Epidemiology of diabetes mellitus in Russian Federation: clinical and statistical report according to the federal diabetes registry

Aim. We analysed the main epidemiological characteristics of diabetes mellitus (DM) in the Russian Federation (prevalence, incidence, mortality and mean life span), degree of diabetes control, and prevalence of diabetic complications (retinopathy, nephropathy, and diabetic foot syndrome and macrovascular pathology) according to the federal DM registry. Materials and methods. The database of the federal DM registry of 79 regions was included using the online system until 31.12.2016. Results. TThe total number of patients with DM in the Russian Federation on 31.12.2016 was 4.348 million (2.97% of the population), comprising 4 million patients with DM2 (92%), 255,000 with type 1 diabetes (T1DM) (6%), and 75,000 with other types of DM (2%). DM prevalence per 100,000 population was as follows: T1DM, 164.19/100,000; type 2 diabetes (T2DM), 2637.17/100,000; and other types of DM, 50.62/100. The incidence per 100,000 population was as follows: T1DM, 16.15/100,000; T2DM, 154.9/100,000; and other types of DM, 8.65/100,000. Mortality per 100,000 population was as follows: T1DM, 2.1/100,000; T2DM, 60.29/100,000; and other types of DM, 0.57/100,000. Mortality decreased in patients with T1DM by 6.6% and with T2DM by 3.6%. Mean life span in patients with T1DM was 50.3 years for men and 58.5 years for women. Mean life span in patients with T2DM was 70.1 years for men and 75.5 years for women. Glycated haemoglobin A1c (HbA1c) levels in T1DM was 7% in 33.4%, 7%7.9% in 28.3%, 8%8.9% in 16.2%, and 9.0% in 22.1% of patients. HbA1c levels in T2DM was 7% in 52.1%, 7%7.9% in 29.1%, 8%8.9% in 10%, and 9.0% in 8.7% of patients. Conclusions. This study evaluated the increase in DM prevalence in the Russian Federation in 2016 and in the dynamics of 20132016, which was mainly due to T2DM. An increase in patients with a target HbA1c level 7% and a decrease in the proportion of patients with severe uncontrolled DM was observed; however, the treatment effectiveness of this key indicator was unsatisfactory, i.e. less than a third of the patients with DM. In the dynamics of 20132016, an increase in mean life span for patients with T2DM and mortality reduction in patients with T1DM and T2DM was observed. The frequency of diabetic complications varied widely, which may reflect differences in the quality of specialised care in different regions.

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Diabetes mellitus in children and adolescents according to the Federal diabetes registry in the Russian Federation: dynamics of major epidemiological characteristics for 2013–2016

Diabetes Mellitus ◽

10.14341/dm9460 ◽

2018 ◽

Vol 20 (6) ◽

pp. 392-402 ◽

Cited By ~ 8

Author(s):

Ivan I. Dedov ◽

Marina V. Shestakova ◽

Valentina A. Peterkova ◽

Olga K. Vikulova ◽

Anna V. Zheleznyakova ◽

...

Keyword(s):

