Steno Diabetes Center opens first overseas branch in Malaysia
Dr John Nolan says that opening the first Steno Diabetes Center branch in Malaysia is a big new step for us. – Novo Nordisk
The Danish diabetes specialist centre expands to Kuala Lumpur to meet increasing demand for diabetes education in South-East Asia.
The Steno Diabetes Center (Steno) occupies a rather odd space within the Danish healthcare system.
In a country where all citizens are entitled to free healthcare provided by government clinics and hospitals, private hospitals are an anomaly.
After all, why pay more when you are already assured of good-quality, efficient medical services and facilities within the public system, funded by the taxes every Dane pays?
However, this private non-profit research hospital has not only survived, but thrived since its establishment in 1932.
Founded by the same men who created Nordisk Insulinlaboratorium (which merged with Novo Terapeutisk Laboratorium in 1989 to form the pharmaceutical company now known as Novo Nordisk), what was originally called the Niels Steensens Hospital has always focused on treating diabetic patients and researching the condition.
As the first diabetes specialist medical institution in the Nordic region, it received both patients referred from government clinics and hospitals, as well as private patients who enrolled themselves.
Eventually, its partnership with the Danish public healthcare system expanded, and now, in a unique private-public partnership, the hospital serves mainly as a referral centre for the Capital region, one of the five administrative regions of Denmark.
Public hospitals within the region can refer diabetic patients to Steno, which will receive the appropriate monies for their treatment from the region. The centre is otherwise funded by the Novo Nordisk Foundation.
The Niels Steensens Hospital merged with Hvidøre Hospital (founded in 1938 by the brothers who created Novo Terapeutisk Laboratorium) in 1991, and the new entity was named the Steno Diabetes Center. (Niels Steensen was a 17th-century Danish scientist and bishop, who was also known as Nicolaus Steno.)
In the same year, the Education Department was established to consolidate and share the knowledge of Steno’s successful method of diabetes care.
REACHing for the STARs
With several decades’ worth of research and experience in diabetic care, Steno decided that it had to share its knowledge with those who needed it the most.
In 2000, the STAR (Steno Application of Resources) programme, under the Education Department, was launched.
Steno Diabetes Center analyst Maria D. Kristensen speaks to a patient at the centre in Copenhagen, Denmark. The diabetes referral center has been dedicated to researching and treating diabetes since its beginning in 1932. – Steno Diabetes Centre
Steno Education Center Affiliate Manager Malaysia Jamal R. Butt shares over the phone: “The STAR programme was initiated by the Steno Diabetes Center and funded by the Novo Nordisk Foundation.
“The initial thought was that doctors from Denmark would travel to middle- and low-income countries like India, China, Indonesia, Mexico, Brazil, Turkey and Tunisia, to teach local healthcare providers about diabetes prevention and management.”
The programme has two components; one aimed at specialists working in diabetology, and the other at general healthcare providers.
The first component shares the latest updates in diabetes research and their clinical applications to the specialists in the field.
The second one targets primary care doctors, nurses, dietitians and other healthcare professionals involved in the care of diabetic patients, and focuses on imparting a patient-centred, multidisciplinary team approach to managing diabetic patients.
In a recent presentation to international journalists in Kalundborg, Denmark, Steno’s Chief Physician Dr Henrik Ullits Andersen shared: “We have the STAR programme where Steno goes around educating around 650 healthcare providers a year. And we calculate that they can reach about 35,000 patients a day.”
However, with the dramatically rising number of diabetic patients around the world, and concurrent demand for appropriate continuous medical education, that programme is no longer enough.
Last year, Steno received a DKK10.7mil (RM6mil) grant from the Novo Nordisk Foundation to run the Steno-REACH programme.
The centre’s CEO Dr John Nolan told international media during his presentation at Copenhagen, Denmark, recently, “We have developed the new REACH programme in 2014 for one reason only.
“The STAR programme was in such demand that we couldn’t cope.”
Dr Ullits noted during his presentation: “When this programme is established, we hope to see the number of healthcare providers reached increase to about 9,200 a year, and the corresponding number of patients go up to about 500,000.”
Dr Nolan shared that there are three components to the REACH programme: the establishment of a satellite Steno Diabetes Center in Kuala Lumpur, e-learning and an international fellowship programme.
Malaysia, the first
Said Dr Nolan: “For the first time, Steno is going to establish a Steno Diabetes Center in Malaysia.”
He shared that among the reasons Malaysia was chosen was its strategic location in South-East Asia and existing working relationships between the Center and local doctors.
Butt adds that Malaysia also has a strong healthcare strategy with a heavy emphasis on non-communicable diseases.
He continues: “There is a large public healthcare system, with services for diabetes that covers a large population of the country.
“And Malaysia also has one of largest prevalence of diabetes in the region.
“The incidence of obesity is also very high.”
Currently, Butt is in the process of speaking to the Health Ministry about partnership in the programme, as well as developing a framework for training local doctors in the Steno principles of diabetic management, identifying primary healthcare clinics to participate in the Steno method of diabetic management, integrating blood glucose screening into current clinical practices, and helping to formulate clinical guidelines for the diagnosis, treatment and follow-up of diabetic patients.
A crucial part of the framework is adapting Steno’s practices to the local culture and healthcare system, so that it is relevant and sustainable.
Having transferred to Malaysia just a month and a half ago, Butt says that there is still much work to be done.
However, he hopes to have the centre with its educational programmes up and running by the second half of next year.
From there, Dr Nolan envisions these locally-adapted practical diabetes management courses being organised two to three times a month, catering to both local and regional healthcare providers.
By 2016, he expects the e-learning modules on diabetes management currently being developed in Copenhagen, to be integrated into the Malaysian branch’s courses, complementing the face-to-face training.
The branch is also targeted to take over the Inspire programme in Indonesia and the Vietnam Diabetes Education Program from Copenhagen in the same year.
Both programmes, which began in 2010 and 2012 respectively, are national diabetes education train-the-trainer programmes.
By 2017, Dr Nolan foresees that the Malaysian centre will take over the development of train-the-trainer programmes for other countries within the region.
He also expects that Steno will be able to use the experiences of setting up this first branch to set up another branch in Latin America, and subsequently, Africa.
