EVALUATION COMMITTEE

The Faculty Council has appointed the following adjudication committee to evaluate the thesis and the associated lecture: 

• Prof. Abdollah Vahabpour-Roudsari, University of Victoria, Canada
• Prof. Mariann Fossum, University of Agder, Norway 
• Associate Prof. Samuel Emil Schmidt, Aalborg University, Denmark (Chairman) 

Moderator: Associate prof. Thomas Kronborg Larsen, Aalborg University, Denmark.

ABSTRACT

People with diabetes and comorbidities encounter numerous challenges in the modern healthcare system. Managing the treatment burden associated with comorbidities to diabetes is notably more complex compared to single-condition counterparts. People with multiple long-term conditions often experience elevated morbidity and mortality rates, reduced functional capacity and health-related quality of life, polypharmacy, frequent healthcare utilization, and fragmented care. Social disparities are also prevalent in people with diabetes and comorbidities where low socioeconomic status (SES) is consistently associated with a range of poor health-related outcomes. Based on these challenges, the need to improve early identification of comorbidities to reduce this burden is imperative. Also, a reconfiguration of healthcare delivery is needed to embrace the challenges associated with having multiple conditions. This PhD thesis investigates the potential for improving early identification and management of comorbidities in people with diabetes. 

The first part of the thesis investigates the preventive aspects of developing comorbidities in diabetes using nationwide register data with a focus on SES. Study I describe the incidence of comorbidities in adults with type 1 diabetes over a 22-year period and explores the association between SES and the development of comorbidities on a population level.

Study II expands on the findings from Study I and presents the development of a novel prediction model to facilitate early identification of comorbidities in adults with type 1 diabetes on the individual level.

The second part of the thesis delves into a potential solution to overcome some of the aforementioned challenges in managing people with diabetes and comorbidities by assessing so-called multidisciplinary teams (MDT). Study III explores, through a scoping review, the characteristics, applications, and effectiveness of MDT in the context of diagnosis and treatment. Study IV explores physicians’ perspectives on MDT and cross-sectorial work in the management of diabetes and comorbidities, and how this might affect coordination and communication. This is done qualitatively through semi-structured expert interviews.