Diabetes Mellitus ◽

Diabetic Neuropathy ◽

Children And Adolescents ◽

Russian Federation ◽

Diabetic Complications ◽

Care Organization ◽

Pump Therapy ◽

Diabetes Registry ◽

Number Of Patients ◽

Epidemiological Characteristics

Background: The data of the register is the main source of up-to-date information about patients with diabetes mellitus (DM). Its very important for improving the quality of medical care organization. Aims: to analyze the main epidemiological DM characteristics in Russian Federation (RF) (prevalence, incidence, mortality) in children and adolescents, to assess the dynamics of these parameters for the period 2013 2016, to analyze the status of compensation for carbohydrate metabolism, therapy of DM1, prevalence of diabetic complications and the reasons for hospitalizations in these age groups. Materials and methods: The database of Federal DM registry of 81 regions was included in the online system. Results: The total number of patients under the age of 18 with DM in RF on 31.12.2016 was 33081 people, there were 95,9% (31727 people) with DM1 and 4,1% (1354 patients) with DM2. The prevalence of DM1 in 20132016 in children: 81.0 91.4 / 100 ths., in adolescents 212,8209,5 / 100 ths. The DM1 incidence/100 thousand population in 2016 in children was 14,2/100 ths., in adolescents 10,0/100 ths. HbA1c levels in DM1 was in children: 7,5% in 32%, 7,69,0% in 33%, 9% in 35% of the patients; in adolescents 7,5% in 25%, 7,69,0% in 30%, 9% in 45% of the patients. Among complications in children and adolescents with DM1, diabetic neuropathy is the most often recorded (in 10,9% of cases and 40,8%, respectively); among DM2 patients, diabetic neuropathy is registered in 4,7% and 8,8% in children and adolescents, respectively. There are associated diseases in DM2 patients arterial hypertension and dyslipidemia. 43,8% of children and 49,2% of adolescents were hospitalized in the anamnesis, most hospitalizations in 2016 (children 71,9%, adolescents 67,1%) were due to diabetes. Conclusions: It is established that in the dynamics of 20132016 the prevalence of DM1 in children continues to increase, with relatively stable indicators in adolescents. According to the register, during last two years there has been a decrease in the incidence of DM1 and, on the contrary, an increase in the prevalence/incidence of DM2 in children. Significant interregional differences in the level of incidence/prevalence have been established, especially in regions located in various geographic regions of the RF. The frequency of diabetic complications in children and adolescents with diabetes varies. There is an association of hospitalizations with higher HbA1c level. In the structure of therapy of this age group the ratio of insulin therapy in syringes-pens and pump therapy is 80.9% / 15.1% according to the register.

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Diabetes mellitus in Russian Federation: prevalence, morbidity, mortality, parameters of glycaemic control and structure of glucose lowering therapy according to the Federal Diabetes Register, status 2017

Diabetes Mellitus ◽

10.14341/dm9686 ◽

2018 ◽

Vol 21 (3) ◽

pp. 144-159 ◽

Cited By ~ 37

Author(s):

Ivan I. Dedov ◽

Marina V. Shestakova ◽

Olga K. Vikulova ◽

Anna V. Zheleznyakova ◽

Michail А. Isakov

Keyword(s):

Diabetes Mellitus ◽

Renal Failure ◽

Chronic Renal Failure ◽

Life Expectancy ◽

Russian Federation ◽

Diabetic Coma ◽

Glucose Lowering ◽

Number Of Patients ◽

Diabetes Register ◽

Epidemiological Characteristics

BACKGROUND: The enormous social lesion caused by high prevalence of diabetes mellitus (DM) determines the state importance of clinical and epidemiological monitoring organization. AIMS: To analyze epidemiological characteristics (prevalence, mortality, morbidity), the level ofHbA1c, evaluate the therapy in Russian Federation in 20132017. METHODS: We have used the database of the Russian Federal Diabetes register 81 regions included in the online register system. RESULTS: The total number of patients with DM was 4,498m. (3.06% RF population), including: Type 1 (T1) 5,7% (0,26 m), T2 92,1% (4,15m), other DM types 1,9% (83,8 ths). Distribution male/female: T1 53.5%/46.5%, T2 29%/71%, other DM types 24%/76%. The proportion of men decreases with aging. Number of patients 65 years was 2.293.520, including T1 21.97ths (3.6%), T2 2m271.5ths (54.7%). The prevalence 20132017 per 100,000 population was as follows: T1 159,8169,6; T2 2455.32775.6; other DM types 51,265,8. Morbidity: T1 9,87,0; T2 226,7185,2; other DM types 7,812,4. The structure of causes of death 20132017: T1: diabetic coma 2,01,5%, myocardial infarction 4,04,4%, cerebral circulation disorders 8,27,6%, cardiovascular insufficiency 18,516,4%, chronic renal failure 6,16,0%; T2 0,20,2%, 4,54,5%, 12,712,2%, 29,028,6%, 1,21,8%, respectively. Mortality: T1 2.3; T2 68.4, other DM types 0,8. Life expectancy (average age of death of patients): T1 male 50.350.2, female 60.257.2; T2 69.870.3, 75.175.9 respectively. The number of patients with targetHbA1clevel 7%: T1 22.334.0%, T2 38.052.4%;HbA1c9.0%: T1 29.221.1%, T2 12.68.8%. The most commonly prescribed classes of glucose lowering medications (GLM) in 2017: in monotherapy Metformin (57.3%), Sulfonilurea (SU) (41,1%); in combination of 2 GLM: Metformin+SU 92,58% Metformin+iDPP-4 5.63%; 3 or more GLM: Metformin+SU+iDPP-4 83,9%, Metformin+SU+iSGLT-2 8.98%. The proportion of patients on aGPP-1 therapy is 0.01%. CONCLUSIONS: We observed the growth of prevalence of DM in Russian Federation and decrease in registered morbidity rate; an increase in life expectancy in T2; decrease in mortality due to diabetic coms and stable mortality rate from cardiovascular events (heart attack, stroke, cv deficiency), gangrene, chronic renal failure in both types of DM; a steady improvement in glycemic control. In the structure of T2 therapy the oral GLMs are dominated, especially Metformin and SU. In the dynamics the prescription of Metformin, insulin, iDPP-4, iSGLT-2 has increased, the proportion of SU has decreased.

