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 ◽  
...  

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.

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.


2020 ◽  
Vol 7 (48) ◽  
pp. 2806-2810
Author(s):  
Niya Babu ◽  
Nima Teresa Andrew ◽  
Mercy Paul ◽  
Chakkalackal Varkey Anthrayose ◽  
Anchitha Meenu Rajeev ◽  
...  

BACKGROUND Diabetes mellitus (DM) is a major cause of avoidable blindness in the developing and the developed countries. Diabetic patients have 25 times more chance of becoming blind than the non-diabetics.1 According to the WHO, the number of people in India affected with Diabetes Mellitus in the year 2000 was 31.7 million which is estimated to rise to 79.4 million by 2030, which would be higher than any other country in the world. 75 percent of all Type 2 diabetics and almost all Type 1 diabetics are expected to develop diabetic retinopathy (DR) over a period of time.2 Diabetic dermopathy or shin spots are the commonest dermatological manifestation in patients with Diabetes Mellitus. It is also known as pigmented pretibial patches, spotted leg syndrome or diabetic dermangiopathy.3 Both diabetic retinopathy and dermopathy are manifestations of diabetic microangiopathy. We wanted to study the association between diabetic retinopathy and diabetic dermopathy. METHODS 182 patients (between 40 - 70 years of age) having diabetes mellitus for at least five years were included in the study and were examined for retinal changes and skin changes. The study period was six months. RESULTS Of the 182 diabetic patients included in this study, 106 (58.2 %) had diabetic retinopathy. Shin spots were seen in 158 cases (86.8 %). 100 (94.3 %) cases with diabetic retinopathy had shin spots. The mean duration of diabetes mellitus in patients with diabetic retinopathy was 11.85 years and it was 8.16 years in those without diabetic retinopathy. The mean duration of diabetes mellitus in patients with shin spots was 14.88 years and it was 10.70 years in those without shin spots. CONCLUSIONS There is significant association between diabetic retinopathy and diabetic dermopathy. KEYWORDS Diabetic Retinopathy, Shin Spots, Diabetic Dermopathy


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.


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.


2020 ◽  
Vol 10 (8) ◽  
pp. 2777
Author(s):  
Eliana B. Souto ◽  
Joana R. Campos ◽  
Raquel Da Ana ◽  
Joana F. Fangueiro ◽  
Carlos Martins-Gomes ◽  
...  

Diabetic retinopathy causes vascular damage to retinal neurons, presenting characteristics of chronic inflammation. The development of new therapies capable of combating vision loss involves knowledge of inflammatory retinal changes. Studies in animal models and patients with diabetes have shown a high expression of the inflammatory molecules that are involved in the progression of diabetic retinopathy. Uveal melanoma is an eye tumour that remains highly deadly, because despite the correct treatment, it still causes metastasis in about 50% of patients. This type of tumour has the ability to produce and store melanin, which may result in resistance to therapy. Over time there has been development of new therapies for this disease, such as radiotherapy and surgical resection. In this review, we discuss diabetic retinopathy and ocular melanoma, their relationship with angiogenesis and the current anti-angiogenic therapies for their treatment.


2014 ◽  
Vol 10 (01) ◽  
pp. 25
Author(s):  
Lauren M Marozas ◽  
Patrice E Fort ◽  
◽  

Diabetic retinopathy is the major ocular complication associated with diabetes, and represents the leading cause of legal blindness in the working-age population of developed countries. Although classically diagnosed based on abnormalities of the retinal microvasculature, diabetic retinopathy is now widely recognized as a neurovascular disease. While all patients with diabetes are at increased risk for eye disease including diabetic retinopathy, proactive measures, and timely intervention can prevent or delay subsequent vision loss. Systemic management of diabetes by combined control of glycemia, blood pressure, and serum lipid levels remains the most important method of preventing diabetic retinopathy onset and progression. Once detected, surgical and medical interventions including photocoagulation, vitrectomy, and intravitral drug injection can help preserve vision. However, the need for improved detection methods and therapies that will allow earlier diagnosis and treatment remains apparent. This review summarizes current techniques for the prevention and intervention for diabetic retinopathy, and examines ongoing developments in the search for new endpoints and therapies as they apply to preventing vision loss associated with diabetes.


