scholarly journals 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

2018 ◽  
Vol 21 (3) ◽  
pp. 144-159 ◽  
Author(s):  
Ivan I. Dedov ◽  
Marina V. Shestakova ◽  
Olga K. Vikulova ◽  
Anna V. Zheleznyakova ◽  
Michail А. Isakov

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.

2021 ◽  
Vol 24 (3) ◽  
pp. 204-221
Author(s):  
I. I. Dedov ◽  
M. V. Shestakova ◽  
O. K. Vikulova ◽  
A. V. Zheleznyakova ◽  
M. А. Isakov

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.


2017 ◽  
Vol 20 (1) ◽  
pp. 13-41 ◽  
Author(s):  
Ivan Ivanovich Dedov ◽  
Marina Vladimirovna Shestakova ◽  
Olga Konstantinovna Vikulova

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.


2019 ◽  
Vol 91 (10) ◽  
pp. 4-13 ◽  
Author(s):  
M V Shestakova ◽  
O K Vikulova ◽  
A V Zheleznyakova ◽  
M A Isakov ◽  
I I Dedov

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


2018 ◽  
Vol 20 (6) ◽  
pp. 392-402 ◽  
Author(s):  
Ivan I. Dedov ◽  
Marina V. Shestakova ◽  
Valentina A. Peterkova ◽  
Olga K. Vikulova ◽  
Anna V. Zheleznyakova ◽  
...  

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.


Author(s):  
Mehmet Harman ◽  
Sema Aytekin ◽  
Sedat Akdeniz ◽  
Mehmet Derici

2001 ◽  
Vol 13 (3) ◽  
pp. 190
Author(s):  
You Son Chong ◽  
Seung Won Ahn ◽  
Myeung Nam Kim ◽  
Byung In Ro ◽  
Kye Yong Song

2020 ◽  
Vol 23 (2) ◽  
pp. 104-112
Author(s):  
Olga K. Vikulova ◽  
Anna V. Zheleznyakova ◽  
Mikhail А. Isakov ◽  
Alexey A. Serkov ◽  
Marina V. Shestakova ◽  
...  

BACKGROUND: Glikogemoglobin (HbA1c) is a key clinical marker for evaluating the effectiveness of glucose-lowering therapy for patients with diabetes mellitus (DM) and the quality of diabetic care. AIMS: to conduct dynamic monitoring of the quality of glycemic control in DM patients based on a comprehensive examination in mobile medical center (Diamodul) during repeated visits to the regions in 2019 compared with visits of Based Federal program Diabetes Mellitus (20052010) and data of the National diabetes register (NDR). MATERIALS AND METHODS: The object of the study: patients with T1DM and T2DM examined in Diamodul in 2019 in Voronezh region (Vr), Krasnodar region (Kr) (n = 600), there were dynamic group of re-examined (Vr n = 224; Kr n = 113), random group of new patients (Vr n = 72; Kr n = 191); group of adult patients from NDR with indicated HbA1c in 2019 (n = 2410067). RESULTS: According to Diamodul, the HbA1c levels are significantly worse than they were reported to NDR: the proportion of patients achieved HbA1c 7% for T1DM is 13.3% and 11.7%; T2DM 25.1% and 28.6%, in Kr and Vr, respectively; in NDR: T1DM 37.4%, T2DM 52.2%. The average HbA1c values in the Diamodul are higher than in NDR by 0.95% for T1DM, 1.41% for T2DM patients. The proportion of patients with HbA1c9% decrease in dynamic of examinations through years in T1: in Vr from 53.1% in 2005 and 55.8% in 2010 to 42.9% in 2019, in Kr from 53.2% in 2006 to 43.8% in 2019; also there were decreases in the average HbA1c values in Vr from 9.3% in 2005 and 9.4% in 2010 to 8.8% in 2019; in Kr from 9.1% in 2006 to 8.7% in 2019. In T2DM patients with the best parameters of DM control in a whole, the positive trends were less pronounced and are assessed as non-deterioration: the proportion of HbA1c9 % in Vr: 34.7%34.7%36.4%, in Kr 40.1%28.4%; average values of HbA1c: 8.2%8.4%8.5% and 8.6%8.4%, respectively. CONCLUSIONS: The data of the research clearly indicates the need for 100% inclusion of HbA1c in the examination standards in all DM patients at the primary level at least 1 time per year, in order to monitor the real clinical situation, the effectiveness of glucose-lowering therapy and its timely intensification to prevent development of complications.


