Diabetes Care in Republic of Macedonia: Challenges and Opportunities

Background: The Republic of Macedonia (RoM) has experienced a rapid rise in the prevalence of type 2 <a title="Learn more about Diabetes" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/diabetes">diabetes</a> (T2D) over the past 2 decades, a period c...

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Autores principales:	Ivica Smokovski, Tatjana Milenkovic, Caroline Trapp, Aleksandar Mitov
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2016
Materias:	cardiovascular disease high prevalence insulin consumption Macedonia plant-based dietary intervention type 2 diabetes vegan vegetarian Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/4c379470384844d9a7000ae445e0f0d4
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spelling	oai:doaj.org-article:4c379470384844d9a7000ae445e0f0d42021-12-02T11:33:14ZDiabetes Care in Republic of Macedonia: Challenges and Opportunities2214-999610.1016/j.aogh.2015.12.017https://doaj.org/article/4c379470384844d9a7000ae445e0f0d42016-04-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/1446https://doaj.org/toc/2214-9996Background: The Republic of Macedonia (RoM) has experienced a rapid rise in the prevalence of type 2 <a title="Learn more about Diabetes" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/diabetes">diabetes</a> (T2D) over the past 2 decades, a period characterized by significant social, political, and economic change. RoM now has one of the highest rates of diabetes in Europe. Objectives: To explore the modifiable conditions that may underlie and exacerbate the T2D epidemic; describe the state of diabetes care; and consider improved mechanisms for prevention and treatment, including research priorities, in RoM. Methods: Methods included data mining from reliable sources and collaboration of authors to consider and describe applications of research from outside RoM and to identify evidence-based strategies to reduce the burden of T2D in RoM. Findings: In 2014, the national prevalence of diabetes was 11.44% of the population (20-79 years) of RoM. Per capita <a title="Learn more about Caloric Intake" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/caloric-intake">caloric intake</a> has increased significantly over the past 2 decades, with the majority of these calories coming from sugar, pork, chicken, beef, and sunflower oil. Excess calories, in the form of nutrient-deficient foods, animal products, and added oils promote <a title="Learn more about Insulin resistance" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/insulin-resistance">insulin resistance</a> and T2D. Tobacco use and lack of physical activity also contribute to the diabetes epidemic. <a title="Learn more about Insulin (medication)" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/insulin-medication">Insulin</a>, especially insulin analogues, are widely available and used to manage diabetes, often over other interventions that are more appropriate for patients with T2D, and more frequently than in other more developed countries, resulting in higher and unsustainable related costs. Conclusions: A new National <a title="Learn more about e-Health" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/e-health">eHealth</a> System allows for better identification and monitoring of citizens with diabetes. However, the rapidly growing expense of insulin in the past has been unsustainable. The potential exists for a stronger role for <a title="Learn more about Lifestyle Intervention" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/lifestyle-intervention">lifestyle interventions</a> in prevention and treatment of T2D. Significant changes in dietary patterns parallel the rise in diabetes prevalence and are likely a leading cause of diabetes and its complications. Research in RoM is needed to determine the impact and acceptability of <a title="Learn more about Dietary Intervention" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/dietary-intervention">dietary interventions</a> for prevention and treatment of T2D, as a first step toward reduction of diabetes prevalence and its complications and controlling spiraling <a title="Learn more about Health Care Cost" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/health-care-cost">health care costs</a>.Ivica SmokovskiTatjana MilenkovicCaroline TrappAleksandar MitovUbiquity Pressarticlecardiovascular diseasehigh prevalenceinsulin consumptionMacedoniaplant-based dietary interventiontype 2 diabetesveganvegetarianInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 81, Iss 6, Pp 792-802 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	cardiovascular disease high prevalence insulin consumption Macedonia plant-based dietary intervention type 2 diabetes vegan vegetarian Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	cardiovascular disease high prevalence insulin consumption Macedonia plant-based dietary intervention type 2 diabetes vegan vegetarian Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 Ivica Smokovski Tatjana Milenkovic Caroline Trapp Aleksandar Mitov Diabetes Care in Republic of Macedonia: Challenges and Opportunities
