Standards of specialized diabetes care. Edited by Dedov II, Shestakova MV (6th edition)

We are glad to present the 7th Edition of Standards of Diabetes Care.These evidence-based guidelines were designed to standardize and facilitate diabetes care in all regions of the Russian Federation.The Standards are updated on the regular basis to incorporate new data and relevant recommendations from national and international clinical societies, including World Health Organization Guidelines (WHO, 2011, 2013), International Diabetes Federation (IDF, 2011, 2012, 2013), American Diabetes Association (ADA, 2012, 2015), American Association of Clinical Endocrinologists (AACE, 2013), International Society for Pediatric and Adolescent Diabetes (ISPAD, 2014) and Russian Association of Endocrinologists (RAE, 2011, 2012).Current edition of the ?Standards? also integrates results of completed randomized clinical trials (ADVANCE, ACCORD, VADT, UKPDS, etc.), as well as findings from the national studies of diabetes mellitus (DM), conducted in close partnership with a number of Russian hospitals.Latest data indicates that prevalence of DM increased during the last decade more than two-fold, reaching some 387 million patients by the end of 2014. According to the current estimation by the International Diabetes Federation, 592 million patients will be suffering from DM by 2035. These observations resulted in the UN Resolution 61/225 passed on 20.12.2006 that encouraged all Member States "to develop national policies for the prevention, treatment and care of diabetes".Like many other countries, Russian Federation experiences a sharp rise in the prevalence of DM. According to Russian State Diabetes Register, there are at least 4.1 million patients with DM in this country. However, the epidemiological survey conducted by the Federal Endocrinology Research Centre during 2002-2010 suggests that actual prevalence is 3 to 4 times greater than the officially recognized and, by this estimate, amounts to 9-10 million persons, comprising 7% of the national population.Severe consequences of the global pandemics of DM include its vascular complications: nephropathy, retinopathy, coronary, cerebral and peripheral vascular disease. These conditions are responsible for the majority of cases of diabetes-related disability and death.Current edition of the "Standards" emphasizes the patient-oriented approach in making decisions on therapeutic goals, such as levels of glycaemia and blood pressure. It also features updated guidelines on the management of vascular complications.This text represents a consensus by the absolute majority of national experts, achieved through a number of fruitful discussions held at national meetings and forums. These guidelines are intended for endocrinologists and diabetologists, primary care physicians, cardiologists and other medical professionals involved in prevention and treatment of diabetes mellitus.

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Standards of specialized diabetes care. Edited by Dedov II, Shestakova MV, Mayorov AY. 8th edition

Diabetes Mellitus ◽

10.14341/dm20171s8 ◽

2017 ◽

Vol 20 (1S) ◽

pp. 1-121 ◽

Cited By ~ 96

Author(s):

Ivan I. Dedov ◽

Marina V. Shestakova ◽

Aleksandr Y. Mayorov ◽

Olga K. Vikulova ◽

Gagik R. Galstyan ◽

...

Keyword(s):

