# Population Screening for Diabetes and Prediabetes in North Macedonia and Bosnia and Herzegovina: A Transnational Epidemiological Report

## TL;DR

This study compares diabetes and prediabetes rates in North Macedonia and Bosnia and Herzegovina, highlighting the need for population screening and health system improvements.

## Contribution

The study provides a transnational epidemiological comparison of diabetes prevalence in two Western Balkan countries.

## Key findings

- The combined diabetes and prediabetes prevalence was 78% in North Macedonia and 71% in Bosnia and Herzegovina.
- North Macedonians were 1.45 times more likely to have diabetes after adjusting for risk factors.
- Population screening is suggested as a cost-effective approach to manage diabetes in the region.

## Abstract

While North Macedonia (NM) and Bosnia and Herzegovina (BH) have a relatively high prevalence of diabetes, both countries have a low diagnostic rate due to the lack of unified eHealth systems.

We conducted a small-scale, general screening epidemiologic study in NM and BH for a better understanding of the high prevalence of diabetes in our region. A total of 1,291 individuals at risk of diabetes were studied. The diagnostic criteria for diabetes included fasting plasma glucose (FPG) ≥7.0 mmol/L or glycated hemoglobin (HbA1c) ≥6.5%, while prediabetes was diagnosed using impaired glucose tolerance (IGT) or impaired fasting glucose (IFG). The prevalence of diabetes and prediabetes was higher in NM, with a combined rate of 78% compared to 71% in BH. After adjusting for gender, smoking, waist circumference, and triglycerides, the NM group is 1.45 times at greater risk for diabetes. General population screening for diabetes and prediabetes can serve as a cost-effective approach to address the escalating diabetes burden in the Western Balkans. Collaborative initiatives to enhance the integration of national health systems, ensure data reliability, and prioritize preventive healthcare are essential for achieving sustainable diabetes management.