scholarly journals Trends in the epidemiology of diabetic foot and lower limb amputations in Russian Federation according to the Federal Diabetes Register (2013–2016)

2018 ◽  
Vol 21 (3) ◽  
pp. 170-177 ◽  
Author(s):  
Gagik R. Galstyan ◽  
Olga K. Vikulova ◽  
Michail A. Isakov ◽  
Anna V. Zheleznyakova ◽  
Alexey A. Serkov ◽  
...  
Keyword(s):  
Russian Federation ◽  
Diabetic Foot ◽  
Adult Patients ◽  
Lower Limbs ◽  
Patients With Diabetes ◽  
Specialized Care ◽  
The Mean ◽  
Diabetes Register

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.

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 ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Russian Federation ◽  
Diabetes Care ◽  
Adult Patients ◽  
Duration Of Diabetes ◽  
Patients With Diabetes ◽  
Quality Of Diabetes Care ◽  
The Russian Federation ◽  
Diabetes Register

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.

scholarly journals Trends in the epidemiology of chronic kidney disease in Russian Federation according to the Federal Diabetes Register (2013–2016)

2018 ◽  
Vol 21 (3) ◽  
pp. 160-169 ◽  
Author(s):  
Minara S. Shamkhalova ◽  
Olga K. Vikulova ◽  
Anna V. Zheleznyakova ◽  
Michail A. Isakov ◽  
Marina V. Shestakova ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Russian Federation ◽  
Stage Renal Disease ◽  
End Stage ◽  
Increasing Trends ◽  
Diabetes Register ◽  
Epidemiological Characteristics

BACKGROUND: Chronic kidney disease (CKD) is one of the most severe complications of diabetes mellitus (DM), this determines the importance of the study of epidemiological characteristics of the disease. AIMS: To assess the epidemiological characteristics of CKD in adult DM patients with type 1 (T1), 2 (T2) in Russian Federation in 201316. METHODS: We have used the database of the Russian Federal Diabetes register, 81st regions included in online register. Indicators were estimated per 10,000 adult DM patients (18years). RESULTS: In 2016, the CKD frequency registration was T1 23%, T2 6.9% with marked interregional differences 1.5-49.9%, 0.623.5%, respectively. The CKD prevalence in dynamics 20132016 was 2171.42303.0 in T1 and 512.687.2 in T2. The incidence of new CKD cases increased 2 times in T1 (215.5 vs 104.2), and 3.7 times in T2 (190.4 vs 51.8). The analysis of distribution by CKD stages by KDIGO indicates the increase in the proportion of patients with low and moderate cardiovascular risk and end stage renal disease (ESRD) (with the initial stages of CKD, C1/2 A1) - 12.046.8% in T1; 10.050.4% in T2. The proportion of patients with a very high risk (stages C4/5 C3aA3 and C3bA2-3) progressively decreases: 13.46.7% in T1, 11.34.4% in T2. We observed relation between the CKD prevalence and DM duration. CKD develops in 5.1% patients if T15 years and in 48.0% if T130years; in T2 3.5% and 20.3%, respectively. The average age of CKD onset in T1 increased for 4,3yr (36,140,2), in T2 for 2,4yr (64,466,8), DM duration until CKD development increased in T1 11.814.2yr, in T2 7.68.2yr. CONCLUSIONS: There is a significant improvement in the quality of CKD diagnostics at the earlier stages, older age and a longer DM duration before CKD onset in both types while we observed the increasing trends in CKD prevalence in Russian Federation in the dynamics of 2013-2016. Advances in the management of patients with DM in recent years do not reduce the risk of CKD, but give us a delay in its development. The marked interregional differences frequency of registration of CKD might indicate some remaining problems in verification in a number of regions where the standard for mandatory assessment of albuminuria and glomerular filtration rate not implemented.

scholarly journals Trends in the epidemiology of diabetic retinopathy in Russian Federation according to the Federal Diabetes Register (2013–2016)

2018 ◽  
Vol 21 (4) ◽  
pp. 230-240 ◽  
Author(s):  
Dmitry V. Lipatov ◽  
Olga K. Vikulova ◽  
Anna V. Zheleznyakova ◽  
Mikhail А. Isakov ◽  
Elena G. Bessmertnaya ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Russian Federation ◽  
Vision Loss ◽  
Duration Of Diabetes ◽  
Frequency Of Use ◽  
Proliferative Stage ◽  
Patients With Diabetes ◽  
The Mean ◽  
Diabetes Register ◽  
Epidemiological Characteristics

