scholarly journals Epidemiology of acute diabetes complications (coma) according to the Federal Diabetes register of the Russian Federation (2013–2016)

2019 ◽  
Vol 21 (6) ◽  
pp. 444-454 ◽  
Author(s):  
Alexander Y. Mayorov ◽  
Olga K. Vikulova ◽  
Anna V. Zheleznyakova ◽  
Mikhail А. Isakov ◽  
Olga G. Melnikova ◽  
...  

Background: Despite the improvement in the quality of diabetes care in the Russian Federation (RF), coma remain one of the causes of death in patients with diabetes. Aim: To assess dynamic of epidemiological characteristic of acute complications in adult patients with T1D and T2D in 201316. Materials and methods: The database of the Russian Federal Diabetes register (81 regions). The indicators of coma for 201316 were estimated for 10000 adult patients with diabetes (18 years). Results: In 2016, the prevalence of coma in RF was 225.9 with T1D and 11.6/10000 adults with T2D. For the period from 2007 the prevalence of ketoacidotic coma decrease three times in T1D, 4 times for T2D.Totally in 2016, 165 new cases of coma for both types of diabetes were registered, an average of 0.4/10000 adults. Interregional differences in the prevalence of coma were observed 04.2/10000 adults. The frequency of new cases of coma has a tendency to decrease: 0,90,4/10000 adults: T1D 5.73.4, T2D 0.60.2/10000 adults. When evaluating the structure of coma, redistribution is evident in their form. So in 2016 the proportion of hypoglycemic coma increased to 40.7%, and ketoacidotic coma decreased to 56.6% in T1D. With T2D, the difference expressed in a lesser degree. The mean duration of diabetes at the time of coma development increased with T1D from 3.89.1 years, with T2D 3.57.0 years. The maximum frequency of development of coma is recorded with the diabetes duration more than 30 years, regardless of the type. The patients age at the time of coma development in T1D increased to 27.5 years old, and in T2D it was 60.4 years, it didnt change significantly. The assessment of glycemic control showed a significant improvement: a decrease in the proportion of patients with HbA1c 9.0% (23% with T1D, 8.8% with T2D), an increase with HbA1c 7% (32.4% and 51.7%, respectively). The average value of HbA1c in 2016 with T1D 8.21%, with T2D 7.48%. Conclusions: It is established that the dynamics of the frequency of development of coma in 201316 in adult patients with diabetes in the RF has a stable tendency to decrease: 1.5 times with T1D and more than 3 times with T2D. It can be assumed that this is due to the improvement in the quality of diabetes care and glycemic control in general, as well as the use of modern medicines. Attention is required to draw to the high frequency of coma in T1D, the development of coma with a longer duration of diabetes, an increase in the proportion of patients with hypoglycemic coma. Significant interregional differences in the frequency of coma registration require additional analysis.

2018 ◽  
Vol 21 (3) ◽  
pp. 170-177 ◽  
Author(s):  
Gagik R. Galstyan ◽  
Olga K. Vikulova ◽  
Michail A. Isakov ◽  
Anna V. Zheleznyakova ◽  
Alexey A. Serkov ◽  
...  

