November 14 is World Diabetes Day. To mark the occasion, CNC-UC shares the work carried out in this area by its principal investigator Eugénia Carvalho
Since 2023, researcher Eugénia Carvalho has spent around three months a year in Guinea-Bissau. There, she carries out fieldwork in Obesity, Diabetes, and Complications, the name of the research group she leads at the Center for Neuroscience and Cell Biology at the University of Coimbra (CNC-UC). For about 25 years, she has maintained a relationship with Swedish and Danish scientists, the latter from the Bandim Health Project (PSB), who have been in Guinea-Bissau for 50 years working on vaccines.
It was through these contacts that, in 2020, Eugénia started a project to study the protective effect of the BCG vaccine on diabetes in Guinea-Bissau (reported by the Portuguese newspaper Público). The study stems from the first major national screening for the disease, which is making it possible to assess the prevalence of diabetes in the country for the first time. The screening has reached more than 5,000 people to date and, in 2023, enabled clinical trials to begin on around 200 people identified as pre-diabetic, who were given the BCG vaccine. They will be monitored for ten years to study the vaccine's protective effect on the disease.
The results of the national screening began to be published in 2024 and 2025, and a new project to study the relationship between diabetes and tuberculosis is now underway: a collaboration with Baltazar Cá, a researcher at PSB and the National Institute of Public Health of Guinea-Bissau (INASA), funded with €100,000 by the “la Caixa” and Calouste Gulbenkian foundations through We Forward grants. Baltazar studies tuberculosis in the country; the projects are now joining forces to track people with both diseases, which will contribute to a broader concerted study, as there is a bidirectional relationship between diabetes and tuberculosis (it is known that diabetes increases the risk of active tuberculosis, while tuberculosis hinders glycemic control).
However, population studies have revealed an even more complex task that scientists and doctors have at hand: cross-cutting action in the areas of health, nutrition, education, and awareness is needed to continue the fight against the disease, which is marked today, November 14, as World Diabetes Day. “People don't know what diabetes is and think it's an infectious, communicable disease. They are also unable to administer treatments independently. We are reaching many thousands of people, and for many of them, it was during the first national screening that they heard about the disease for the first time,” says the CNC-UC researcher.
Historically, for organizations operating in Guinea-Bissau — such as the Institute of Hygiene and Tropical Medicine, a Portuguese public health institution founded in 1902 — the focus has been on infectious diseases. Thus, in one of the poorest countries in the world, less attention is paid to chronic non-communicable diseases (NCDs), such as diabetes, obesity, and hypertension, which are growing exponentially. Since 2021, the scientist has raised around €900,000, distributed among various institutions, to combat the disease. With the PSB, she has a new application underway to the World Diabetes Foundation and has been supported by the Portuguese navy. Through the Mar Aberto program, she transported 700 kilograms of material to Guinea-Bissau in 2024. She is also involved in two recent applications, one with the UC and the other with Danish researchers, to European Cooperation in Science and Technology (COST) programs for Africa.
Eugénia Carvalho's goal is now to raise awareness among the population of Guinea-Bissau about the major problem of NCDs. Her priorities are divided between raising awareness and literacy among the population and promoting a new screening program, now for pregnant women. With funding from Camões — Instituto da Cooperação e da Língua and in collaboration with the non-governmental organization Bisturi Humanitário, the largest screening program for pregnant women ever conducted in the country has been underway since February to identify women at high risk due to diabetes. The goal is to improve the monitoring of this and other NCDs and, over the years, to screen between 3,500 and 5,000 women, which will help combat maternal and infant mortality in Guinea-Bissau, which is among the highest in the world. About 500 women have been screened since February.
Literacy among the population, which is essential for managing the disease, is one of the most complex tasks to be accomplished. With funding from the Camões Institute, Eugénia Carvalho has been working to promote literacy by promoting the dissemination of comic strips in Portuguese and Creole, in collaboration with local artist Manuel Júlio, and informative spots on community radio stations in local languages.
The lack of local training and capacity building led to the creation of another project, led by the NGO HELPO and also funded by the Camões Institute. Since January this year and until December 2026, a nutrition training and literacy plan has been underway across the country. To map malnutrition nationwide, Eugénia Carvalho and HELPO are working with local students and applying questionnaires adapted from PAS GRAS, a European project studying metabolic risks that she co-coordinates at CNC-UC.
The researcher's focus is now on creating national structures for the prevention of NCDs. In 2023, she helped to create the Guinea-Bissau National Diabetes Meeting, which brings together doctors, researchers, public entities, and the population around the disease every year. She created a working group of experts and statistics teachers from various schools who have been giving pro bono online classes to master's and doctoral students from Portuguese-speaking African countries, who often lack the knowledge to analyze the fieldwork they carry out. She also wants to create a structure for training and educating health technicians and public health students, and since 2023 she has been giving advanced training and lectures in schools across the country.
An example of this is the career of Lilica Sanca, a Guinean biologist who works at the National Public Health Laboratory and the Global Fund and who defended her doctoral thesis in February at UC on the prevalence of diabetes in the country, funded by grants from the European Foundation for the Study of Diabetes (EFSD), Gulbenkian, and Grupo Coimbra. The second scholarship holder in this area is Guinean doctor Vasco Iala, funded by the Foundation for Science and Technology/PALOP, at UC. Other Guinean students have also defended their master's theses. All of them are in the field in Guinea, identifying and working with high-risk individuals: there are already 50 children with type 1 diabetes identified in the country without access to insulin.
Inês Amado da Silva (CNC-UC)