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.

scholarly journals Narcolepsy Severity Scale: a reliable tool assessing symptom severity and consequences

SLEEP ◽  
2020 ◽  
Vol 43 (6) ◽  
Author(s):  
Yves Dauvilliers ◽  
Lucie Barateau ◽  
Regis Lopez ◽  
Anna Laura Rassu ◽  
Sofiene Chenini ◽  
...  
Keyword(s):  
Daytime Sleepiness ◽  
Age At Onset ◽  
Group Differences ◽  
Diagnosis Delay ◽  
Severity Scale ◽  
The Mean ◽  
Nighttime Sleep ◽  
Self Administered Questionnaire

Abstract Study Objectives To define clinically relevant Narcolepsy Severity Scale (NSS) score ranges, confirm its main performances and sensitivity to medications, and determine whether items need to be weighted. Methods One hundred and forty-three consecutive untreated and 238 treated adults with narcolepsy type 1 (NT1) completed the NSS, a 15-item self-administered questionnaire (score: 0–57) that assesses the severity and consequences of the five major narcolepsy symptoms such as daytime sleepiness, cataplexy, hallucinations, sleep paralysis, and disturbed nighttime sleep (DNS). They also completed the Epworth Sleepiness scale (ESS; daytime sleepiness), Beck Depression Inventory (BDI; depressive symptoms), and EQ5D (quality of life). Results The mean symptom number (4.3 vs 3.5), NSS total score (33.3 ± 9.4 vs 24.3 ± 10.2), and number of narcolepsy symptoms (five symptoms: 53.1% vs 24.8%; four symptoms: 26.6% vs 22.7%; three symptoms: 15.4% vs 32.4%; two symptoms: 4.9% vs 20.2%) were significantly different between untreated and treated patients (p < 0.0001). DNS was often the third symptom (95.5 per cent). The symptom number was associated with diagnosis delay, age at onset, and ESS and BDI scores. Comparisons with ESS, BDI and EQ5D showed that NSS item weighting was not necessary to highlight between-group differences. Four NSS severity levels were defined (mild, moderate, severe, and very severe) with between-group differences related to treatment. The probability of having ESS ≥ 16, BDI ≥ 20, and EQ-5D < 60 increased with the severity level. Conclusion NSS is valid, reliable, and responsive to treatment in patients with NT1, with four clinically relevant severity score ranges provided. NSS has adequate clinimetric properties for broadening its use for both clinic and research.

scholarly journals Mediating Effect of Acceptance Action in relationship between Diabetes Self-Stigma and Quality of Life in People with Diabetes in Korea

2021 ◽  
Vol 28 (3) ◽  
pp. 384-394
Author(s):  
Kawoun Seo
Keyword(s):  
Quality Of Life ◽  
Explanatory Power ◽  
Mediating Effect ◽  
Research Approach ◽  
Mediating Effects ◽  
Descriptive Research ◽  
Patients With Diabetes ◽  
The Mean ◽  
The Relationship

Purpose: This study was done to investigate the mediating effects of acceptance action on the relationship between diabetes self-stigma and quality of life in diabetes patients.Methods: For this study a descriptive research approach was used. Patients (237) with a diagnosis of diabetes mellitus from a doctor of endocrinology were included. Data collection was done from March 26, to March 28, 2020. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson’s correlation coefficient analysis, and hierarchecal multiple regression.Results: The mean scores for diabetes self-stigma, acceptance action and quality of life were 2.67±0.71, 4.12±0.38, and 3.26±0.48, respectively. Acceptance action was found to partial mediate the relationship between diabetes self-stigma and quality of life (z=-4.20, p<.001), and its explanatory power was 17.6%.Conclusion: To improve the quality of life among patients with diabetes in diabetes self-stigma situations, it is necessary to improve their acceptance action and develop step-by-step and differentiated acceptance action enhancement programs through multidisciplinary collaboration.