BACKGROUND: The epidemiological study of diabetic foot (DF) is very important because of high risk lower limbs amputations in patients with diabetes mellitus (DM). AIMS: The aim of the study was to evaluate the DF prevalence in adult patients with type 1 (T1) and 2 (T2) diabetes in Russian Federation for period 201316years. METHODS: We have used the database of the Russian Federal Diabetes register, 81st regions included in the online register. Indicators were estimated per 10,000 adult DM patients (18years). RESULTS: In 2016, the prevalence of DF in RF was T1 4,7%, T2 1,9%, with marked interregional differences: 0,1519,9%, 0,0710,3%, respectively. The DF prevalence in RF decreased: T1 506,3473,6, T2 214,60194,8. The incidence of new DF cases/per year was stable in adults with T1: 20,820,4/; increased in T2 13.214.2. The mean age of DF diagnosis increased by 2years for both DM types. The average DM duration of DF determine increased T1 15.419.0years, T2 7.410.1years. Proportion of DF forms: neuropathic with trophic ulcer 41.6%, neuropathic form (Charcot's foot) 17.9%, the neuroischemic 28.3%, ischemic 12.2%, in T2: 41.6%, 7,4%, 32,4%, 18,5%, respectively. The amount of new cases of amputations/per year in dynamics: T1 10,512,4, T2 9,610,9, with marked interregional differences 0.132.9% in T1, 0.04-6.0% in T2. The mean DM duration before amputation increased in T1 18.421.3years, in T2 9.19.9. The average amputation age: T1 51.7years, T2 66.2years. There was marked decrease in proportion of major amputations: T1 43,637,0%, T2 52.245.5 by redistribution in one toe amputations T14,010.0%, in T22,89.1%. CONCLUSIONS: The dynamic of new DF cases in adult patients in Russian Federation is stable at T1, in T2 tends to increase. The interregional differences in frequency of DF and amputations may be due to differences in the quality of specialized care, the lack or shortage of diabetic foot cabinets, treatment of patients with DF in general surgical practice in a number of regions, which is recognized as a less effective strategy. A positive fact that proportion of high amputations declines, DF develops in later age and longer diabetes duration, that may reflect the increasing effectiveness of preventive lower limbs in diabetes.


2011 ◽  
Vol 5 (2) ◽  
pp. 131-137 ◽  
Author(s):  
Kirsten J. Coppell ◽  
Karen Anderson ◽  
Sheila M. Williams ◽  
Claire Lamb ◽  
Victoria L. Farmer ◽  
...  

2008 ◽  
Vol 79 ◽  
pp. S113
Author(s):  
Kirsten Coppell ◽  
Karen Anderson ◽  
Claire Lamb ◽  
Sheila Williams ◽  
Victoria Farmer ◽  
...  

2019 ◽  
Vol 22 (2) ◽  
pp. 105-114 ◽  
Author(s):  
Viktor Y. Kalashnikov ◽  
Olga K. Vikulova ◽  
Anna V. Zheleznyakova ◽  
Mikhail А. Isakov ◽  
Irina Z. Bondarenko ◽  
...  

BACKGROUND: Cardiovascular diseases (CVD) are the main cause of death for patients with diabetes mellitus (DM). AIMS: To evaluate the CVD epidemiology: coronary heart disease (CHD), myocardial infarction (MI) and cerebrovascular diseases in adult patients with type 1 (T1DM) and type 2 (T2DM) diabetes, compare dynamics with data of implementation of the Federal Program Diabetes mellitus in 20072012 and over the online period 20132016. MATERIALS AND METHODS: The database of the Federal Diabetes register (81 regions at 12.2017). We estimated prevalence and incidence rates/10 thousand (th) adult DM patients over 18 years. RESULTS: The prevalence of CVD for the period 2007 2016 significant decreased in CHD for T1DM from 14,9% to 3,5%, for T2DM from 20,1% to 11,7%; MI for T1DM from 5,7% to 1,3%, for T2DM from 7,6% to 3,5%; cerebrovascular diseases for T1DM from 4,9% to 1,7%, for T2DM from 7,6% to 4,3%, respectively. In 20132016 positive trends continued: MI for T1DM 8,25,9/10th patients, for T2DM 19,214,7/10th patients, respectively; CVD for T1DM 11,310,5, for T2DM 29,425,4/10th patients, respectively. There was a large heterogeneity of the prevalence of CVD in the regions. MI varied in patients for T1DM from 319/10 th patients to absence, for T2DM from 800 to 7/10 th patients; the development of cerebrovascular diseases for T2DM from 900 to less than 100/10 th patients, which is largely due to differences in their registration. A small number of cases may be due to insufficient filling of the database, the facts of a huge number require further analysis. The average age of development of MI had increased: for T1DM 51,253 years, for T2DM 63,565 years, cerebrovascular diseases for T1DM 52,352.5 years, for T2DM 65,266,5, respectively. CONCLUSIONS: The prevalence of CVD significantly decreased in the Russian Federation compared to 20072012, as well as for the period 20132016: the prevalence of CHD and cerebrovascular diseases declined, the number of new cases of MI decreased, the average age and duration of DM before the development of CVD significantly increased. These data reflect the results of the program for improvement medical care and prevention measures for patients with diabetes.


