scholarly journals Consensus position of endocrinologists and pathologists on coding causes of death in patients with diabetes mellitus (expert opinion)

2021 ◽  
Vol 24 (3) ◽  
pp. 300-309
Author(s):  
I. I. Dedov ◽  
G. A. Frank ◽  
N. G. Mokrisheva ◽  
M. V. Shestakova ◽  
G. A. Melnichenko ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Russian Federation ◽  
Causes Of Death ◽  
Prime Minister ◽  
Negative Impact ◽  
Mortality Risks ◽  
Deputy Prime Minister ◽  
Patients With Diabetes ◽  
Icd 10 ◽  
The Russian Federation

Coding of the causes of death of patients with diabetes mellitus (DM) in the Russian Federation is one of the long-discussed problems, due to the comorbidity of diabetes and cardiovascular diseases (CVD) and a number of contradictions in the key regulatory documents regulating the statistics of mortality in this category of patients, which acquires particular relevance in the context of the coronavirus pandemic, due to its negative impact on the outcomes of the course of COVID-19 and mortality risks. In pursuance of the decisions of the Minutes of the meeting of the working group under the project committee of the National Project «Health» on identifying patterns in the formation of mortality rates of the population dated January 20, 2021 No. 1, chaired by Deputy Prime Minister of the Russian Federation T.A. Golikova, experts of two directions - endocrinology and pathological anatomy, prepared a Draft of agreed recommendations on the Rules for coding the causes of death of patients with diabetes, causing the greatest problems in terms of the use of ICD-10 when choosing the initial cause of death, including in the case of death from CVD and COVID-19.

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

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.

scholarly journals Speech by the deputy prime minister of the Russian Federation T.A. Golikova

2019 ◽  
Vol 89 (9) ◽  
pp. 892-894
Author(s):  
T. A. Golikova
Keyword(s):  
Russian Federation ◽  
Prime Minister ◽  
Deputy Prime Minister ◽  
The Russian Federation

Speech by the deputy prime minister of the Russian Federation T.A. Golikova

scholarly journals The Characteristics and Mortality of Osteoporosis, Osteomyelitis, or Rheumatoid Arthritis in the Diabetes Population: A Retrospective Study

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Jin-Feng Huang ◽  
Qi-Nan Wu ◽  
Xuan-Qi Zheng ◽  
Xiao-Lei Sun ◽  
Chen-Yu Wu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Diabetes Mellitus ◽  
Retrospective Study ◽  
Mortality Rate ◽  
Causes Of Death ◽  
Treatment Strategies ◽  
Mortality Rates ◽  
Crude Mortality ◽  
Patients With Diabetes ◽  
Icd 10

Background. Patients with diabetes mellitus are prone to develop osteoporosis, osteomyelitis, or rheumatoid arthritis (RA). Furthermore, the presence of these complications in those with diabetes may lead to higher mortality. The aim of our study was to assess characteristics and mortality of osteoporosis, osteomyelitis, or rheumatoid arthritis in individuals with diabetes. Methods. We analyzed osteoporosis, osteomyelitis, and RA deaths associated with diabetes from 1999–2017 using the CDC WONDER system (CDC WONDER; https://wonder.cdc.gov). We used ICD-10 codes to categorize the underlying and contributing causes of death. Crude mortality rates (CMR) and age-adjusted mortality rates (AAMR) per 1,000,000 person-years were calculated. Results. The AAMR for osteoporosis in the population with diabetes was significantly higher in females (AAMR: 4.17, 95% CI: 4.10–4.24) than in males (AAMR: 1.12, 95% CI: 1.07–1.16). Deaths due to osteoporosis increased gradually from 1999, peaked in 2003 (AAMR: 3.78, 95% CI: 3.55–4.00), and reached a nadir in 2016 (AAMR: 2.32, 95% CI: 2.15–2.48). The AAMR for RA associated with diabetes was slightly higher in females (AAMR: 4.04, 95% CI: 3.98–4.11) than in males (AAMR: 2.45, 95% CI: 2.39–2.51). The mortality rate due to RA increased slightly from 1999 (AAMR: 3.18, 95% CI: 2.97–3.39) to 2017 (AAMR: 3.20, 95% CI: 3.02–3.38). The AAMR for osteomyelitis associated with diabetes was higher in males (AAMR: 4.36, 95% CI: 4.28–4.44) than in females (AAMR: 2.31, 95% CI: 2.26–2.36). From 1999 to 2017, the AAMR from osteomyelitis in this population was 2.63 (95% CI: 2.44–2.82) per 1,000,000 person-years in 1999 and 4.25 (95% CI: 4.05–4.46) per 1,000,000 person-years in 2017. Conclusions. We found an increase in the age-adjusted mortality rates of RA and osteomyelitis and a decrease of osteoporosis associated with diabetes from 1999 to 2017. We suggest that increased attention should therefore be given to these diseases in the population with diabetes, especially in efforts to develop preventative and treatment strategies.

