Maritime Health Research and Education-NET/The International Type 2 Diabetes Mellitus and Hypertension Research Group

International Diabetes and Hypertension Research GroupEdit

The International Diabetes and Hypertension Research Group for fishers, seafarers and other transport workers was created the 12 Jan 2022 in a Zoom conference by specialists in diabetes epidemiology, diabetology, occupational epidemiology, occupational/maritime medicine and public health from Denmark, Greenland, Spain, France, Panamá. Russia and The Filippines. The aim is to provide a foundation for safe and healthy preventive strategies within the UN Global Sustainable Goals, especially Goal 3: Good health and well-being for all workers ,Goal 4: Quality education,Goal 8: Decent Work and Economic Growth and Goal 17: Partnerships to achieve the goals with the primary tasks. Millions of medical examinations are done every year for seafarers, fishers, truck drivers, loco-, bus- and taxi drivers. Most of them use the non-valid urine-sticks and no valid test for T2D, no A1c or FG. By adding biannual screening of hypertension and diabetes mellitus the target groups can be rescued from loss of workability, loss of QUALies and loss of living years. Screening for hypertension and diabetes is cost-effective and sustainable with low extra cost, possibility for no or small extra visit fee and A1C test around 20-50 USD[1] as the target group need to attend to the medical clinics for their obligatory often biannual medical examination, anyway. While the extra cost for A1c blood test, lack of laboratory access and clinical time consume might be a problem, then the strategy is to validate and replace A1C with Glukometer test[2][3][4][5][6][7]


Screening program for diabetes type 2 and hypertension in seafarers’ routine medical examinationsEdit

The program combines the biannual, mandatory clinical fit-for-duty health examinations for seafarers in a Public Health perspective with biannual screening for Diabetes Type 2 and Hypertension. An improved prevention is expected by combining with the "Green-ship" health promotion program. The neglected diagnostic problem that the urine dipstick of low validity erroneously has been used for diagnosis of diabetes type 2 in the fit-for-duty medical examinations, is solved. The study adds a protocol with a ready to use Excel Data Entry scheme for the medical clinics to perform an accurate screening for diabetes mellitus type 2 and hypertension. Sustainability is obtained by having seafarers coming biannually for mandatory medical examination, anyway. With the advantages that extra costs for the screening are minimized and the participation in the screening program will be nearly 100%. Implementation of the protocol in a global perspective is expected to have significant health impact not only for seafarers, but also for other transport workers, the companies and the society. The screening program is derived from the initial two projects: "Early diagnostics of T2DM via routine medical exams" and "Early diagnostics of Hypertension via routine medical exams" It is important to record the pre-hypertension epidemiologically and for the seafarers as there is an obvious possibility of prevention. It is also important to have a plan for the prevention of the various degrees of hypertension[8]

Revision of the ILO Guidelines for medical examination for seafarersEdit

Revision of the WHO International Medical Guide for ShipsEdit

Revision of the Ships Medical ChestEdit

T2D and HTN Research and Education plan 2030Edit

Research seminarsEdit

Learning from Interventions in non-maritime workplacesEdit

Diabetes T2 and Hypertension Research and Education plan 2022-2030Edit

Annual International Research and Education Seminars (Dec 2022)
Revise the International ILO Guide medical examinations for seafarers
Establish T2D and HTN international/national data register
Revision of the WHO International Medical Guide for Ships
Revision of the Ships Medical Chest
Multi faceted health promotion “Sustainable ship”guidelines
Knowledge and practice of what works review study
Strategic diferentiated education and training for the social groups
Education and training health promotion
Education program on knowledge and practice T2D & HTN
Development online educational- and training materials T2D and HTN
Implementation, evaluation and revision of online materials
Establish the "International Maritime Public Health School"
Accuracy of screening and follow-up for T2D
Accuracy of glucose meters for seafarers own control on board
Accuracy and costs of glucose meters for screening in clinics
Accuracy and costs of non-invasive glucose meters screening
Clinical applicability and cost-effectiveness of DIABSCORE
Accuracy of screening and follow-up for HTN
Epidemiology multicenters
Monitoring T2D and hypertension (HTN) from the Screening program
Loss of working years for seafarers with T2D and HTN
Co-morbidity for T2D and HTN (mental, CVD, feet, vision)
Seafarers selection out of cohort due to HTN and T2D
Seafarers' lack compliance with the advice and need for booster training
Electronic Data Capture Software:
Google Forms, other
Workplace risk factors
Work risk factors like stress, strain, shift-work for T2D and HTN risk
Workplace stigma and discrimination for T2D and HTN
How to continue working at sea with T2D and HTN
Guide to manage T2D znd HTN at the workplaces at sea
Best clinical practices for maritime T2D and HTN diagnostics
Guidelines for T2D and HTN diagnostics (A1C, FPG)
Program for the newly diagnosed type 2 diabetes seafarers (ILO)*
Best care practices for T2D/HTN seafarers at work and home
Non-pharm maritime intervention
Review of effect workplace interventions T2D HTN
Pharmacological and non-pharm T2D/HTN Interventions
Review of pharmacological intervention study effects
Review of combined pharm/non-pharm intervention study effects
Protocol for combined pharm and non-pharm intervention study effects
Financial costs for HTN and T2D
Loss of workability and compensation costs
Medical treatment and diagnostics cost for HTN, T2D and co-morbidities
Review and Guidelines to reduce inappropriate laboratory testing


  2. Chen, Huizhen, Qingtao Yao, Yang Dong, Zhimei Tang, Ruiying Li, Baochao Cai, Ruili Wang, and Qiu Chen. “The Accuracy Evaluation of Four Blood Glucose Monitoring Systems According to ISO 15197:2003 and ISO 15197:2013 Criteria.” Primary Care Diabetes 13, no. 3 (June 2019): 252–58.
  3. Chubb, S. A. Paul, Kylie Van Minnen, Wendy A. Davis, David G. Bruce, and Timothy M. E. Davis. “The Relationship between Self-Monitoring of Blood Glucose Results and Glycated Haemoglobin in Type 2 Diabetes: The Fremantle Diabetes Study.” Diabetes Research and Clinical Practice 94, no. 3 (December 2011): 371–76.
  4. Kenning, Matthes, Anselm Puchert, Sabine Berg, and Eckhard Salzsieder. “System Accuracy of the Blood Glucose Monitoring System TD4216.” Journal of Diabetes Science and Technology 14, no. 5 (March 7, 2020): 976–77.
  5. Makris, K., L. Spanou, A. Rambaouni-Antoneli, K. Koniari, I. Drakopoulos, D. Rizos, and A. Haliassos. “Relationship between Mean Blood Glucose and Glycated Haemoglobin in Type 2 Diabetic Patients.” Diabetic Medicine: A Journal of the British Diabetic Association 25, no. 2 (February 2008): 174–78.
  6. Pashintseva, L. P., V. S. Bardina, I. R. Il’iasov, B. P. Mishchenko, and M. B. Antsiferov. “[The clinical laboratory evaluation of accuracy of portable glucometers ‘Satellite Express’ and ‘Satellite Express mini’].” Klinicheskaia Laboratornaia Diagnostika, no. 11 (November 2011): 33–35.
  7. Sarwat, S., L. L. Ilag, M. A. Carey, D. S. Shrom, and R. J. Heine. “The Relationship between Self-Monitored Blood Glucose Values and Glycated Haemoglobin in Insulin-Treated Patients with Type 2 Diabetes.” Diabetic Medicine: A Journal of the British Diabetic Association 27, no. 5 (May 2010): 589–92.