2018 ◽  
Vol 21 (4) ◽  
pp. 230-240 ◽  
Author(s):  
Dmitry V. Lipatov ◽  
Olga K. Vikulova ◽  
Anna V. Zheleznyakova ◽  
Mikhail А. Isakov ◽  
Elena G. Bessmertnaya ◽  
...  

Background: Diabetic retinopathy (DR) is one of the most common causes of blindness in patients with diabetes mellitus (DM) that is why its necessary to study the epidemiological characteristics of this complication. Aims: The aim of the study was to evaluate the epidemiological characteristics of DR and blindness in adult patients with type 1 (T1) and 2 (T2) diabetes in Russian Federation (RF) for period 201316years. Materials and methods: Database of Federal Diabetes register, 81st regions included in the online register. Indicators were estimated per 10,000 adult DM patients (18years). Results: In 2016 the DR prevalence in RF was T1 38,3%, T2 15,0%, with marked interregional differences: 2,666,1%, 1,146,4%, respectively. The DR prevalence within 20132016 years was: T1 3830,93805,6; T2 1586,01497,0. Trend of new DR cases/per year increased: T1 153,2187,8; T2 99,7114,9. The structure of new cases of DR in 2016: non-proliferative stage (T1 71,4%, T2 80,3%), pre-proliferative stage 16,4%, 13,8%, proliferative 12,1%, 5,8%, terminal 0,2%, 0,1%, respectively, these data indicated the earlier detection of DR. The mean age of DR diagnosis increased: T1 by 1,2 years, T2 by 2,6. The average DM duration of DR determine increased T1 9,613,1 years, T2 6,09,1. The prevalence of blindness tends to decrease: T1 92,390,8; T2 15,415,2/10.000 DM adults. The amount of new cases of blindness/per year increased: T1 4,34,6; T2 1,21,4. The mean age of blindness increased: T1 39,141,6 years, T2 64,467,4; the mean duration of diabetes before blindness occur (from the time of DM diagnosis) increased: T1 20,221,2 years, in T2 10,711,3. We observed growth of DR treatment (laser surgery, vitrectomy, anti-VEGF medication) but the frequency of use in T2 patients is about 2 times less than in T1. Conclusions: There was a decrease in the overall incidence of eye damage in diabetes (DR and blindness) in the analyzed period in RF. DR and blindness develops at advanced age and with a longer duration of diabetes. As the main directions of eye care development in diabetes it is necessary to standardize primary care in the regions, to unify the examination algorithms and methods of early diagnostic, to increase the continuity and interaction of endocrinologists and ophthalmologists in managing patients with diabetes in order to prevent the development of new cases of vision loss.


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.