description	Background: The Republic of Macedonia (RoM) has experienced a rapid rise in the prevalence of type 2 <a title="Learn more about Diabetes" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/diabetes">diabetes</a> (T2D) over the past 2 decades, a period characterized by significant social, political, and economic change. RoM now has one of the highest rates of diabetes in Europe. Objectives: To explore the modifiable conditions that may underlie and exacerbate the T2D epidemic; describe the state of diabetes care; and consider improved mechanisms for prevention and treatment, including research priorities, in RoM. Methods: Methods included data mining from reliable sources and collaboration of authors to consider and describe applications of research from outside RoM and to identify evidence-based strategies to reduce the burden of T2D in RoM. Findings: In 2014, the national prevalence of diabetes was 11.44% of the population (20-79 years) of RoM. Per capita <a title="Learn more about Caloric Intake" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/caloric-intake">caloric intake</a> has increased significantly over the past 2 decades, with the majority of these calories coming from sugar, pork, chicken, beef, and sunflower oil. Excess calories, in the form of nutrient-deficient foods, animal products, and added oils promote <a title="Learn more about Insulin resistance" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/insulin-resistance">insulin resistance</a> and T2D. Tobacco use and lack of physical activity also contribute to the diabetes epidemic. <a title="Learn more about Insulin (medication)" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/insulin-medication">Insulin</a>, especially insulin analogues, are widely available and used to manage diabetes, often over other interventions that are more appropriate for patients with T2D, and more frequently than in other more developed countries, resulting in higher and unsustainable related costs. Conclusions: A new National <a title="Learn more about e-Health" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/e-health">eHealth</a> System allows for better identification and monitoring of citizens with diabetes. However, the rapidly growing expense of insulin in the past has been unsustainable. The potential exists for a stronger role for <a title="Learn more about Lifestyle Intervention" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/lifestyle-intervention">lifestyle interventions</a> in prevention and treatment of T2D. Significant changes in dietary patterns parallel the rise in diabetes prevalence and are likely a leading cause of diabetes and its complications. Research in RoM is needed to determine the impact and acceptability of <a title="Learn more about Dietary Intervention" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/dietary-intervention">dietary interventions</a> for prevention and treatment of T2D, as a first step toward reduction of diabetes prevalence and its complications and controlling spiraling <a title="Learn more about Health Care Cost" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/health-care-cost">health care costs</a>.
format	article
author	Ivica Smokovski Tatjana Milenkovic Caroline Trapp Aleksandar Mitov
author_facet	Ivica Smokovski Tatjana Milenkovic Caroline Trapp Aleksandar Mitov
author_sort	Ivica Smokovski
title	Diabetes Care in Republic of Macedonia: Challenges and Opportunities
title_short	Diabetes Care in Republic of Macedonia: Challenges and Opportunities
title_full	Diabetes Care in Republic of Macedonia: Challenges and Opportunities
title_fullStr	Diabetes Care in Republic of Macedonia: Challenges and Opportunities
title_full_unstemmed	Diabetes Care in Republic of Macedonia: Challenges and Opportunities
title_sort	diabetes care in republic of macedonia: challenges and opportunities
publisher	Ubiquity Press
publishDate	2016
url	https://doaj.org/article/4c379470384844d9a7000ae445e0f0d4
work_keys_str_mv	AT ivicasmokovski diabetescareinrepublicofmacedoniachallengesandopportunities AT tatjanamilenkovic diabetescareinrepublicofmacedoniachallengesandopportunities AT carolinetrapp diabetescareinrepublicofmacedoniachallengesandopportunities AT aleksandarmitov diabetescareinrepublicofmacedoniachallengesandopportunities
_version_	1718395818557308928

Diabetes Care in Republic of Macedonia: Challenges and Opportunities

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