Russian Federation ◽

Diabetes Care ◽

Primary Care Physicians ◽

Randomized Clinical Trials ◽

Vascular Complications ◽

International Diabetes Federation ◽

World Health ◽

Therapeutic Goals ◽

Type 2 Dm

Dear Colleagues! We are glad to present the8th Editionof Standards of Diabetes Care. These evidence-based guidelines were designed to standardize and facilitate diabetes care in all regions of the Russian Federation. The Standards are updated on the regular basis to incorporate new data and relevant recommendations from national and international clinical societies, including World Health Organization Guidelines (WHO, 2011, 2013), International Diabetes Federation (IDF, 2011, 2012, 2013), American Diabetes Association (ADA, 2012, 2017), American Association of Clinical Endocrinologists (AACE, 2017), International Society for Pediatric and Adolescent Diabetes (ISPAD, 2014) and Russian Association of Endocrinologists (RAE, 2011, 2012, 2015). Current edition of the Standards also integrates results of completed randomized clinical trials (ADVANCE, ACCORD, VADT, UKPDS, SAVOR, TECOS, LEADER, EMPA-REG OUTCOME, etc.), as well as findings from the national studies of diabetes mellitus (DM), conducted in close partnership with a number of Russian hospitals. Latest data indicates that prevalence of DM in the world increased during the last decade more than two-fold, reaching some 415 million patients by the end of 2015. According to the current estimation by the International Diabetes Federation, 642 million patients will be suffering from DM by 2040. These observations resulted in the UN Resolution on Diabetes 61/225 passed on 20.12.2006, and in 2011 - UN Political Declaration, addressed to national health systems, calling for the establishment of multidisciplinary strategy in the prevention and control of non-communicable diseases, where special attention is drawn to the problem of diabetes as one of the leading causes of disability and mortality. Like many other countries, Russian Federation experiences a sharp rise in the prevalence of DM. According to Russian Federal Diabetes Register, there are at least 4.35 million patients with DM in this country by the end of 2016 (3% of population) with 92% (4 million) Type 2 DM, 6% (255 th) Type 1 DM and 2% (75 th) other types of DM. However, these results underestimates real quantity of patients, because they consider only registered cases. Results of Russian epidemiological study (NATION) confirmed that only 50% of Type 2 DM are diagnosed. So real prevalence of patients with DM in Russia is no less than 8-9 million patients (about 6% of population). This is a great long-term problem, because a lot of patients are not diagnosed, so they dont receive any treatment ant have high risk of vascular complications. Severe consequences of the global pandemics of DM include its vascular complications: nephropathy, retinopathy, coronary, cerebral, coronary and peripheral vascular disease. These conditions are responsible for the majority of cases of diabetes-related disability and death. Current edition of the Standards emphasizes the patient-oriented approach in making decisions on therapeutic goals, such as levels of glycaemia and blood pressure. It also features updated guidelines on the management of Type 2 DM and its vascular complications, added information about bariatric surgery as a method of treatment of DM with morbide obesity. This text represents a consensus by the absolute majority of national experts, achieved through a number of fruitful discussions held at national meetings and forums. These guidelines are intended for endocrinologists and diabetologists, primary care physicians, cardiologists and other medical professionals involved in prevention and treatment of DM. On behalf of the Working Group

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Standards of specialized diabetes care. Edited by Dedov I.I., Shestakova M.V., Mayorov A.Yu. 9th edition

Diabetes Mellitus ◽

10.14341/dm221s1 ◽

2019 ◽

Vol 22 (1S1) ◽

pp. 1-121 ◽

Cited By ~ 41

Author(s):

Ivan I. Dedov ◽

Marina V. Shestakova ◽

Aleksandr Y. Mayorov ◽

Olga K. Vikulova ◽

Gagik R. Galstyan ◽

...

Keyword(s):