2020 ◽  
Author(s):  
Abel Sinshaw Assem ◽  
Mebratu Muusew Tegegne ◽  
Destaye Shiferaw Alemu ◽  
Asamere Tsegaw Woredekal ◽  
Tsehay Kassa Tefera

Abstract Background: Routine eye examination plays a vital role in detecting diabetic retinopathy in its earliest stage before the onset of blindness. Patients’ knowledge about the nature and the consequences of diabetic retinopathy and routine eye checkup helps for timely identification and early treatment. However, there is limited evidence on knowledge of patients with diabetes mellitus on diabetic retinopathy and their eye check-up practices in Ethiopia. The aim of this study was to assess knowledge about diabetic retinopathy, eye check-up practice and associated factors of diabetic retinopathy among adult diabetic patients at Debark hospital, Northwest Ethiopia. Methods: Institution based cross-sectional study was conducted at Debark hospital, Northwest Ethiopia, from April 20/2018- May 20/2018. A pretested interviewer administered structured questionnaire was used to collect data among 230 diabetic patients aged 18 years and above. Data were entered in to Epi Info version 7 and exported to SPSS version 20 for analysis. Bivariable and multivariable binary logistic regression analyses were done. Odds ratio with 95% confidence level was determined and variables with p–value of < 0.05 were considered as statistically significant. Result: Out of 238 sample 230 were participated, among this, 119 (51.7%) were males. The mean age of the respondents was 49 (SD ±17.6) years. One hundred nine (47.4%) participants had good knowledge and 91 (39.6%) had good eye check-up practice. Urban residence [AOR= 2.65;95% CI: 1.16-6.07)]), monthly income of 3501-8000 birr [AOR=4.54;(1.31-15.7)], type II diabetes mellitus [AOR=3.9;(1.6-9.6)], duration of diabetes (6-12 years[AOR=4.4;(1.4-13.5)]), history of eye disease [AOR=5.5;(2.3-13.0)] were associated with good knowledge. Similarly, longer duration of diabetes (13-25 years [AOR=3.77; (1.05-13.5)]) and history of eye disease [AOR=2.47; (1.09-5.62)] were associated with good eye check-up practice. Conclusion: The proportion of good knowledge about diabetic retinopathy among diabetic patients at Debark hospital was fair (47.4%) and good eye check-up practice (eye examination at least once in the past year) was low (39.6%). Longer duration of diabetes and history of eye disease were identified as positive factors for good knowledge and eye check-up practice. Knowledge and regular eye check-up practice needs to be enhanced through provision of appropriate health education.


2018 ◽  
Vol 21 (3) ◽  
pp. 160-169 ◽  
Author(s):  
Minara S. Shamkhalova ◽  
Olga K. Vikulova ◽  
Anna V. Zheleznyakova ◽  
Michail A. Isakov ◽  
Marina V. Shestakova ◽  
...  

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.


2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Syeda Birjees Anwar ◽  
Naveed Asif ◽  
Syed Abid Hassan Naqvi ◽  
Sidra Malik

