Diabetes
Bandim Health Project – diabetes group
Morten Bjerregaard-Andersen, MD, PhD, Associate Professor, University Hospital of South Denmark, Esbjerg / Steno Diabetes Center Odense, Denmark.
E-mail: mbjerreandersen@health.sdu.dk
ORCID: https://orcid.org/0000-0002-4128-5714
Eugenia Carvalho, MSc, PhD, Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Portugal
E-mail: ecarvalho@cnc.uc.pt
Webpage: https://www.cnc.uc.pt/en/research-group/obesity-diabetes-and-complications
ORCID: https://orcid.org/0000-0001-6264-3632
Lilica Sanca, MSc, PhD, National Public Health Laboratory (LNSP), Bissau, Guinea-Bissau
Purpose: The diabetes group at the Bandim Health Project (BHP) is committed to enhancing diabetes knowledge and care in Guinea-Bissau in all aspects, though primarily within the clinical and epidemiological field. The activities cover a broad array of scientific studies, including early diabetes detection, prevention and characterization of people with diabetes. Furthermore, we are profoundly engaged in the teaching and training of both health care personnel, but also the public in general. This capacity building has much expanded over recent years.
Our primary collaborator is the Guinean Diabetes Association (ANDD), with this collaboration established since 2010. But we are also working with many other stakeholders in Bissau, as well as foreign NGOs and organizations. Current major research project and activities are listed below.
– Screening for gestational diabetes: In this study, pregnant women in week 24 to 28 attending five different health centers in the greater Bissau area are being screened and treated for gestational diabetes (GDM), using standard oral glucose tolerance testing (OGTT). Previously, no such data have been available from Guinea-Bissau, but GDM may be an important predictor for later development of diabetes in the women and it also increases the risk of adverse outcomes during pregnancy and birth. Important collaborators include the NGOs Bisturi and AIFO (PI Eugenia Carvalho).
–Diabetes diagnosis, management, prevention and education in Guinea-Bissau: In this major activity, which has been ongoing since 2022, we are strengthening diabetes knowledge through training and educational activities, both at health care facilities with attendance from physicians, nurses, dietitians and others working with diabetes. At the same time, general diabetes education, including risk factors, has been initiated among the public in places such as schools and churches. Another part of the project has been diabetes screenings, which have been done not only in Bissau, but also in rural areas of the country. We have identified a high burden of diabetes (and obesity and hypertension) country wide, with the results being part of the PhD thesis of Lilica Sanca from the National Health Laboratory, defended in Coimbra, Portugal, in 2025. The final aspect of the project is diabetes prevention. Here, a randomized vaccine trial is investigating whether the well-known BCG vaccine could have overall beneficial effects among adults with pre-diabetes, thereby preventing progression to overt diabetes over a three-year period. This is relevant in an area with limited diabetes treatment. The primary endpoint results (fasting glucose) are expected by mid-2027 (Clinical trials NCT05591339). In order to inform all stakeholders on the gradual progression of our work, an annual diabetes day has been held for the last three years (PI Eugenia Carvalho).
Comic on type 1 diabetes, translated by Manuel Julio to Criolo, with support from Life for a Child.
-Collaboration with National Diabetes Association (ANDD): This long-standing collaboration has focused in improving diabetes care and collection of diabetes data, with the purpose of better characterizing persons with diabetes in Guinea-Bissau. We have documented how diabetes patients have a much-elevated mortality, compared to the general population, often related to complications such as infected foot ulcers. A current investigation aims at characterizing how this relates to treatment, with the overall aim of obtaining data that can be used in establishing local diabetes treatment guidelines and a national diabetes strategy (PI Morten Bjerregaard-Andersen and Nelson Delgado, Head of ANDD).
-Diabetes care and surveillance in Guinea-Bissau: This is a major new capacity building, training and diabetes screening project (non-research), expected to initiate in March 2026, and funded by the World Diabetes Foundation (WDF24-1947). The project is led by the ANDD, and supported by the Guinean Ministry of Health, and it aims to improve diabetes care by health center refurbishments, screening activities, training sessions and the establishing of an electronic diabetes patient registry. The project will cover interior parts of Guinea-Bissau, and the trainings will include doctors and nurses from both Bissau and outside. Celebration of the World Diabetes Day in November is part of the project, where both stakeholders and the Guinean population will have the opportunity to hear about the activities (Responsible Nelson Delgado, ANDD, co-responsible Morten Bjerregaard-Andersen).
-Radio programs on diabetes literacy: With support from the Camões Institute and the Portuguese Cooperation, and through the Community Radios of Guinea-Bissau (RENARC), the ANDD and Eugenia Carvalho have established radio talks on diabetes literacy in local languages. Audio files available here: Criolo, Balanta, Fula, Pepel, Biafada, Manjaco, Mandinga. The objective was to expand diabetes awareness and knowledge in the general population (responsible Nelson Delgado ANDD, Eugenia Carvalho).
-Diabetes and tuberculosis: A bidirectional relationship between diabetes and tuberculosis may exist. Diabetes can increase the risk of active tuberculosis, while tuberculosis could hinder glycemic control. In a planned project funded by Gulbenkian/La Caixa, We Foward, led by Baltazar Cá, a Guinean researcher and MD who studies tuberculosis in collaboration with the National Institute of Public Health of Guinea-Bissau (INASA) and the BHP, a group of people with both diseases will be followed. This investigation is planned for initiation in 2026 (PI Baltazar Cá), in collaboration with Eugenia Carvalho.
-Research training: In collaboration with the University of Coimbra (UC), Portugal, several Guinean researchers have been enrolled in PhD and master programs, including Lilica Sanca (UC, PhD completed) and also Vasco Iala (UC, PhD ongoing), who is funded by the Foundation for Science and Technology/PALOP and is currently a PhD student at the Faculty of Medicine at the University of Coimbra and is planning a diabetes and obesity study in Bissau. Master students who have already defended their theses include Siaca Sambu, Adjou Miguel Sa, Midana Diamantino. The thesis of Hipolito Lona is to be completed, and all have carried out field work Guinea-Bissau, identifying and working with high-risk individuals as part of their master programs (supervisor Eugenia Carvalho, UC).
Key publications:
Stine Byberg, Camilla Bundesen, Frauke Rudolf, Thorny Linda Haraldsdottir, Lamine Indjai, Rui Barai, Henning Beck-Nielsen, Morten Sodemann, Dorte Møller Jensen, Morten Bjerregaard-Andersen. Diabetes in urban Guinea-Bissau; patient characteristics, mortality and prevalence of undiagnosed dysglycemia. Glob Health Action. 2020 Dec 31;13(1):1802136. (doi: 10.1080/16549716.2020.1802136)