Diabetes epidemiology in Russia: What has changed over the decade?

Abstract

The National diabetes register (NDR) was created as unified dynamic database in online format. It allows providing clinical and epidemiological monitoring of diabetes mellitus (DM) in the whole country. Aim: To analyze the epidemiological characteristics of diabetes over the past decade, to access the dynamics of the prevalence of acute (coma) and chronic (micro- and macrovascular) complications of DM. Materials and methods: The object of the study was the depersonized NDR database of DM patients. It consists of 84 regions of the Russian Federation (RF), included in the online registry system on 01.01.2019. Results and discussion: The total number of patients with DM in RF on 01.01.2019 was 4 584 575 (3.12% of the population), comprising 256.2 thousand patients with T1DM, 4.24 million with T2DM, 89.9 thousand other types of DM. Since 2000, the number of DM patients in RF has grown 2.2 times. 34.7% patients with T1DM reached target level of HbA1c <7% in 2018, with T2DM - 52.2%. There is a decrease in prevalence of complications in T1/T2 patients compare with 2007 year: ketoacidotic coma in 3/4 times, blindness in 2/4.4, diabetic foot syndrome in 1.5/3 times, respectively. Detailed analysis of DM complications became available after NDR was transferred to the online format (for the period since 2013). The article presents data of the prevalence of diabetic retinopathy and blindness, chronic kidney disease, diabetic foot syndrome, amputations and cardiovascular complications in DM patients. Conclusions: Despite the continued increase in the number of DM patients, significant achievements have been made in the management of DM in RF over the past decade. There is a significant improvement in the quality of diagnosis of complications and decrease in its frequency. The priority remains the development of specialized diabetes care at all levels from primary care to regional centers, as well as standardization of screening algorithms and early diagnosis methods.