Objective: To determine the role of hypertension, hyperlipidemia, smoking and positive family history of diabetes and hypertension in the development of diabetic retinopathy. Methods: This prospective cohort study was conducted at the Department of Chemical Pathology, Armed Forces Institute of Pathology, Rawalpindi over 2 years period from June 2014 to June 2016. One hundred consecutive diabetic patients with no signs of diabetic retinopathy and good glycemic control (HbA1c<6.5%) were registered by non-probability convenient sampling after taking written informed consent. They were evaluated for hypertension, hyperlipidemia and smoking status. These patients were then followed 6 monthly for 2 years to look for the development of diabetic retinopathy. Results: The mean age of the patients was 50.72±9.29 years and there were 57 (57%) male and 43 (43%) female patients. Majority (82%) of the patients had NIDDM. The mean duration of diabetes was 8.31±6.83 years. 11% of the patients were smoker, 37% were hypertensive, 6% had hyperlipidaemia, 62% had family history of diabetes and 30% had family history of hypertension. At the end of follow-up, 9 (9.0%) patients had diabetic retinopathy. The frequency of diabetic retinopathy increased with increasing age of the patient; however, the difference was statistically insignificant. A comparatively higher frequency of diabetic retinopathy was also seen in patients with IDDM and those with positive family history of diabetes and hypertension yet again, the difference was statistically insignificant. Also, no significant difference was noted among male and female genders and smokers vs. non-smoker. However, the frequency of diabetic retinopathy increased significantly with increasing duration of diabetes. It was also higher among those with hypertension and hyperlipidemia. Conclusion: Higher patient age (≥50 years), increasing duration of diabetes (≥20 years), insulin dependent diabetes mellitus, hypertension, hyperlipidemia, and positive family history of diabetes and hypertension were found to be associated with increased frequency of diabetic retinopathy. How to cite this:Anwar SB, Asif N, Naqvi SAH, Malik S. Evaluation of multiple risk factors involved in the development of Diabetic Retinopathy. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.279 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2019 ◽  
Author(s):  
Mebratu Muusew Tegegne ◽  
Abel Sinshaw Assem ◽  
Destaye Shiferaw Alemu ◽  
Asamere Tsegaw Woredekal ◽  
Tsehay Kassa Alemu

Abstract Background: Routine eye examination plays a vital role in detecting diabetic retinopathy in its earliest stage before the onset of blindness. Patients’ knowledge about the nature and the consequences of diabetic retinopathy and routine eye checkup helps in timely identification and early treatment. However, there is limited evidence on knowledge of patients with diabetes mellitus on diabetic retinopathy and their eye check-up practices in Ethiopia in general and the study area in particular. Purpose: The aim of this study was to assess knowledge, eye check-up practice and associated factors of diabetic retinopathy among diabetic patients at Debark hospital, Northwest Ethiopia. Materials and Methods: Institution based cross – sectional study was conducted at Debark hospital, Northwest Ethiopia, from April 20/2018- May 20/2018. A pretested interviewer administered structured questionnaire was used to collect data among 230 diabetic patients aged 18 years and above. Data were entered in to Epi Info version 7 and exported to SPSS version 20 for analysis. Bivariable and multivariable binary logistic regression analyses were done. Odds ratio with 95% confidence level was determined and variables with p–value of < 0.05 were considered as statistically significant. Result: Out of 238 sample 230 were participated, among this, 119 (51.7%) were males. The mean age of the respondents was 49 (SD ±17.6) years. One hundred nine (47.4%) participants had good knowledge and 91 (39.6%) had good eye check-up practice. Urban residence [AOR= 2.65;95% CI: 1.16-6.07)]), monthly income of 3501-8000 birr [AOR=4.54;(1.31-15.7)], type II diabetes mellitus [AOR=3.9;(1.6-9.6)], duration of diabetes (6-12 years[AOR=4.4;(1.4-13.5)]), history of eye disease [AOR=5.5;(2.3-13.0)] were associated with good knowledge. Similarly, longer duration of diabetes (13-25 years [AOR=3.77; (1.05-13.5)]) and history of eye disease [AOR=2.47;(1.09-5.62)] were associated with good eye check-up practice. Conclusion: The proportion of good knowledge about diabetic retinopathy among diabetic patients was fair (47.4%) in the study setting and good eye check-up practice was low (39.6%) Longer duration of diabetes and history of eye disease were identified as positive factors for good knowledge and eye check-up practice. Knowledge and regular eye check-up practice needs to be enhanced through provision of appropriate health education.


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