2010 ◽  
Vol 40 (14) ◽  
pp. 58-59
Author(s):  
MICHELE G. SULLIVAN

Author(s):  
Vladimir M. Yakovlev

The article analyzes the problems of the manifestation of risks of shadow and criminal activity in the life support system of citizens of the Russian Federation, the dissemination of which requires the development of effective measures to prevent and eliminate them. The most important issue is the formation of an effective economic security system with an emphasis on the new quality of life support for citizens of the Russian Federation in an adequate combination with the high growth rate of NTP in the Russian economy. The new technological structure emerging from the new achievements of scientific and technological progress involves the harmonization of the pace of scientific and technological development, combined with an adequate improvement in the quality of life support for citizens performing such achievements. Owing to this fact formation of new quality of the housing and communal services (HCS) as bases of life support of citizens becomes a prerequisite of increase in performance and intellectualization of human work. With this in mind, early recognition, prevention and elimination of risks of shadow and criminal activities in the housing and communal services system (housing and communal services) is considered as a significant mechanism to increase the effectiveness of the system of comfortable life support for citizens of the Russian Federation. The existing lag in the development of a high-quality and comfortable system for providing citizens of Russia on the basis of housing and communal services, the subject of which is the provision of quality and comfortable services, influenced by numerous risks of shadow and criminal influence, becomes a condition for intensifying economic development and increasing labor productivity on this basis. The need to develop and use modern scientific and technical achievements, especially in the field of digitalization, is emphasized in order to increase the efficiency of the economic security system of housing and communal services organizations based on innovative control mechanisms - internal control, audit, compliance control, taking into account financial investigations in order to prevent and eliminate the risks of shadow and criminal activities in the housing and communal services system.


2020 ◽  
Vol 19 (4) ◽  
pp. 618-632
Author(s):  
A.S. Panchenko

Subject. The article addresses the public health in the Russian Federation and Israel. Objectives. The focus is on researching the state of public health in Russia and Israel, using the Global Burden of Disease (GBD) project methodology, identifying problem areas and searching for possible ways to improve the quality of health of the Russian population based on the experience of Israel. Methods. The study draws on the ideology of the GBD project, which is based on the Disability-Adjusted Life-Year (DALY) metric. Results. The paper reveals the main causes of DALY losses and important risk factors for cancer for Russia and Israel. The findings show that the total DALY losses for Russia exceed Israeli values. The same is true for cancer diseases. Conclusions. Activities in Israel aimed at improving the quality of public health, the effectiveness of which has been proven, can serve as practical recommendations for Russia. The method of analysis, using the ideology of the GBD project, can be used as a tool for quantitative and comparative assessment of the public health.


2020 ◽  
Vol 1 (10(79)) ◽  
pp. 12-18
Author(s):  
G. Bubyreva

The existing legislation determines the education as "an integral and focused process of teaching and upbringing, which represents a socially important value and shall be implemented so as to meet the interests of the individual, the family, the society and the state". However, even in this part, the meaning of the notion ‘socially significant benefit is not specified and allows for a wide range of interpretation [2]. Yet the more inconcrete is the answer to the question – "who and how should determine the interests of the individual, the family and even the state?" The national doctrine of education in the Russian Federation, which determined the goals of teaching and upbringing, the ways to attain them by means of the state policy regulating the field of education, the target achievements of the development of the educational system for the period up to 2025, approved by the Decree of the Government of the Russian Federation of October 4, 2000 #751, was abrogated by the Decree of the Government of the Russian Federation of March 29, 2014 #245 [7]. The new doctrine has not been developed so far. The RAE Academician A.B. Khutorsky believes that the absence of the national doctrine of education presents a threat to national security and a violation of the right of citizens to quality education. Accordingly, the teacher has to solve the problem of achieving the harmony of interests of the individual, the family, the society and the government on their own, which, however, judging by the officially published results, is the task that exceeds the abilities of the participants of the educational process.  The particular concern about the results of the patriotic upbringing served as a basis for the legislative initiative of the RF President V. V. Putin, who introduced the project of an amendment to the Law of RF "About Education of the Russian Federation" to the State Duma in 2020, regarding the quality of patriotic upbringing [3]. Patriotism, considered by the President of RF V. V. Putin as the only possible idea to unite the nation is "THE FEELING OF LOVE OF THE MOTHERLAND" and the readiness for every sacrifice and heroic deed for the sake of the interests of your Motherland. However, the practicing educators experience shortfalls in efficient methodologies of patriotic upbringing, which should let them bring up citizens, loving their Motherland more than themselves. The article is dedicated to solution to this problem based on the Value-sense paradigm of upbringing educational dynasty of the Kurbatovs [15].


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