. Bruselius-Jensen, M. The poetic perspective

of school lunches—the possibility of involving

children in school meals. Roskilde University.

Master’s Degree Dissertations

1. Maiken Bang Hansen: Causes of Death among

Diabetes Patients. University of Copenhagen.

2. Stine Byberg: Sleep Duration and Markers

of Glucose Homeostasis. University of

Copenhagen.

3. Stine Kolind Krogsgaard. Repeatability

and reproducibility of two measurements

of arterial stiffness: Pulse wave velocity

and augmentation index. University of

Copenhagen.


For the second year in a row, a researcher at Steno won the best poster award

at the 47th eaSD (european association for the Study of Diabetes) annual

Meeting in Lisbon, 12-16 September 2011. the poster, by ingrid Wallaing, was

entitled ”Patients with type 2 diabetes prefer education based on participa-

tion and development of competences over information”.

“BEST POSTER AWARD” AT EASD

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Publications

Steno published over 80 peer-reviewed articles in

2011. Please visit www.stenodiabetescenter.com

for a complete list and the link to pub med.

Fig 6 - Number of publication by impact factor 2008-2011


45

Fig 7 - Number of Publications by Year


STENO DIABETES CENTER is a world leading institution within diabetes care and

prevention. Steno is owned by Novo Nordisk A/S and is a not for profit organisation

working in partnership with the Danish healthcare system. Steno treats around 6000

people with diabetes.

Documents

Annual Report