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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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Diabetes epidemiology in Russia: what has changed over the decade?

Terapevticheskii arkhiv ◽

10.26442/00403660.2019.10.000364 ◽

2019 ◽

Vol 91 (10) ◽

pp. 4-13 ◽

Cited By ~ 14

Author(s):

M V Shestakova ◽

O K Vikulova ◽

A V Zheleznyakova ◽

M A Isakov ◽

I I Dedov

Keyword(s):

Diabetes Mellitus ◽

Target Level ◽

The Past ◽

Registry System ◽

Epidemiological Monitoring ◽

Number Of Patients ◽

The Russian Federation ◽

Online Format ◽

Diabetes Register ◽

Epidemiological Characteristics

The National diabetes register (NDR) was created as unified dynamic database in online format. It allows providing clinical and epidemiological monitoring of diabetes mellitus (DM) in the whole country. Aim. To analyze the epidemiological characteristics of diabetes over the past decade, to access the dynamics of the prevalence of acute (coma) and chronic (micro - and macrovascular) complications of DM. Materials and methods. The object of the study was the depersonized NDR database of DM patients. It consists of 84 regions of the Russian Federation (RF), included in the online registry system on 01.01.2019. Results and discussion. The total number of patients with DM in RF on 01.01.2019 was 4 584 575 (3.12% of the population), comprising 256.2 thousand patients with T1DM, 4.24 million with T2DM, 89.9 thousand other types of DM. Since 2000, the number of DM patients in RF has grown 2.2 times. 34.7% patients with T1DM reached target level of HbA1c

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Epidemiological characteristics of diabetes mellitus in the Russian Federation: clinical and statistical analysis according to the Federal diabetes register data of 01.01.2021

Diabetes Mellitus ◽

10.14341/dm12759 ◽

2021 ◽

Vol 24 (3) ◽

pp. 204-221

Author(s):

I. I. Dedov ◽

M. V. Shestakova ◽

O. K. Vikulova ◽

A. V. Zheleznyakova ◽

M. А. Isakov

Keyword(s):