scholarly journals Sexual Dysfunction in Young Women with Type 1 Diabetes

2020 ◽  
Vol 17 (12) ◽  
pp. 4468
Author(s):  
Edyta Cichocka ◽  
Michał Jagusiewicz ◽  
Janusz Gumprecht
Keyword(s):  
Type 1 Diabetes ◽  
Urinary Tract ◽  
Sexual Function ◽  
Urinary Tract Infections ◽  
Vascular Complications ◽  
Chronic Complications ◽  
Patients With Diabetes ◽  
The Mean ◽  
Tract Infections

Introduction: Sexual dysfunctions (SD) are chronic complications that can develop due to vascular complications or autonomic neuropathy. Additionally, such complications can be of hormonal, infectious or psychogenic etiology. Objectives: The aim of study was to assess the sexual function and acceptance of the chronic disease in young sexually active women with type 1 diabetes (T1DM). Materials and methods: A total of 169 female patients with T1DM completed two standardized questionnaires, the Female Sexual Function Index (FSFI) and the Acceptance of Illness Scale (AIS). Other medical data were collected from medical history. Results: The mean FSFI score was 27.96 ± 5.00, and the mean AIS score was 29.67 ± 8.28. The score < 26 points in FSFI was obtained by 28.7% of patients. Analysis of correlation between the FSFI and the AIS showed that the higher the score on the FSFI, the higher the score on the AIS. Patients who underwent regular physical activity (55%) had a significantly higher acceptance of the disease (p = 0.0026) and reported painful intercourse significantly less frequently (p = 0.01). The value of HbA1c in the study group was 7.31 ± 1.25%. Patients with poorer glycemic control (HbA1c > 8%) obtained significantly lower scores on the FSFI (p = 0.03), whereas no differences were found on the AIS. Diabetes-related complications were observed in 25.5% of patients. The presence of chronic complications did not affect the results of the FSFI or the AIS. Patients with diabetes and hypertension had poorer functioning in the sexual sphere and had significantly lower scores on the FSFI. Past or present history of depression was reported by 36% of patients and also negatively affected acceptance of diabetes (p = 0.0015). Patients who reported recurrent urinary tract infections (17%) achieved significantly lower scores on the FSFI (p = 0.03) and showed that sex-related pain was significantly more prevalent (p = 0.02). In the case of the statement related to the embarrassment of people around the patient due to diabetes, patients with lower scores complained of SD significantly more often (p = 0.0033). Past deliveries, the type of labor, the use of contraceptives or the number of sexual partners had no influence on the overall assessment in both scales. However, in terms of desire, women who had delivered obtained higher scores (p = 0.0021). Conclusion: SD in women with T1DM may result from diabetes-related complications, hormonal disorders or recurrent genital or urinary tract infections. However, they usually have a psychological basis due to the lack of acceptance of the problems related to the treatment of diabetes.

scholarly journals Chronic Spontaneous Urticaria and Type 1 Diabetes Mellitus—Does Quality of Life Impairment Always Reflect Health Danger?

2020 ◽  
Vol 9 (8) ◽  
pp. 2505
Author(s):  
Zenon Brzoza ◽  
Katarzyna Nabrdalik ◽  
Lukasz Moos ◽  
Hanna Kwiendacz ◽  
Karina Badura-Brzoza ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Social Functioning ◽  
Short Form ◽  
Well Being ◽  
Chronic Spontaneous Urticaria ◽  
The Mean ◽  
Being There

Background and aims: Chronic spontaneous urticaria (CSU) and diabetes mellitus type 1 (T1DM) may compromise the quality of life (QoL). We decided to compare the QoL of T1DM patients to those suffering from CSU. Materials and methods: Sixty-six patients with well-controlled T1DM (male 52%) in the mean age of (SD) 36.3 (11.09) years and 51 patients with CSU (male 33%) in the mean age of (SD) 35.8 (8.53) years were enrolled in this observational study. All the participants completed a Short-Form 36 (SF-36) QoL. Results: The QoL related to social functioning was significantly worse among CSU patients. There were differences related to gender found in the group of patients with T1DM—where men tended to declare a better quality of life than women (p = 0.015)—especially in the area of energy/fatigue and pain. It appeared that due to physical and emotional problems occurring in married patients, the QoL is lower in T1DM group in comparison to the CSU one. Conclusions: The patients with CSU presented significantly worse social functioning compared to the ones with T1DM. This fact proves the QoL impairment level is not always related to the level of health danger. The differences in the QoL related to gender and marital status found among T1DM patients point to the necessity for further exploration in a larger group of patients. Due to the fact that optimal disease management should ensure patient’s good emotional well-being, there is a need for additional psychological and social care for patients from those two groups.

