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 ofHbA1c, evaluate the therapy in Russian Federation in 20132017. 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 20132017 per 100,000 population was as follows: T1 159,8169,6; T2 2455.32775.6; other DM types 51,265,8. Morbidity: T1 9,87,0; T2 226,7185,2; other DM types 7,812,4. The structure of causes of death 20132017: T1: diabetic coma 2,01,5%, myocardial infarction 4,04,4%, cerebral circulation disorders 8,27,6%, cardiovascular insufficiency 18,516,4%, chronic renal failure 6,16,0%; T2 0,20,2%, 4,54,5%, 12,712,2%, 29,028,6%, 1,21,8%, respectively. Mortality: T1 2.3; T2 68.4, other DM types 0,8. Life expectancy (average age of death of patients): T1 male 50.350.2, female 60.257.2; T2 69.870.3, 75.175.9 respectively. The number of patients with targetHbA1clevel 7%: T1 22.334.0%, T2 38.052.4%;HbA1c9.0%: T1 29.221.1%, T2 12.68.8%. 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.

Background: The data indicate a higher mortality rate in patients with diabetes mellitus (DM) due to COVID-19, which determines the high relevance for study of risk factors for outcomes. Aim: to assess the effect of clinical and demographic parameters (age, gender, body mass index (BMI), glycemic control (HbA1c), antidiabetic and antihypertensive drugs, including ACE inhibitors and ARB) on clinical outcomes (recovery or death) in patients with T2DM. Materials and methods: A retrospective analysis of the Russian Diabetes Register database, included T2DM patients (n=309) with pneumonia/COVID-19 since 01.02.2020 to 04.27.2020 and known outcome (recovery/death ) Results: Lethality was 15.2% (47/309). Lethality was found to be significantly higher in males (OR=2.08; 95% CI 1.1-3.9; p=0.02) and in patients on insulin therapy (OR = 2.67; 95% CI; 1.42-5.02; p=0.02). Lethality was significantly lower at the age of 65 years (OR= 0.34; 95% CI 0.18-0.67; p = 0.01), in patients receiving metformin (OR=0.26; 95% CI 0.14-0 , 5; p 0.0001), antihypertensive therapy (OR=0.43; 95% CI 0.22-0.82; p=0.009), beta-blockers (OR = 0.26; 95% CI 0.08-0.86; p = 0.018), diuretics (OR=0.4; 95% CI 0.17-0.93; p=0.028) and blockers of the renin-angiotensin system (ACE inhibitors or ARB) (OR=0.36; 95% CI 0.18-0.74; p=0.004). There was a tendency to an increase in lethality at higher rates of HbA1c and BMI, but not reaching statistical significance. Patients on insulin had longer DM duration (13.4 versus 6.8 years, p 0.0001), worse HbA1c (8.1% versus 7.0%, p0.0001) and 3 times more patients with HbA1c 2.5% above goal (14.7% versus 5.9%, p=0.04). Conclusion: Higher lethality on insulin therapy was due to worse glycemic control in this group of patients.The identified risk factors for lethality in patients with type 2 DM indicate that good glycemic control, previous treatment with metformin and antihypertensive drugs (including RAS blockers) could reduce the mortality risks.

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.

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

Федеральное государственное бюджетное учреждение «НАЦИОНАЛЬНЫЙ МЕДИЦИНСКИЙ ИССЛЕДОВАТЕЛЬСКИЙ ЦЕНТР ЭНДОКРИНОЛОГИИ» Министерства здравоохранения Российской Федерации АВТОРСКИЙ КОЛЛЕКТИВ Дедов Иван Иванович -президент ФГБУ «НМИЦ эндокринологии» МЗ РФ, главный внештатный специалист эндокринолог Министерства здравоохранения России, д. м. н., профессор, академик РАН, президент Российской ассоциации эндокринологов. Шестакова Марина Владимировна -директор Института диабета ФГБУ «НМИЦ эндокринологии» МЗ РФ, д. м. н., профессор, академик РАН. Викулова Ольга Константиновна -зав. отделением эпидемиологии и государственного регистра сахарного диабета ФГБУ «НМИЦ эндокринологии» МЗ РФ, к. м. н., доцент. Исаков Михаил Андреевич -сотрудник отделения эпидемиологии и государственного регистра сахарного диабета ФГБУ «НМИЦ эндокринологии» МЗ РФ, к. б. н. Железнякова Анна Викторовна -старший научный сотрудник отделения эпидемиологии и государственного регистра сахарного диабета ФГБУ «НМИЦ эндокринологии» МЗ РФ, к. м. н. Работа по развитию регистра СД проводится ФГБУ «НМИЦ эндокринологии» Минздрава России в рамках выполнения Государственного задания Министерства здравоохранения Российской Федерации (Номер государственного учета НИОКТР АААА-А19-119060690023-7) 2019 г. В 2017 ГОДУ РОССИЯ ВОШЛА В ЧИСЛО СТРАН С ВЫСОКИМ КАЧЕСТВОМ ЭПИДЕМИОЛОГИЧЕСКИХ ДАННЫХ ПО САХАРНОМУ ДИАБЕТУ [IDF] 1 Качество данных нет данных низкое высокое и среднее «НМИЦ эндокринологии» Минздрава РФ при технической поддержке Астон Консалтинг Эндокринологический диспансер или региональный центр диабета ЛПУ региона • Врач-эндокринолог • Медицинский регистратор / мед. сестра Работает онлайн 84 региона РФ • Главный эндокринолог • Ответственный за ведение регистра в регионе • МИАЦ СТАТУС 2018 г. | 5КОЛИЧЕСТВО ПАЦИЕНТОВ В Российской Федерации, как и во всех странах мира, отмечается значимый рост распространенности СД. В РФ на 01.01.2019 г. состояло на диспансерном учете 4,58 млн человек (3,1% населения), из них: 92% (4,2 млн) -СД 2 типа, 6% (256 тыс.) -СД 1 типа и 2% (90 тыс.) -другие типы СД, в том числе 8 006 человек с гестационным диабетом.