2016 ◽  
Vol 6 (4) ◽  
pp. 01
Author(s):  
Tiago Rozendo Evangelista ◽  
Antônio Ricardo Lisboa ◽  
Antônia Elinaide Ferreira Dantas ◽  
Itatyane Batista de Oliveira ◽  
Elvira Uchoa dos Anjos

<p>A Insuficiência Renal Crônica (IRC) é uma doença crônica, progressiva, debilitante, que causa incapacidades e que apresenta alta taxa de mortalidade, sendo que a incidência e prevalência têm aumentado ainda mais na população mundial, relacionada a histórico familiar, sedentarismo, dieta com alto teor de sódio, assim como taxas alteradas de ureia e creatinina, bem como outros fatores que se relacionam com a história clínica e individual. O número de pacientes em tratamento hemodialítico vem aumentando gradualmente ao longo dos anos, sendo a hemodiálise o tratamento mais comum, os pacientes vivenciam mudanças bruscas na sua vida influenciando de forma considerável na qualidade de vida do portador de IRC. O presente trabalho tem como objetivo avaliar a repercussão do tratamento hemodialítico na vida dos pacientes com Insuficiência Renal Crônica. A pesquisa foi realizada no Centro de Hemodiálise do Hospital Regional de Cajazeiras. Os dados foram coletados após a aprovação do CEP, sob o protocolo nº1.515.907. Para a coleta de dados foi utilizado um roteiro de entrevista semiestruturado contendo informações a respeito de fatores sócios demográficos, bem como questões pertinentes ao tratamento hemodialítico. Os dados qualitativos foram organizados conforme a técnica e análise de dados de LEFEVRE; LEFEVRE e analisados mediante leitura pertinente. A pesquisa seguiu a Resolução 466/12 do Conselho Nacional de Saúde que trata de pesquisas desenvolvidas com seres humanos. A hemodiálise repercute de forma significativa na vida do portador de DRC, influenciando de várias maneiras desde aspectos clínicos, como social, financeiro e emocional.</p><p><strong><em>Impact of hemodialysis in the lives of patients with chronic renal failure in Paraiba Hinterland</em></strong></p><p><strong>Abstract </strong>Chronic Renal Failure (CRF) is a chronic, progressive, debilitating disease which causes disabilities and has a high mortality rate, and the incidence and prevalence have increased even more in the world population, related to family background, physical inactivity, diet high sodium content, as well as altered rates of urea and creatinine and other factors that are related to clinical and personal history. The number of patients in hemodialytic treatment has been increasing gradually over the years, in which hemodialysis is the most common treatment. Patients experience sudden changes in their lives influencing considerably in the quality of life of the IRC carrier. To assess the repercussion of hemodialytic treatment in the lives of patients with Chronic Renal Failure. The research was conducted in the Hemodialysis Center at Regional Hospital of Cajazeiras. For the data collection a semi-structured interview guide was used, containing information about social and economic factors, as well as issues related to hemodialytic treatment. The qualitative data were organized according to the technique and data analysis of LEFEVRE; LEFEVRE and analyzed through relevant reading. The research followed the Resolution 466/12 of the National Health Council, which deals with researches conducted on human subjects. A better understanding and characterization of the factors related to the repercussion of the hemodialytic treatment in the lives of the patients affected by Chronic Renal Failure.</p>


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