Vol. 16 No. 1 (2024): Arch Pub Health
Public Health

Diabetes in the Republic of North Macedonia: epidemiology and economic burden, 2018-2021

Vjosa Recica
Institute of Public Health of the Republic of North Macedonia, Skopje, Republic of North Macedonia
Zorica Naumovska
Faculty of Pharmacy, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia

Published 2024-07-01


  • diabetes,
  • mortality,
  • morbidity,
  • health care costs

How to Cite

Recica V, Naumovska Z. Diabetes in the Republic of North Macedonia: epidemiology and economic burden, 2018-2021. Arch Pub Health [Internet]. 2024 Jul. 1 [cited 2024 Jul. 20];16(1). Available from: https://id-press.eu/aph/article/view/6117


Diabetes is a chronic, metabolic disease with hyperglycemia caused by defects in insulin secretion, insulin action, or both, results in dysfunction and failure of various organs, reduced quality of life, increased medical costs, reduced productivity and premature mortality in diabetic patients. The main goal of the study is presentation of epidemiological data for diabetes, evaluation of complications associated with the disease and economic burden of diabetes in the Republic of North Macedonia. Materials and methods: A retrospective epidemiological study based on prevalence data from the Diabetes Registry in the Republic of North Macedonia, as well as data from primary and specialized healthcare centers was conducted. It combined population demographics in our country in 2021 with epidemiological data for diabetes, as well as healthcare costs associated with diabetes obtained from WHO, Institute of Health Metrics and Evaluation and National Health Insurance Fund. Results: The incidence rate of type 1 diabetes (T1DM) in the Republic of North Macedonia was presented with 1.21%ooo newly diagnosed in 2018 and 2.8%ooo in 2021 with is highest rate in the age group of youths from 10-14 (12.4%ooo) in 2021. In time period 2018-2021, the incidence rate of patients with type 2 diabetes (T2DM) also enlarged from 323.3%ooo to 355.5%ooo, while the prevalence rate increased from 5554.4%ooo to 6549.3%ooo.  The highest prevalence rates for T2DM analyzed by age were observed in age groups between 55 and 79 years. The highest rate of diabetes-associated complications in North Macedonia are complication on peripheral circulation, followed by ketoacidosis, neurological complications, ophthalmic complication, diabetic coma and multiple complications. The percentage of prescriptions for blood glucose lowering drugs (excluding insulin) in our country rose form 7.3% in 2018 up to 7.6% in 2020, whereas the cost of provision of diabetes treatment supplies in 2021 for patients on insulin amounted to approximately 13,457,508,62 USD. The calculated burden of diabetes mellitus and diabetic complications in the Republic of North Macedonia amounted to 42,806.59 disability-adjusted life-years (DALYs). Conclusions: Diabetes rates are increasing worldwide and in the Republic of North Macedonia, too. This epidemiological study is a solid base for implementation of the national strategy for diabetes and will contribute in effective planning and evaluation of all aspects of diabetes control in the Republic of North Macedonia.


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