Diabetes Care in Republic of Macedonia: Challenges and
                        Opportunities

Smokovski, Ivica; Milenkovic, Tatjana; Trapp, Caroline; Mitov, Aleksandar

doi:10.1016/j.aogh.2015.12.017

Cited by 24 publications

(29 citation statements)

References 24 publications

(19 reference statements)

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“…This system fulfils all requirements of the international standards and covers studyrelevant information for all citizens of the Republic of Macedonia [23,24]. Patients recruited for the current study have been identified as postmenopausal females with past history of menopause defined as one year after last menstrual period without bleeding, who have developed breast cancer after this time (in menopause), therefore, being postmenopausal breast cancer patients.…”

Section: Breast Cancer Patient Cohortmentioning

confidence: 99%

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Postmenopausal breast cancer: European challenge and innovative concepts

et al. 2017

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Breast cancer (BC) epidemic is recognised now worldwide as the reality of the early twenty-first century. Increasing trends in the postmenopausal BC prevalence, even for the European countries earlier demonstrating relatively stable incidence rates of the disease, are highly alarming for the healthcare givers. This new actuality requires a substantial revision of the paradigm currently applied to the BC management and creation of highly innovative concepts. Current multi-centred study highlights new complex mechanisms of the development and progression of the postmenopausal BC. Innovative concepts are presented which argue for more effective predictive and preventive approaches well justified in view of the clusters of the symptoms analysed here and demonstrated as highly prevalent in the postmenopausal breast cancer versus BC-free individuals. Another conceptual novelty presented here is a new interpretation of the BSeed and Soilt heory of metastasis in BC. According to the new concept, the Bpre-metastatic niches^(BSoil^) are created by a systemic hypoxia a long time before the breast malignancy is clinically manifested.

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Section: Breast Cancer Patient Cohortmentioning

confidence: 99%

“…The age difference was evaluated as statistically non-significant. Postmenopausal breast cancer group demonstrated in average the BMI = 26 (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). Fifty percent of this group were overweight persons and 20% were diagnosed with diabetes type 2.…”

Section: General Statisticsmentioning

confidence: 99%

Postmenopausal breast cancer: European challenge and innovative concepts

et al. 2017

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“…A considerable increase in calories per capita per day, a sedentary lifestyle, transition society-related stress, and a high national smoking rate are the main reasons for the dramatic rise of type 2 diabetes in the past 25 years [2].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, public awareness programs were developed highlighting the importance of nutrition, physical activity and smoking cessation, and diabetesspecific patient data were integrated into the National eHealth System [2].…”

Section: Introductionmentioning

confidence: 99%

“…Diabetes mellitus poses a huge health care and socioeconomic threat to the Republic of Macedonia, with a national prevalence of 12%, being the fourth highest in Europe, and a comparative (age-adjusted) prevalence of 10.3%, being the third highest in Europe [1,2]. A considerable increase in calories per capita per day, a sedentary lifestyle, transition society-related stress, and a high national smoking rate are the main reasons for the dramatic rise of type 2 diabetes in the past 25 years [2].…”

Section: Introductionmentioning

confidence: 99%

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Effects of Structured Diabetes Education Program on diabetes knowledge and metabolic control in insulin-treated diabetes patients from Republic of Macedonia

Milenković¹,

Smokovski²,

Bozhinovska³

et al. 2017

Endocr oncol metab

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Background and Aims: We aimed to compare the diabetes knowledge and metabolic control between insulin-treated diabetes patients who completed structured and those who completed unstructured diabetes education at diagnosis and to evaluate the effects of structured diabetes education program (SDEP) on diabetes knowledge and metabolic control. Subjects and Methods: Prospective, observational study of 59 insulin-treated diabetes patients invited for SDEP at University Clinic of Endocrinology, Diabetes and Metabolic Disorders, Skopje, in the period from March 2013 to December 2014 and divided into two groups if they completed SDEP at diagnosis. Patients were tested for their diabetes knowledge (scale of 0 to 100 points) before SDEP and immediately after SDEP and evaluated for their metabolic control. Patients were invited 1 year after completion of SDEP for evaluation of their diabetes knowledge and metabolic parameters. Results: Groups were not significantly different in diabetes knowledge before SDEP (67.3 ± 11.1 vs. 68.0 ± 13.1 points, P = 0.835), and results improved in both groups after completion of SDEP (Group 1: 19.6 ± 8.9 points, P < 0.001; Group 2: 16.9 ± 7.8 points, P < 0.001) with no significant difference between groups. Diabetes knowledge 1 year after SDEP was significantly higher in Group 2 (82.9 ± 7.8 vs. 76.6 ± 11.1 points, P = 0.014). Significant reduction in glycated hemoglobin was obtained 1 year after SDEP within both groups with no significant difference between groups. Conclusion: Continuous SDEP results in sustainable increase in diabetes knowledge and improved glycemic control, thus avoiding or delaying diabetes complications, and reducing the burden on the society.

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