scholarly journals A combination of ultrasonic debridement and Shenghong wet dressing in patients with chronic ulcers of the lower limbs

2019 ◽  
Vol 47 (10) ◽  
pp. 4656-4663
Author(s):  
Xie Xiaolan ◽  
Guan Wujie ◽  
Tang Xiaoyan ◽  
Chang Wenlai
Keyword(s):  
Clinical Efficacy ◽  
Ulcer Healing ◽  
Lower Limbs ◽  
Control Group ◽  
Pain Intensity Score ◽  
Ulcer Healing Rate ◽  
Patients With Diabetes ◽  
Chronic Ulcers ◽  
The Mean ◽  
Experimental Group

Objective This study aimed to examine the effects of ultrasonic debridement plus a wet dressing of Shenghong (SH) on chronic ulcer healing of the lower extremities in patients with diabetes. Methods Sixty cases of diabetes combined with chronic lower limb ulcers were randomly divided into control (n = 30) and experimental (n = 30) groups. The control group was treated with ultrasonic debridement plus recombinant human fibroblast growth factor (FGF) gel. The experimental group was treated with ultrasonic debridement plus SH wet dressing. Results The mean clinical efficacy in the experimental group was significantly higher than that in the control group (93.33% ± 6.32% versus 60.0% ± 5.87%). The mean ulcer area was significantly smaller and the mean ulcer healing rate was significantly shorter in the first 3 months, and the mean overall pain intensity score was significantly lower in the experimental group than in the control group. Moreover, the positive rates of bacterial culture on the 7th and 15th days were significantly lower in the experimental group than in the control group. Conclusion The use of ultrasonic debridement plus SH wet dressing for treating ulcers can significantly improve clinical efficacy and promote healing.

scholarly journals Predictive Factors of the Adherence to Real-Time Continuous Glucose Monitoring Sensors: A Prospective Observational Study (PARCS STUDY)

2020 ◽  
pp. 193229682093920
Author(s):  
Takashi Murata ◽  
Akio Kuroda ◽  
Munehide Matsuhisa ◽  
Masao Toyoda ◽  
Moritsugu Kimura ◽  
...  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Prospective Observational Study ◽  
Insulin Infusion ◽  
Glucose Monitoring ◽  
Self Monitoring ◽  
Related Quality ◽  
The Mean ◽  
One Year

Background: Information about factors related to better adherence to continuous glucose monitoring (CGM) sensor adherence is quite limited. Materials and Methods: Forty-six participants with type 1 diabetes using continuous subcutaneous insulin infusion (CSII) without CGM were recruited. The participants’ characteristics and diabetes-related quality of life (QOL) were evaluated at baseline and one year after starting to use CGM. Participants wearing the sensor for ≥60% of the time were considered as adherent. Results: The mean age of the 46 participants was 44.1 ± 15.0 years old and the mean glycohemoglobin (HbA1c) was 7.7 ± 1.0%; 60.9% of the participants were classified as adherent. The duration of using CSII was longer in the adherent group, and the degree of diabetic retinopathy was significantly different. There were no significant differences in age, frequency of self-monitoring of blood glucose, or Hypoglycemia Fear Survey (HFS-B for behavior, HFS-W for worry) score at baseline between the adherent and nonadherent groups. The Problem Areas in Diabetes (PAID) score at baseline was significantly higher and the total CSII-QOL score at baseline was significantly lower in the adherent group. The usage of dual-wave bolus was significantly increased in the adherent group (34.6%-61.5%, P = .016), but not in the nonadherent group (33.3%-33.3%, P > .999). The HbA1c level showed a significant improvement in the adherent group (7.8%-7.3%, P < .001), but not in the nonadherent group (7.5%-7.2%, P = .102). Conclusions: Higher adherence to CGM sensors may be associated with a heavier emotional burden of diabetes and a worse QOL in relation to CSII at baseline.

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