Diabetes Mellitus ◽

Russian Federation ◽

Dynamic Assessment ◽

Point Of View ◽

Sex Characteristics ◽

Glucose Lowering ◽

Patients With Diabetes ◽

The Russian Federation ◽

Diabetes Register ◽

Epidemiological Characteristics

BACKGROUND. One of the priority directions in the development of the health care system is to reduce the medical and social damage caused by the increase in the prevalence of diabetes mellitus (DM). From this point of view, the development of a diabetes register is very important as the main information and analytical platform for clinical and epidemiological monitoring of diabetes in the Russian Federation (RF).AIMS. The aim of our study was to analyze a dynamic (2016–2020) of the epidemiological characteristics of diabetes mellitus in the Russian Federation (prevalence, morbidity, mortality), the prevalence of complications, the level of HbA1c and the dynamics of the structure of glucose-lowering therapy (GLT) according to the Federal Diabetes Register (FDR).MATERIALS AND METHODs. The database of FRD (http://diaregistry.ru) 84 regions of the RF. The data are presented in dynamics 2016→2020.RESULTS. The total number of DM patients in the RF as of 01.01.2021 was 4,799,552 (3.23% of the population), including: Type 1 (T1) — 5.5% (265.4 ths) , T2 — 92.5% (4.43 million), other DM types — 2.0% (99.3 ths). The dynamics of prevalence was 168.7→180.9/100 ths people with T1, and 2709 → 3022/100 ths people with T2; morbidity in T1 10.5→7.7/100 ths population, in T2 219.6→154.2/100 ths population. Age and sex characteristics: the proportion of men in T1 — 54%, in T2 — 30%; the max proportion of patients with T1 at the age of 30–39 years, T2 65–69 years. Mortality: T1 3.0 → 2.7/100 ths population, T2 87.7→93.9/100 ths of the population, the main cause of death was cardiovascular: in T1 38,1% cases, in T2 — 52,0%. Life expectancy (average age of death of patients): T1 was 53.2years, the dynamics in males 50.7 → 50.5years, females 58.7→55.2years; in T2 — 73.5 years, males 70.2→70.1years, females 75.7→75.4 years. The dynamic of DM duration until the death: in T1 17.4→19.0 years; in T2 11→11.4 years. The incidence of diabetic complications in T1 and T2 patients: neuropathy 43.3% and 24.4%, nephropathy (CKD) 25.9% and 18.4%, retinopathy 31.7% and 13.5%, respectively. The proportion of patients with HbA1c <7%: in T1 32.3%→36.9%, in T2 51.9%→52.1%, with HbA1c ≥ 9.0% in T1 23.1%→18.7% , in T2 8.9%→8.0%. The structure GLT in T2 patients: glucose lowering medications (GLM) — 76.2% (monotherapy — 44.1%; combination of 2 GLM — 28.9%, 3 GLM — 3.2%), insulin therapy in 18,8%, without drug therapy in 4.9%.CONCLUSIONS. The performed analysis demonstrates the importance of dynamic assessment of epidemiological characteristics and monitoring of clinical data on patients with diabetes through a registry for assessing the quality of diabetes care and the prospects for its development.

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Objectification of the Amount of Compensation for Non-Pecuniary Damage in Claims Against Medical Organizations

RUSSIAN JUSTICE ◽

10.37399/issn2072-909x.2020.6.35-44 ◽

2020 ◽

Vol 6 ◽

pp. 35-44

Author(s):

L. A. Shmarov ◽

Keyword(s):

Law Enforcement ◽

Russian Federation ◽

Medical Assistance ◽

Criminal Proceedings ◽

Enforcement Officer ◽

Number Of Patients ◽

The Russian Federation ◽

Law Enforcement Officer

Based on the analysis of citizens’ claims against medical organizations, as well as on the basis of the analysis of the courts’ consideration of such claims, significant differences were found in the amount of compensation for non-pecuniary damage under various conditions related to both the condition of the victim of medical assistance rendered with defects and on the number of patients. It was shown that it is necessary to further accumulate material in order to obtain a more objective picture of satisfied claims and unification in the Russian Federation. Similar calculations can be carried out for other situations related to the possibility of causing moral harm, for example, disseminating information defaming the honor and dignity of a citizen, or compensating moral harm caused by unlawful actions of a law enforcement officer during criminal proceedings. Using the established average values, the court can, on the basis of established factual circumstances, calculate the amount of compensation for non-pecuniary damage in a particular case.

