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

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 of HbA1c, evalu...

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Autores principales:	Ivan I. Dedov, Marina V. Shestakova, Olga K. Vikulova, Anna V. Zheleznyakova, Michail А. Isakov
Formato:	article
Lenguaje:	EN RU
Publicado:	Endocrinology Research Centre 2018
Materias:	diabetes mellitus diabetes register prevalence mortality cause of death glucose lowering medications Nutritional diseases. Deficiency diseases RC620-627
Acceso en línea:	https://doaj.org/article/7c70d40812064a479d753a649bcc4467
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spelling	oai:doaj.org-article:7c70d40812064a479d753a649bcc44672021-11-14T09:00:21ZDiabetes mellitus in Russian Federation: prevalence, morbidity, mortality, parameters of glycaemic control and structure of glucose lowering therapy according to the Federal Diabetes Register, status 20172072-03512072-037810.14341/DM9686https://doaj.org/article/7c70d40812064a479d753a649bcc44672018-08-01T00:00:00Zhttps://www.dia-endojournals.ru/jour/article/view/9686https://doaj.org/toc/2072-0351https://doaj.org/toc/2072-0378BACKGROUND: 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 of HbA1c, evaluate the therapy in Russian Federation in 2013–2017. 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 2013→2017 per 100,000 population was as follows: T1 159,8→169,6; T2 2455.3→2775.6; other DM types 51,2→65,8. Morbidity: T1 9,8→7,0; T2 226,7→185,2; other DM types 7,8→12,4. The structure of causes of death 2013→2017: T1: diabetic coma 2,0→1,5%, myocardial infarction 4,0→4,4%, cerebral circulation disorders 8,2→7,6%, cardiovascular insufficiency 18,5→16,4%, chronic renal failure 6,1→ 6,0%; T2 0,2→0,2%, 4,5→4,5%, 12,7→12,2%, 29,0→28,6%, 1,2→1,8%, respectively. Mortality: T1 2.3; T2 68.4, other DM types 0,8. Life expectancy (average age of death of patients): T1 male 50.3→50.2, female 60.2→ 57.2; T2 69.8→70.3, 75.1→75.9 respectively. The number of patients with target HbA1c level <7%: T1 22.3→34.0%, T2 38.0→52.4%; HbA1c≥9.0%: T1 29.2→21.1%, T2 12.6→8.8%. 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.Ivan I. DedovMarina V. ShestakovaOlga K. VikulovaAnna V. ZheleznyakovaMichail А. IsakovEndocrinology Research Centrearticlediabetes mellitusdiabetes registerprevalencemortalitycause of deathglucose lowering medicationsNutritional diseases. Deficiency diseasesRC620-627ENRUСахарный диабет, Vol 21, Iss 3, Pp 144-159 (2018)
institution	DOAJ
collection	DOAJ
language	EN RU
topic	diabetes mellitus diabetes register prevalence mortality cause of death glucose lowering medications Nutritional diseases. Deficiency diseases RC620-627
spellingShingle	diabetes mellitus diabetes register prevalence mortality cause of death glucose lowering medications Nutritional diseases. Deficiency diseases RC620-627 Ivan I. Dedov Marina V. Shestakova Olga K. Vikulova Anna V. Zheleznyakova Michail А. Isakov 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
description	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 of HbA1c, evaluate the therapy in Russian Federation in 2013–2017. 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 2013→2017 per 100,000 population was as follows: T1 159,8→169,6; T2 2455.3→2775.6; other DM types 51,2→65,8. Morbidity: T1 9,8→7,0; T2 226,7→185,2; other DM types 7,8→12,4. The structure of causes of death 2013→2017: T1: diabetic coma 2,0→1,5%, myocardial infarction 4,0→4,4%, cerebral circulation disorders 8,2→7,6%, cardiovascular insufficiency 18,5→16,4%, chronic renal failure 6,1→ 6,0%; T2 0,2→0,2%, 4,5→4,5%, 12,7→12,2%, 29,0→28,6%, 1,2→1,8%, respectively. Mortality: T1 2.3; T2 68.4, other DM types 0,8. Life expectancy (average age of death of patients): T1 male 50.3→50.2, female 60.2→ 57.2; T2 69.8→70.3, 75.1→75.9 respectively. The number of patients with target HbA1c level <7%: T1 22.3→34.0%, T2 38.0→52.4%; HbA1c≥9.0%: T1 29.2→21.1%, T2 12.6→8.8%. 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.
format	article
author	Ivan I. Dedov Marina V. Shestakova Olga K. Vikulova Anna V. Zheleznyakova Michail А. Isakov
author_facet	Ivan I. Dedov Marina V. Shestakova Olga K. Vikulova Anna V. Zheleznyakova Michail А. Isakov
author_sort	Ivan I. Dedov
title	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
title_short	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
title_full	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
title_fullStr	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
title_full_unstemmed	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
title_sort	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
publisher	Endocrinology Research Centre
publishDate	2018
url	https://doaj.org/article/7c70d40812064a479d753a649bcc4467
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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

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