Diabetes Mellitus ◽

Russian Federation ◽

Diabetes Care ◽

Vascular Complications ◽

International Diabetes Federation ◽

World Health ◽

Hypoglycemic Agents ◽

Type 2 Dm ◽

The Russian Federation

Dear Colleagues! We are glad to present the 9th Edition (revised) of Standards of Diabetes Care. These evidence-based guidelines were designed to standardize and facilitate diabetes care in all regions of the Russian Federation. The Standards are updated on the regular basis to incorporate new data and relevant recommendations from national and international clinical societies, including World Health Organization Guidelines (WHO, 2011, 2013), International Diabetes Federation (IDF, 2011, 2012, 2013), American Diabetes Association (ADA, 2018, 2019), American Association of Clinical Endocrinologists (AACE, 2019), International Society for Pediatric and Adolescent Diabetes (ISPAD, 2014, 2018) and Russian Association of Endocrinologists (RAE, 2011, 2012, 2015). Current edition of the Standards also integrates results of completed randomized clinical trials (ADVANCE, ACCORD, VADT, UKPDS, SAVOR, TECOS, LEADER, EXAMINE, ELIXA, SUSTAIN, DEVOTE, EMPA-REG OUTCOME, CANVAS, DECLARE, CARMELINA, REWIND, etc.), as well as findings from the national studies of diabetes mellitus (DM), conducted in close partnership with a number of Russian hospitals. Latest data indicates that prevalence of DM in the world increased during the last decade more than two-fold, reaching some 463 million patients by the end of 2019. According to the current estimation by the International Diabetes Federation, 578 million patients will be suffering from diabetes mellitus by by 2030 and 700 million by 2045. Like many other countries, Russian Federation experiences a sharp rise in the prevalence of DM. According to Russian Federal Diabetes Register, there are at least 4 584 575 patients with DM in this country by the end of 2018 (3,1% of population) with 92% (4 238 503) Type 2 DM, 6% (256 202) Type 1 DM and 2% (89 870) other types of DM, including 8 006 women with gestational DM. However, these results underestimates real quantity of patients, because they consider only registered cases. Results of Russian epidemiological study (NATION) con- firmed that only 54% of Type 2 DM are diagnosed. So real number of patients with DM in Russia is 9 million patients (about 6% of population). This is a great long-term problem, because a lot of patients are not diagnosed, so they dont receive any treatment ant have high risk of vascular complications. Severe consequences of the global pandemics of DM include its vascular complications: nephropathy, retinopathy, coronary, cerebral, coronary and peripheral vascular disease. These conditions are responsible for the majority of cases of diabetes-related disability and death. In сurrent edition of the Standards: New goals of glycemic control for the elderly, based on the presence of functional dependence, as well as for pregnant women, children and adolescents, are given. Added a snippet that describes the continuous glucose monitoring. Only low-density lipoprotein cholesterol level is used as a target for lipid metabolism. Proposes more stringent target levels of blood pressure. It also features updated guidelines on stratification of treatment in newly diagnosed Type 2 diabetes: the excess of the initial level of HbA1c over the target level was used as a criterion. In the recommendations for the personalization of the choice of antidiabetic agents, it is taken into account that in certain clinical situations (the presence of atherosclerotic cardiovascular diseases and their risk factors, chronic heart failure, chronic kidney disease, obesity, the risk of hypoglycemia) certain classes of hypoglycemic agents (or individual drugs) have proven advantages. Recommendations for psychosocial support are added. The position of metabolic surgery as a method of treatment of DM with morbid obesity is updated. Recommendations for diagnostic and treatment of hypogonadism syndrome in men with DM are added. For the first time, evidence levels of confidence and credibility levels of recommendations for diagnostic, therapeutic, rehabilitative and preventive interventions based on a systematic review of the literature are given in accordance with the recommendations of the Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian Federation. This text represents a consensus by the absolute majority of national experts, achieved through a number of fruitful discus- sions held at national meetings and forums. These guidelines are intended for endocrinologists, primary care physicians and other medical professionals involved in the treatment of DM. On behalf of the Working Group

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Standards of specialized diabetes care. Edited by Dedov I.I., Shestakova M.V., Mayorov A.Yu. 9th edition

Diabetes Mellitus ◽

10.14341/dm12211 ◽

2019 ◽

Vol 22 (1S1) ◽

pp. 1-121 ◽

Cited By ~ 3

Author(s):

Ivan I. Dedov ◽

Marina V. Shestakova ◽

Aleksandr Y. Mayorov ◽

Olga K. Vikulova ◽

Gagik R. Galstyan ◽

...

Keyword(s):