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Cardio-Ankle Vascular Index in the Persons with Pre-Diabetes and Diabetes Mellitus in the Population Sample of the Russian Federation

Diagnostics ◽

10.3390/diagnostics11030474 ◽

2021 ◽

Vol 11 (3) ◽

pp. 474

Author(s):

Alexei N. Sumin ◽

Natalia A. Bezdenezhnykh ◽

Andrey V. Bezdenezhnykh ◽

Galina V. Artamonova

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Arterial Stiffness ◽

Russian Federation ◽

Population Sample ◽

Visceral Obesity ◽

Cardiovascular Complications ◽

Cross Sectional ◽

The Russian Federation ◽

Diabetes Patients

The aim of this study was to evaluate Cardio-Ankle Vascular Index (CAVI) and increased arterial stiffness predictors in patients with carbohydrate metabolism disorders (CMD) in the population sample of Russian Federation. Methods: 1617 patients (age 25–64 years) were enrolled in an observational cross-sectional study Epidemiology of Cardiovascular Diseases and Their Risk Factors in the Regions of the Russian Federation (ESSE-RF). The standard ESSE-RF protocol has been extended to measure the cardio-ankle vascular index (CAVI), a marker of arterial stiffness. Patients were divided into three groups: patients with type 2 diabetes mellitus (n = 272), patients with prediabetes (n = 44), and persons without CMD (n = 1301). Results: Median CAVI was higher in diabetes and prediabetes groups compared with group without CMD (p = 0.009 and p < 0.001, respectively). Elevated CAVI (≥9.0) was detected in 16.8% of diabetes patients, in 15.9% of those with prediabetes, and in 9.0% of those without CMD (p < 0.001). The factors affecting on CAVI did not differ in CVD groups. In logistic regression the visceral obesity, increasing systolic blood pressure (SBP) and decreasing glomerular filtration rate (GFR) were associated with a pathological CAVI in CMD patients, and age, diastolic blood pressure (DBP), and cholesterol in persons without CMD. Conclusions: the CAVI index values in the prediabetes and diabetes patients were higher than in normoglycemic persons in a population sample of the Russian Federation. Since the identified disorders of arterial stiffness in prediabetes are similar to those in diabetes, their identification is important to prevent further cardiovascular complications.

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Features of the acid-base balance of the prosthetic cavity in patients with diabetes mellitus

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-2-111-115 ◽

2021 ◽

pp. 111-115

Author(s):

N.S. Alkhateeb, ◽

◽

M.A. Frolov ◽

V.V. Shklyaruk ◽

K.N. Odinaeva ◽

...

Keyword(s):

Diabetes Mellitus ◽

Russian Federation ◽

Acid Base Balance ◽

Acid Base ◽

Diabetes Mellitus Group ◽

Ocular Prosthesis ◽

Patients With Diabetes ◽

Base Balance ◽

Eye Prosthesis ◽

The Russian Federation

The number of patients with diabetes mellitus in the Russian Federation on January 1, 2019 is more than 4.5 million people, which is 3.12% of the population of the Russian Federation. Metabolic disorders in diabetes mellitus cause physicochemical changes, including a violation of acid-base balance (pH). Aim. To study the effect of diabetes mellitus and ocular prosthetics on the acid-base balance of the prosthetic cavity. Materials and methods. From 2018 to 2021 - 185 patients of both sexes from 21 to 80 years old (57.73±17.34 years old) were examined. 47 patients using an eye prosthesis and without diabetes mellitus (group I); 93 patients using an eye prosthesis with diabetes (group II), which were divided into two subgroups depending on the level of glycated hemoglobin (HbA1c): II-a subgroup - 47 patients with HbA1c up to 7.5%, II-b group – 46 patients with HbA1c more than 7.5%; 45 patients, without an eye prosthesis and without diabetes mellitus (group III). Results. In patients with an ocular prosthesis and without diabetes, a shift in pH to the side of acidosis was observed. In patients with an ocular prosthesis and with diabetes mellitus, the greatest shift in the pH of the conjunctival cavity to the side of acidosis, depending on the level of HbA1c (8-8.5 – in 25.8% of cases, 9-9.5 – in 43% of cases, and <10 – in 31.2% of cases). Conclusions. The presence of an ocular prosthesis in the conjunctival cavity leads to a shift in pH to the side of the alkaline side. The progression of the pH shift to the side of acidosis directly depends on the HbA1c level in patients, and the combination of two factors (the use of an ocular prosthesis in the conjunctival cavity and the presence of diabetes in the anamnesis) leads to an aggressive shift in the pH of the conjunctival cavity to the side of acidosis. Key words: acid-base balance, ocular prosthesis, diabetes mellitus.

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