Publications

Diabetes mellitus is a large and growing worldwide health issue. Prior to this publication, a direct comparison of the prevalence of persons treated with anti-diabetic medicine in Greenland and Denmark has not been found. Therefore, the aim of this study is to estimate and compare the age- and gender-specific prevalence of patients treated with anti-diabetic medicine comparing Greenland and Denmark. The study was performed as a cross-sectional register study using data from population and medical registers in Greenland and Denmark. A total of 784 Greenlandic and 215,580 Danish patients treated with anti-diabetic medicine were included. The prevalence of patients aged 20–79 years treated with anti-diabetic medicine in Greenland was 2.6% (95% CI 2.4–2.8), much lower (p < 0.001) compared to Denmark with 5.2% (95% CI 5.2–5.2). The difference was less pronounced after excluding those treated with insulin and women below 45 years treated with metformin. In conclusion, this study showed a lower prevalence of patients treated with anti-diabetic medicine in Greenland than Denmark. The main reason may be a much higher prevalence of undiagnosed diabetes in Greenland, particularly among the middle-aged. Differences in awareness of diabetes and access to continued primary healthcare may be contributing factors.

Greenland and the Faroes are autonomous jurisdictions within the Danish Realm, having undertaken a continuous process of extended self-determination in the post-WWII era. In both jurisdictions there are strong movements of secession and counter-secession, whose respective strengths are largely achieved through external relations. This paper will first provide an introduction to the historical background and the formal relationship between the two jurisdictions and their metropolitan state. We will then extend the two cases with a description of how increased internal autonomy has evolved in a dynamic interaction with changes in international affairs. Whether the two jurisdictions may move towards full secession or new forms of unity is difficult to predict, but external relations keep on pushing at the formal structures and limits of the realm, which we will briefly reflect upon in the final section.