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

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.

scholarly journals Epidemiology of cardiovascular diseases among patients with diabetes mellitus according to the federal diabetes register of the Russian Federation (2013–2016)

2019 ◽  
Vol 22 (2) ◽  
pp. 105-114 ◽  
Author(s):  
Viktor Y. Kalashnikov ◽  
Olga K. Vikulova ◽  
Anna V. Zheleznyakova ◽  
Mikhail А. Isakov ◽  
Irina Z. Bondarenko ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Diseases ◽  
Russian Federation ◽  
Cerebrovascular Diseases ◽  
Incidence Rates ◽  
Prevention Measures ◽  
Patients With Diabetes ◽  
Large Heterogeneity ◽  
The Russian Federation ◽  
Diabetes Register

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.

scholarly journals Speech of the deputy prime minister of the Russian Federation T.A. Golikova

2019 ◽  
Vol 89 (4) ◽  
pp. 311-314
Author(s):  
T. A. Golikova
Keyword(s):  
Russian Federation ◽  
Prime Minister ◽  
Deputy Prime Minister ◽  
The Russian Federation

Speech of the deputy prime minister of the Russian Federation T.A. Golikova

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

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.

A comparative analysis of the anthropogenic impact and user-pays principle availability in the model areas of the Russian Federation

2020 ◽  
Vol 18 (9) ◽  
pp. 1787-1798
Author(s):  
S.N. Ayusheeva
Keyword(s):  
Environmental Management ◽  
Comparative Analysis ◽  
Russian Federation ◽  
Natural Environment ◽  
Anthropogenic Impact ◽  
Negative Impact ◽  
Economic Behavior ◽  
Environmental Investment ◽  
The Russian Federation ◽  
Comparative Systems

Subject. This article assesses the effectiveness of the existing system of environmental management based on the user-pays principle in terms of reducing the negative impact on the environment. Objectives. The article aims to conduct a comparative analysis of the anthropogenic impact on natural environment components and deficiency payments for pollution in the model areas of the Russian Federation. Methods. For the study, I used the methods of computational, comparative, systems, and structural analyses. Results. Based on the ecological rating of the Russian Federation subjects, the article defines model areas, assesses the degree of anthropogenic impact on the basis of pollution relative rates, and describes the particularities of environmental investment in the selected areas. Conclusions. The system of payments for pollution does not affect the economic behavior of economic entities.

Socio-Economic Analysis of the Proposal to Switch to a Four-Day Working Week in Russia

2019 ◽  
pp. 60-66
Author(s):  
R. A. Lugovskoy ◽  
E. V. Mikhaylov
Keyword(s):  
Public Administration ◽  
Russian Federation ◽  
Social Protection ◽  
Prime Minister ◽  
Working Hours ◽  
Working Time ◽  
Production Costs ◽  
Historical Background ◽  
Labor Legislation ◽  
The Russian Federation

The presented study analyzes the proposal of the Prime Minister of the Russian Federation D. A. Medvedev to switch to a four-day working week. In the context of the topic, the experience of dealing with this issue is examined, including international practices. A similar proposal was discussed by I.V. Stalin as far back as Soviet times, although in the context of switching to five- or six-hour working days, but only in 2019 did this issue become the subject of debate. In light of the pension reform, which has led to an increase in the retirement age in Russia, a number of experts believe that such proposals may entail potential changes that could have a negative effect on the situation of workers. This study examines the mechanisms of public administration in coordination with enterprises relating to changes in the working hours.Aim. The authors aim to analyze potential directions for the improvement of public administration in the field of labor legislation, which has a significant impact on the development of the economy, business, and the situation of workers.Tasks. This study determines the historical background of Russia’s switch to a four-day working week; examines the legal mechanisms and specific features of labor legislation in Russia in the context of the planned switch to a four-day working week; explores international practices in the field of regulation of working hours; analyzes the benefits and drawbacks of switching to a four-day working week in Russia; develops proposals associated with Russia’s switch to a four-day working week.Methods. The methodological basis for the consideration of the problems includes general scientific methods, systems, structural, functional, and institutional analysis.Results. The ongoing processes in the field of improvement of labor legislation and its impact on the economy, business, and the situation of workers are comprehensively analyzed. The historical background of Russia’s switch to a four-day working week is determined; fundamentals of Russian labor legislation are examined; benefits and drawbacks of the potential innovations in the field of regulation of working hours are identified with allowance for international practices. The authors formulate proposals, the implementation of which will bring Russia closer to the switch to a four-day working week.Conclusions. The proposals of the Prime Minister of the Russian Federation to switch to a four-day working week has raised a lot of questions. For instance, it is unclear whether the current wages will be maintained. It is also questionable whether it is a step towards artificially reducing unemployment, in which fields this idea is likely to manifest itself first, and so on. These questions need to be thoroughly discussed by the representatives of the Government of the Russian Federation, Ministry of Labor and Social Protection of the Russian Federation, trade unions, and the scientific community. It is necessary to conduct a sociological survey to determine and prevent concerns among citizens about the upcoming changes. That said, the authors believe that the idea itself is conceptually correct, but it still valid to doubt whether it can be successfully implemented at the time of capitalism, when entrepreneurs focus on profit and are not interested in reducing the working time of their employees. According to the authors, the plans of I.V. Stalin to reduce working time could faster come into fruition with the socialist economic model, which facilitated innovations in the machine tool industry that would boost GDP growth and significantly reduce production costs. Assessing the prospects of development of this idea at the present stage is difficult.

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