Diabetes Mellitus ◽

Russian Federation ◽

Diabetes Care ◽

Vascular Complications ◽

International Diabetes Federation ◽

World Health ◽

Hypoglycemic Agents ◽

Type 2 Dm ◽

The Russian Federation

Dear Colleagues! We are glad to present the 9th Edition (revised) of Standards of Diabetes Care. These evidence-based guidelines were designed to standardize and facilitate diabetes care in all regions of the Russian Federation. The Standards are updated on the regular basis to incorporate new data and relevant recommendations from national and international clinical societies, including World Health Organization Guidelines (WHO, 2011, 2013), International Diabetes Federation (IDF, 2011, 2012, 2013), American Diabetes Association (ADA, 2018, 2019), American Association of Clinical Endocrinologists (AACE, 2019), International Society for Pediatric and Adolescent Diabetes (ISPAD, 2014, 2018) and Russian Association of Endocrinologists (RAE, 2011, 2012, 2015). Current edition of the Standards also integrates results of completed randomized clinical trials (ADVANCE, ACCORD, VADT, UKPDS, SAVOR, TECOS, LEADER, EXAMINE, ELIXA, SUSTAIN, DEVOTE, EMPA-REG OUTCOME, CANVAS, DECLARE, CARMELINA, REWIND, etc.), as well as findings from the national studies of diabetes mellitus (DM), conducted in close partnership with a number of Russian hospitals. Latest data indicates that prevalence of DM in the world increased during the last decade more than two-fold, reaching some 463 million patients by the end of 2019. According to the current estimation by the International Diabetes Federation, 578 million patients will be suffering from diabetes mellitus by by 2030 and 700 million by 2045. Like many other countries, Russian Federation experiences a sharp rise in the prevalence of DM. According to Russian Federal Diabetes Register, there are at least 4 584 575 patients with DM in this country by the end of 2018 (3,1% of population) with 92% (4 238 503) Type 2 DM, 6% (256 202) Type 1 DM and 2% (89 870) other types of DM, including 8 006 women with gestational DM. However, these results underestimates real quantity of patients, because they consider only registered cases. Results of Russian epidemiological study (NATION) con- firmed that only 54% of Type 2 DM are diagnosed. So real number of patients with DM in Russia is 9 million patients (about 6% of population). This is a great long-term problem, because a lot of patients are not diagnosed, so they dont receive any treatment ant have high risk of vascular complications. Severe consequences of the global pandemics of DM include its vascular complications: nephropathy, retinopathy, coronary, cerebral, coronary and peripheral vascular disease. These conditions are responsible for the majority of cases of diabetes-related disability and death. In сurrent edition of the Standards: New goals of glycemic control for the elderly, based on the presence of functional dependence, as well as for pregnant women, children and adolescents, are given. Added a snippet that describes the continuous glucose monitoring. Only low-density lipoprotein cholesterol level is used as a target for lipid metabolism. Proposes more stringent target levels of blood pressure. It also features updated guidelines on stratification of treatment in newly diagnosed Type 2 diabetes: the excess of the initial level of HbA1c over the target level was used as a criterion. In the recommendations for the personalization of the choice of antidiabetic agents, it is taken into account that in certain clinical situations (the presence of atherosclerotic cardiovascular diseases and their risk factors, chronic heart failure, chronic kidney disease, obesity, the risk of hypoglycemia) certain classes of hypoglycemic agents (or individual drugs) have proven advantages. Recommendations for psychosocial support are added. The position of metabolic surgery as a method of treatment of DM with morbid obesity is updated. Recommendations for diagnostic and treatment of hypogonadism syndrome in men with DM are added. For the first time, evidence levels of confidence and credibility levels of recommendations for diagnostic, therapeutic, rehabilitative and preventive interventions based on a systematic review of the literature are given in accordance with the recommendations of the Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian Federation. This text represents a consensus by the absolute majority of national experts, achieved through a number of fruitful discus- sions held at national meetings and forums. These guidelines are intended for endocrinologists, primary care physicians and other medical professionals involved in the treatment of DM. On behalf of the Working Group

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National register of diabetes mellitus in Russian Federation.

Diabetes Mellitus ◽

10.14341/dm201535-22 ◽

2015 ◽

Vol 18 (3) ◽

pp. 5-22 ◽

Cited By ~ 48

Author(s):

Ivan Ivanovich Dedov ◽

Marina Vladimirovna Shestakova ◽

Olga Konstantinovna Vikulova

Keyword(s):

Diabetes Mellitus ◽

Russian Federation ◽

Diabetic Complications ◽

Diabetes Care ◽

Research Centre ◽

Reference Center ◽

Epidemiological Monitoring ◽

Diabetes Register ◽

Related Mortality ◽

Online Software

Clinical and epidemiological monitoring of diabetes in Russian Federation (RF) is carried out by the National diabetes register, which methodological and organizational reference center is Federal Endocrinology Research Centre. Since 2014 initiated the translation the National diabetes register on online software system in order to increase the effectiveness of the register as a scientific and analytical platform. The article include the analysis of DM prevalence, incidence,DM-related mortality,the prevalence of diabetic complications and analysis of effectiveness of diabetes care (included HbA1c) and according to the data of online register.

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Basic principles of management of patients with diabetes mellitus type 2 in outpatient practice. Part 1. Diagnostics

Russian Family Doctor ◽

10.17816/rfd62679 ◽

2021 ◽

Vol 25 (1) ◽

pp. 19-25

Author(s):

Ludmila N. Degtyareva

Keyword(s):

Diabetes Mellitus ◽

Russian Federation ◽

Primary Care Physicians ◽

Vascular Complications ◽

High Rate ◽

Global Epidemic ◽

Number Of Patients ◽

Patients With Diabetes ◽

The Russian Federation ◽

Outpatient Practice

Worldwide, there is a high rate of growth in the incidence of diabetes mellitus. In the Russian Federation, the prevalence of diabetes is also high. According to some data, the number of patients with this disease in the Russian Federation can reach at least 9 million people (about 6% of the population). The most dangerous consequences of the global epidemic of diabetes mellitus are the development of its systemic vascular complications-nephropathy, retinopathy, lesions of the main vessels of the heart, brain, and arteries of the lower extremities. To prevent the development of complications of diabetes mellitus, its timely diagnosis is extremely important. Primary care physicians play a key role in early detection of diabetes. In this lecture, the risk factors for the development of diabetes mellitus, prevention of this disease, diagnostic approaches that allow timely detection of diabetes mellitus and start its treatment are considered. Diagnostic criteria for various disorders of the glycemic profile are presented. The role of glycated hemoglobin as a diagnostic criterion for diabetes mellitus is noted.

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A1chieve Program in Russian Federation: a multicenter prospective observational study of insulin analogue treatment efficiency and safety in daily management of patients with type 2 diabetes mellitus, who startand intensify insulin treatment having never received it before

Diabetes Mellitus ◽

10.14341/2072-0351-5981 ◽

2012 ◽

Vol 15 (1) ◽

pp. 63-70 ◽

Cited By ~ 3

Author(s):

Marina Vladimirovna Shestakova

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Observational Study ◽

Russian Federation ◽

Randomized Clinical Trials ◽

Vascular Complications ◽

Insulin Analogues ◽

Modern Approach

Prevalence rate of diabetes mellitus worldwide and in Russian Federation is epidemic in its nature. Prospective studies have shown thatmaintenance of glycemic target reduces risk of late vascular complications. In turn, strict glycemic control requires modern approach tointensification of glucose lowering therapy. Randomized clinical trials prove capacity of modern insulin analogues to improve glycemiccontrol while decreasing risk of hypoglycemic events and weight gain. Current paper presents initial data on 9342 patients, participatedin multicenter prospective 52-week observational study A1chieve, conducted in order to assess efficiency and safety of treatment withinsulin analogues Levemir?, NovoMix? and NovoRapid? (Novo Nordisk) in daily management of patients with type 2 diabetes mellitus,who never received that treatment before.

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The Main Determinants of Diabetes Mellitus Vascular Complications: Endothelial Dysfunction and Platelet Hyperaggregation

International Journal of Molecular Sciences ◽

10.3390/ijms19102968 ◽

2018 ◽

Vol 19 (10) ◽

pp. 2968 ◽

Cited By ~ 18

Author(s):

Albino Carrizzo ◽

Carmine Izzo ◽

Marco Oliveti ◽

Antonia Alfano ◽

Nicola Virtuoso ◽

...

Keyword(s):

Diabetes Mellitus ◽

Endothelial Dysfunction ◽

Molecular Mechanisms ◽

Vascular Complications ◽

World Health ◽

Northern Europe ◽

Common Disease ◽

Main Determinants ◽

Health Organization ◽

Platelet Hyperaggregation

Diabetes mellitus is a common disease that affects 3–5% of the general population in Italy. In some countries of northern Europe or in North America, it can even affect 6–8% of the population. Of great concern is that the number of cases of diabetes is constantly increasing, probably due to the increase in obesity and the sedentary nature of the population. According to the World Health Organization, in the year 2030 there will be 360 million people with diabetes, compared to 170 million in 2000. This has important repercussions on the lives of patients and their families, and on health systems that offer assistance to patients. In this review, we try to describe in an organized way the pathophysiological continuity between diabetes mellitus, endothelial dysfunction, and platelet hyperaggregation, highlighting the main molecular mechanisms involved and the interconnections.

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A comparative study of antihyperglycemic effect of Gymnema sylvestre and metformin in streptozotocin induced diabetic rats

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20183027 ◽

2018 ◽

Vol 7 (8) ◽

pp. 1579

Author(s):

Sarita Mulkalwar ◽

Aadil S. Shah ◽

Pallav Kataria ◽

Tanya Gupta ◽

A. V. Tilak ◽

...

Keyword(s):

Diabetes Mellitus ◽

Methanolic Extract ◽

Statistical Significance ◽

International Diabetes Federation ◽

Diabetic Rats ◽

World Health ◽

Gymnema Sylvestre ◽

Sprague Dawley ◽

Prediabetic State ◽

Antihyperglycemic Effect

Background: Diabetes mellitus (DM) is a metabolic disorder that has the phenotype of hyperglycemia. According to World Health Organization (WHO) there were 65.1 million diabetics in India in 2013, International Diabetes Federation estimates this to increase to 190 million by 2035. Although a number of drugs are available for treatment of DM, their cost and safety profile are major concern. Medicinal plants are used by clinicians for treatment of diabetes. Gymnema sylvestre (GS) extract has been reported to increase insulin levels in diabetic rats. This study was designed to compare the antihyperglycemic effect of Gymnema sylvestre with metformin.Methods: Diabetes was induced in Sprague-Dawley rats using streptozotocin 45mg/kg. Methanolic extract of Gymnema sylvestre 120mg/kg p.o. prepared using Soxhlet apparatus.Results: GS extract reduced blood glucose levels but not statistically significant. GS extract increased HDL and triglycerides, reduced both serum ALT and AST but no statistical significance seen. Metformin significantly increased serum urea, which was not seen in GS extract group. GS extract showed regenerative changes in pancreas, liver and kidney.Conclusions: The study investigation demonstrates that methanolic extract of GS possesses antihyperglycemic and hypolipidaemic activity and so it can be considered as a promising natural remedy in a prediabetic state and in mild hyperlipidaemia to prevent its progression. Increase in β cell regeneration activity could be a probable mechanism of action. However, further long term clinical studies are recommended to define its possible role in diabetes mellitus and hyperlipidaemia. Role of GS as a potential hepatoprotective agent also needs further evaluation.

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Economic evaluation of type 2 diabetes mellitus burden and its main cardiovascular complications in the Russian Federation

Diabetes Mellitus ◽

10.14341/dm8153 ◽

2016 ◽

Vol 19 (6) ◽

pp. 518-527 ◽

Cited By ~ 10

Author(s):

Ivan I. Dedov ◽

Anna V. Koncevaya ◽

Marina V. Shestakova ◽

Yuriy B. Belousov ◽

Julia A. Balanova ◽

...

Keyword(s):

Diabetes Mellitus ◽

Russian Federation ◽

Complex Analysis ◽

Vascular Complications ◽

Cardiovascular Complications ◽

Permanent Disability ◽

Clinical Investigations ◽

The Russian Federation ◽

Cardio Vascular

Background. Diabetes Mellitus Type 2 (DMT2) is a complex medical and social problem in the world and in the Russian Federation also due to prevalence and probability of cardio-vascular complications (CVC).Aim. Economic burden evaluation of DMT2 in the Russian Federation.Methods. Complex analysis of expenditures (direct and non-direct costs) based on epidemiological, pharmacoeconomics and clinical investigations, population and medical statistics data.Results. Calculated expenditures for DMT2 are 569 bln RUR per year, that is correspond to 1% of the Russian GDP, and 34,7% of that are expenditures for main CVC (ischemic heart disease, cardiac infarction, stroke). Main part of expenses are non-medical (losses GDP) due to temporary and permanent disability, untimely mortality – 426,7 bln RUR per year. Expenditures in estimated group of patients with non-diagnosed DMT2 but with already having CVC were at least 107 bln per year (18,8% from total cost). Relationship between cost of DMT2 and degree of it’s control was found in the Russian conditions. Estimated cost for compensated patient (HbA1c6,5%) per year was 88 982 RUR, in the same time cost of non-control patient (HbA1c9,5%) was in 2,8 times higher due to more often main CVC in this group.Conclusion. DMT2 diagnosis improvement as well as effective treatment of early stages of illness can decrease probability of CVC and social economic expenditures.

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