Every fifth child, at the time of diagnosis of diabetes, had one of the associated diseases. The number of children with diabetes has been growing in the last three decades, placing Montenegro among the countries with a high incidence rate.
This was, among other things, told "Vijesti" by an endocrinologist and pediatrician at the Clinical Center of Montenegro (KCCG). Maja Raičević, who was promoted to Doctor of Medicine by the Rector of the University of Montenegro (UCG) at the end of last month.
Although healthcare is more accessible in the central region of Montenegro, there is no earlier recognition of diabetes in children compared to other parts of the country.
The incidence of type 1 diabetes in Montenegro, claims the interviewee of "Vijesti", is similar to that in some countries in the region - Serbia, Croatia and Slovenia, and is significantly higher than in Bosnia and Herzegovina and North Macedonia.
According to Raičević, the research, which was part of her doctoral thesis, consisted of two parts. The first part, she said, included 588 children who were diagnosed with newly diagnosed type 30 diabetes over the past XNUMX years.
"Similar to Europe, the diagnosis of type 10 diabetes is predominantly made in children aged 14 to 87, but patients in Montenegro were slightly younger at the time of diagnosis. This may be a result of high rates of obesity among children or low immunization rates. In the second part of the study, we examined the quality of life of children with type 248 diabetes who attend primary school. The questionnaire was completed by 12 children with diabetes and their parents, and the control group was composed of XNUMX of their peers, classmates who were selected by random selection. The average age in this group of children was around XNUMX years old," she said.
The diagnosis is more common in boys
Diabetes is defined as a systemic metabolic disorder characterized by elevated blood glucose levels. This is why, as Raičević assessed, diabetes is one of the biggest problems in modern healthcare.
"In this study, we have shown that the number of newly diagnosed children with type 10 diabetes is increasing over the observed thirty-year period, and that it places Montenegro among the countries with a high incidence of the disease. In our country, the diagnosis is most often made in children between the ages of 14 and XNUMX, more often in boys. It has a pronounced seasonal character, the diagnosis is predominantly made in the winter months. In the first year of the coronavirus pandemic, we registered a higher number of newly diagnosed cases than in previous years, especially among boys."
He notes that, despite the same symptoms (increased thirst, frequent urination, weight loss), in one in four patients "the diagnosis of type 1 diabetes is made late."
"And this at a time when the child had already developed an acute complication of diabetes (diabetic ketoacidosis), accompanied by severe dehydration of the body, which is a life-threatening condition. We also showed that children with type 1 diabetes who attend primary school have a worse quality of life compared to their peers. They achieved the lowest scores in the field of functioning at school compared to their healthy peers, and this problem is more pronounced in the central region of Montenegro, as well as among children living in rural areas," said Raičević, adding that every third child with diabetes who filled out the questionnaire said "that they had felt uncomfortable about their illness at least once in the last month."
Raičević reminds that the highest rate of diabetes is in Nordic countries such as Finland, Sweden, Norway, and Denmark, "followed by Great Britain and Sardinia."
"However, compared to Croatia and Slovenia, many things that make diabetes care easier are less accessible or unavailable to our children, such as modern technologies, intranasal glucagon (a nasal spray that raises blood sugar levels in a child with diabetes who has very low blood sugar and is unconscious), but also the simplest preparations, syrups that do not contain added sugar, and can be used for high fever, pain and other conditions. Also, all neighboring countries have adopted regulations on the treatment of children with diabetes in schools, where they spend most of their time, which is still unregulated in our country," she told "Vijesti".
In the top of Europe in obesity
Bad eating habits and obesity, says Raičević, do not cause type one diabetes, "but type two, which is rarely registered in children."
"But it is the most common type of diabetes in adults. In children, in most cases, it is type one diabetes, which is an autoimmune disease. A child is born with a predisposition to develop autoimmunity, that is, to create antibodies directed against its own organs. The initiator of this process, as research shows, is most often a virus or exposure to radiation or toxins, after which children with diabetes develop antibodies that damage the pancreas, the gland that secretes insulin. In my dissertation, I discussed the possibility that the cause of the increasing number of newly diagnosed children with type one diabetes is a significantly lower rate of vaccination of children according to the regular calendar."
Montenegro, Raičević reveals, is participating in the COSI study that examines the level of nutrition and eating habits of children aged six to nine in European countries.
"The results showed that we are among the top ten countries in terms of the frequency of overnutrition, obesity, the number of hours spent in front of small screens, and active consumption of juices and other sweetened beverages, and at the bottom of the list when comparing the frequency of physical activity and consumption of fruits and vegetables. Most children do not have a healthy meal at school, and they continue to have bad habits at home. Children with diabetes who are advised to take care of their meals at school often become conspicuous," she said.
Diabetes, he claims, brings with it numerous challenges that place a heavy burden on children and their parents.
"A diabetes diagnosis brings with it the need for regular blood sugar testing throughout the day and night, calculating carbohydrates in meals, determining insulin doses, choosing physical activity and the time of day when it will be practiced... This is too much of a burden for a child, and the parent must be fully involved, and diabetes care sometimes requires 'full-time work,'" said Raičević.
As he points out, children of unemployed mothers have "better disease control, but financially these families have difficulties."
"The Ministry of Labor and Social Welfare in neighboring countries solves this problem by providing modest compensation for these children, but also by providing an opportunity for one of the parents to work part-time. I would like this dissertation to help children in Montenegro and their families realize this right," said the interviewee of "Vijesti".
Bonus video:
