DC1-project 1: Ulcer risk stratification in high-risk patients with diabetes

Background

The current understanding of diabetic foot disease is based on a biomedical model of predominantly non-modifiable risk factors, including neuropathy, vascular disease, foot deformity, and ulcer history. For that reason, ulcer risk stratification systems only incorporate these traditional risk factors, not taking important, novel, and modifiable biomechanical and patient-behaviour parameters, or any personalised, gender or cultural differences into account. While some of these parameters are proven as independent risk factors for ulceration, there are no risk stratification systems incorporating these. The consequence is a significant variation in ulcer risk within current risk strata, and stratification systems that are not specific, not novel, and not intervention oriented. These systems do not guide personalised medicine, nor stimulate efficient use of resources for screening and treatment. In this DIALECT project we aim to assess groups of people at high risk of ulceration and amputation for modifiable biomechanical, behavioural, and other personalised outcomes to improve risk stratification and create starting points for personalised treatment approaches in ulcer and amputation prevention.

Approach

This project will focus on examinations of the lower extremity, physical functioning, biomechanics, and mobility. Data on a comprehensive set of disease-specific, biomedical, and behavioural parameters, as well as clinical outcomes from three existing, unique, and large datasets that have not yet been used for this purpose will be analysed (the Steno Diabetic Foot Cohort, the Maastricht study, and the Safe Haven diabetes registry). Using a variety of statistical methods, the doctoral candidate will determine risk factors for ulcer development, its recurrence and amputation and will build and validate a personalised risk factor model for ulcer and amputation risk. The aim of this project is to update existing risk stratification systems.

Our research team

Steno Diabetes Center Copenhagen (SDCC) is a diabetes center within the public authority of the Capital Region of Copenhagen. SDCC is the largest diabetes clinic in Scandinavia and treats each year more than 11,000 people with diabetes from the Capital Region. SDCC is organised in four departments (Patient Care, Clinical Research, Health Promotion, and Education) that work closely together around the unifying focus of translational research, care, and prevention. The doctoral candidate will be part of the Clinical Epidemiological Research group which is embedded within the department of Clinical Research and the candidate will learn from, and collaborate with a multidisciplinary team of clinicians, epidemiologists, and statisticians. The doctoral candidate will also work together with another doctoral candidate from DIALECT at SDCC who focuses on patient involvement and shared decision-making.

Your experience

Candidates should be eligible to enrol for a doctoral program in Denmark and have a Master’s degree in the fields of statistics, epidemiology, public health, or related field
Strong higher education track record and broad scientific curiosity
Strong analytical and communication skills
Experience with statistical analytical programs
Demonstrable fluent spoken and written English skills
Capable of functioning in an interdisciplinary environment, with researchers, clinicians and patients, requiring interpersonal curiosity and soft skills

Experience with register research within diabetes or other diseases is an advantage.

We seek a highly motivated scientist who enjoys an interdisciplinary environment and an interdisciplinary project and who is able to work independently but also as part of a team. The research project should result in a PhD thesis.

Our offer

This PhD position is funded by the Marie Skłodowska-Curie Actions (MSCA)of the European Union’s Europe 2022 research and innovation program under grant agreement No 101073533. You will be employed as a fulltime PhD for 3 years at Steno Diabetes Center Copenhagen and will be enrolled in the PhD programme for Health and Medical Sciences at the University of Copenhagen. The MSCA programme offers a competitive and attractive salary and working conditions. The successful candidate will receive a salary in accordance with the MSCA regulations for early-stage researchers. Exact salary will be confirmed upon appointment [Living Allowance = €40.800/year (correction factor to be applied for Denmark: 1.32) + Monthly mobility allowance = €600. An additional monthly allowance of €660 is applicable depending on family situation. Please be aware that these amounts are subject to taxes, the exact salary will be confirmed upon appointment. In addition to their individual scientific projects, all doctoral candidates will benefit from further continuing education, which includes internships and secondments, a variety of training modules as well as transferable skills courses and active participation in workshops and conferences.

Steno Diabetes Center Copenhagen

Steno Diabetes Center Copenhagen (SDCC) is a diabetes center within the public authority of the Capital Region of Copenhagen. SDCC is the largest diabetes clinic in Scandinavia and treats each year more than 11,000 people with diabetes from the Capital Region. The ambition of SDCC is to improve the entire field of diabetes in the Capital Region, but also to contribute with inspiration and new knowledge nationally and internationally. SDCC is focused on clinical care, research and teaching and currently has more than 400 employees. The clinical staff in the center includes doctors, nurses, dieticians, patient coordinators, podiatrists, and lab technicians. More than half of the employees are involved full-time or part-time in research. In 2021, World Economic Forum’s Global Coalition for Value in Healthcare nominated SDCC as one of the best hospitals in the world in relation to developing a value-based healthcare system for the benefit of people with diabetes and other chronic diseases. For more information, please visit www.sdcc.dk and follow us on LinkedIn and Twitter.

University of Copenhagen

University of Copenhagen (UCPH) will be the PhD awarding institute for the doctoral candidate. Driven by intellectual creativity and critical thinking since 1479, researchers and students at the University of Copenhagen have expanded horizons and contributed to moving the world forward. With its 5,000 researchers and 37,500 students, the University boasts an international research and study environment and is highly ranked on the leading ranking lists of the world’s best universities. The University offers researchers and students the opportunity to develop their talent and launches ambitious interdisciplinary initiatives to support its strong academic communities. Through research-based teaching – and by involving them in research – students are equipped to address society’s challenges and needs. The doctoral candidate will be enrolled at the doctoral program of the Department of Clinical Medicine, UCPH (see https://ikm.ku.dk/english/ for more information).