Milmedika

In Montenegro, cardiovascular diseases and cancers are among the leading causes of illness and death. What is especially concerning is that more and more people in middle age are developing metabolic disorders and chronic diseases that, in many cases, could be prevented.

Regular annual checkups with an internal medicine specialist are one of the most important steps in prevention. They can help detect changes early, before they turn into more serious health problems. These changes may include occasional high blood pressure, abnormal blood fats, prediabetes, and diabetes.

We spoke with Dr. Miloš Ivanović, internal medicine specialist, who has extensive experience in emergency medicine and clinical trials. Dr. Ivanović is also the official physician of the Volleyball Federation and Boxing Federation of Montenegro, where he takes care of athletes’ health.

Dr. Ivanović regularly attends international and local trainings and professional conferences, follows current medical research, and continues to build on his expertise.

Learn more about Dr. Miloš Ivanović’s education, experience, and professional background in his full biography.

Interview with Dr. Miloš Ivanović

Why are young people developing health problems more often, and earlier in life, than previous generations? And why should these conditions be taken seriously?

Dr. Miloš Ivanović:

You are right, and that is an excellent question. First of all, thank you for choosing this topic. It is always relevant — it was, it is, and it will continue to be, especially now, when we are seeing more and more noncommunicable cardiovascular and metabolic diseases, as well as cancers. Montenegro is among the countries where this is particularly noticeable, and the available incidence data make this topic very important.

People are living longer, but chronic noncommunicable diseases are still very common. That is why timely diagnosis matters so much. Many diseases can be prevented if they are found at a stage when they are still treatable for most patients. When we detect them early, we can keep them under control instead of waiting until treatment becomes more difficult.

That is the main point of this whole topic, and of routine checkups in general. They should be done regularly at every age. When it comes to prevention, I believe the period between 35 and 40 is the right time to start taking this more seriously.

You mentioned that the period between ages 45 and 55 is especially important for internal medicine follow-up. How common are preventive checkups in Montenegro? Are people becoming more aware of how important they are for staying healthy?

Dr. Miloš Ivanović:

Those are definitely key years, because that is when different issues may start to appear: fluctuating high blood pressure, metabolic or pre-metabolic syndrome, abnormal cholesterol and triglyceride levels, as well as changes in pancreatic function and insulin levels. All of this can be part of metabolic syndrome, which can be confirmed through a detailed exam, medical history, and diagnostic testing with an internal medicine specialist, cardiologist, or endocrinologist.

Additional tests help us understand the problem more clearly. And again, many of these conditions can be influenced preventively, especially through lifestyle changes.

Life has become faster, and our habits have changed — the way we sleep, eat, and deal with everyday stress. All of this affects the body through hormone changes and blood pressure variations. High blood pressure can go unnoticed for years, just like abnormal blood fats or prediabetes, also known as insulin resistance. These are the kinds of conditions we need to identify right at the beginning.

What are the early signs of fluctuating high blood pressure and insulin resistance?

Dr. Miloš Ivanović:

Regular checkups with a doctor are important, but it is also helpful for patients to monitor their blood pressure at home. A digital blood pressure monitor is enough. If the readings are repeatedly above 120/80 mmHg, even if they go up and down, that is a sign that the patient should see a doctor — whether they are 30, 35, or 40 years old.

Sometimes there are no symptoms at all. This often happens with “silent” insulin resistance, which plays a major role in metabolic problems and impaired glucose tolerance in both men and women.

With yearly lab tests — including HbA1c, which shows average blood sugar over the past three months, fasting glucose, and other tests recommended by the doctor — we can detect changes in pancreatic function and respond in time.

I would also emphasize the importance of gastroenterology exams to check for changes in the digestive tract, as well as breast ultrasound for female patients. We should also remember that digital mammography after age 40 is the gold standard. Regular gynecological exams and Pap tests are important too, as are urological exams with abdominal ultrasound. With a systematic approach, we can prevent a lot and help people avoid chronic disease.

Which laboratory and biochemical tests are most important for checking heart, metabolic and liver health?

Dr. Miloš Ivanović:

I would highlight an expanded biochemistry panel. This includes blood fats, or lipids; blood sugar; kidney function markers such as urea and creatinine; liver enzymes, or transaminases; thyroid hormones with antibodies; electrolytes; and bilirubin levels, which help assess bile duct function.

We should not leave out vitamins or tumor markers either. They can be important in an initial assessment, especially when a doctor is monitoring for precancerous or premalignant changes and decides that these tests are indicated.

How often should these tests be repeated if the first results are normal?

Dr. Miloš Ivanović:

If the results are within the reference range, they are usually repeated once a year, which is also the usual rhythm for a routine preventive checkup. If digital mammography is normal, it is usually done every two years, depending on the radiologist’s recommendation.

So, most tests and exams are repeated every one to two years, depending on the type of findings.

Why is it so important for men to keep up with urological exams, including prostate ultrasound, as well as preventive colonoscopy?

Dr. Miloš Ivanović:

The focus is definitely on urological issues and detecting changes such as benign prostate enlargement or prostate cancer, which often develops slowly. That slower development can be a positive factor, but symptoms are not always obvious, so some patients come to the doctor late.

The same applies to gastroenterology exams. Digestive symptoms or changes in bowel habits often become clear only later. That is why these exams, as part of a preventive checkup, are so important for finding conditions that can be successfully treated.

I would also point out that lifestyle in the 21st century is changing rapidly. The advice is simple: balanced nutrition and good sleep. I cannot just say “avoid stress.” It is more realistic to say that we should try to handle everyday situations with reason, balance, and moderation.

It is essential that patients have access to a doctor who can perform a comprehensive exam and evaluate everything properly. That is how people can maintain the stability, confidence, and vitality that everyone deserves.

We’re seeing more young people with heart-related symptoms. How much of this is linked to diet, drug use and the way people live today?

Dr. Miloš Ivanović:

This is a broad topic and deserves a separate discussion. Young people are under a lot of pressure from the modern way of life. Genetics is something we cannot change, and everyone should know where their body is most vulnerable — whether that is the cardiovascular system, the lungs, or another system.

When it comes to drugs, their use is unfortunately becoming more common, perhaps as part of a trend or because some people feel they cannot cope with stress. They are certainly one of the causes of serious cardiovascular problems, high blood pressure, rapid heartbeat, and conditions that can precede a heart attack.

This is a topic that should be discussed in more detail on its own.

How can we encourage people to see preventive checkups as an important part of taking care of their health, not a waste of time?

Dr. Miloš Ivanović:

This comes down to general health awareness. Times are changing, and more and more young people are getting information through media like yours. In a way, you are our “extended hand” toward patients.

It is important for doctors to be accessible, and for patients to have enough quality time with them. That way, they can decide together what the next steps should be. We all make mistakes in everyday life, but the focus should be on reducing unhealthy habits related to food, drink, and lifestyle in general.

A time is definitely coming when the focus will shift more toward prevention, not just treatment.