Objectives - to improve the quality and efficiency of primary endocrinological care for patients with diabetes mellitus by formalizing outpatient admission and optimizing the professional time of an endocrinologist spent on documentation. Material and methods. A protocol of examination, developed according to the specifity of care of outpatients with diabetes mellitus, was introduced into practice of endocrinologists. To assess the usability of the protocol, the timing of outpatient admission and the quality control of outpatient medical care was carried out. Results. The trial of the formalized protocol in clinical settings have confirmed its convenience for doctor's daily work. It does not require extra time for patient registration, while significantly improves the quality of outpatient appointment records, ensures the complete primary medical data recording, eliminates inaccuracies in the formulation of the diagnosis, program of dispensary observation and treatment. Conclusion. The formalization of the outpatient endocrinologist appointment allows for development of an automated workplace of an endocrinologist with the prospect of its further implementation as a software module for collecting primary medical data in the regional integrated electronic medical record.

Significance: analysis of the mortality structure of patients with diabetes mellitus makes it possible to obtain information not only about the disease outcomes, but also to assess dynamics in epidemiological indicators of complications of diabetes mellitus, especially their terminal stages, which is one of the key effectiveness indicators of medical and rehabilitation measures. The purpose of the study: to conduct a dynamic analysis of the level and structure of mortality of patients with diabetes mellitus in the Samara region for the period from 2000 to 2017. Material and methods: the object of the study was a depersonalized database of the state register of diabetes mellitus in the Russian Federation and the Samara region and the death registration form of patients with diabetes mellitus of the annual report on diseases of the endocrine system. The mortality rates were calculated, the structure of mortality of patients with diabetes mellitus was analyzed according to the ICD-10 disease classes individually for diabetes mellitus type 1 and 2. Results: trends in the dynamics in mortality of patients with diabetes mellitus in the Samara region generally correspond to the Russian ones. Significant differences in the trends in mortality rates in patients with type 1 diabetes mellitus have been identified: the mortality rate in the Samara region increases against the background of the decreased indicator in the Russian Federation, and different vectors of the dynamics in mortality from atherosclerotic cardiovascular diseases are registered. Conclusion: the main reason for changes in the long-term decreasing trend in mortality from diabetes mellitus in the Samara region in 2010-2017 was changes introduced to the procedure for registering causes of death. When entering data into the state register of diabetes mellitus, if the cause of death is indicated as "diabetes mellitus", it is mandatory to indicate the direct cause of death. A limited list of basic mortality indicators of patients with diabetes mellitus is proposed, which can serve as indicators for the dynamic assessment of the epidemiological situation with complications of diabetes mellitus, as well as objective criteria for effectiveness of the ongoing medical and rehabilitation measures.

Objectives the in-depth analysis of the informational and legal base for organisation of remote medical care for patients with diabetes mellitus in the context of the COVID-19 pandemic. Material and methods. Official memoranda of the WHO and the International Labour Organization (ILO), decisions of the Government of the Russian Federation and foreign countries on the use of remote telemedicine counseling in the context of the COVID-19 pandemic were reviewed and analysed. Results.After reviewing the results of remote telemedicine counseling to provide specialized medical care to patients with diabetes during COVID-19 pandemic on various virtual platforms, we defined the factors limiting the widespread use of this technology. We collected metadata of the results of the original experience of remote consultation of patients with endocrine pathology using the automated workplace of an endocrinologist (AWPE). Conclusion.In the context of the COVID-19 pandemic, the development and implementation of new promising forms of outpatient work using digital telecommunication technologies is particularly relevant. The use of remote access telemedicine consulting techniques via Automated endocrinologist's workplace for patients with endocrine pathology during the period of self-isolation showed its effectiveness in a pilot study. Its widespread introduction into outpatient practice will not only significantly increase the availability of medical care for patients with diabetes, but also minimize the risk of infection with a new coronavirus for doctors.

The socio-economic development of the country and any region is influenced by many factors, among which the most important role belongs to the demographic, in a generalized form representing the demographic situation. The demographic situation is usually understood as the demographic situation, the state of demographic processes, the composition and placement of the population at a certain time in a country or a particular region. Thus, the analysis of the demographic situation is necessary for understanding the main parameters of the population, trends in their dynamics, forecasting the number, demographic structure, demographic behavior of the population. Objective: to conduct a comparative analysis of official statistical data on demographic processes (statics and population dynamics) in the Moscow region (MO) for 2000-2015. Materials and methods: at the first stage, the collection and analysis of information and statistical sources were carried out, requests were sent to the Federal and territorial state statistics services of the Russian Federation (Rosstat, Mosobstat, MIAC MO). At the second stage, the data on demographic processes in the Moscow region were copied from the responses of Rosstat, Mosobstat, MIAC MO and from the websites of relevant organizations. Statistical analysis included calculation of simple arithmetic mean, percentage values, economic and demographic burden on the working population, demographic factors and the efficiency of population growth. Results and conclusions. The population of the Moscow region at the beginning of the XXI century continues to increase, but mainly due to migrants arriving from neighboring regions of the country and abroad. Males constitute 46.2% of the population and females 53.8% (2015). Boys are born more than girls by 6% and this advantage is maintained until the age of 30. And starting from the age of 35, the number of women begins to prevail over the number of men by 3.5%. This trend continues to 75 years and older. Age groups of the region's population are formed according to the regressive type: children - 15.9%; working-age population - 59.8%, and persons older than working age - 24.3% (2015). The economic and demographic burden of children and the elderly on the working population is more than 40%. The birth rate in the region increased by 76.7% from 2000 to 2015 and was higher than in 1990. Analysis of the total fertility rate indicates that in the Moscow region remains mononuclear family type (1-2-child family), ie there is no expanded reproduction of the population. In children, and especially in working age, the mortality rate is higher in men than in women. In men, the mortality rate reaches 41% of the total mortality at the working age. The number of women who died in working age is 4 times less than men. The natural increase in the population of the Moscow region for 15 years of the XXI century has a small but negative value, since the population is decreasing, and the increase in the population is mainly due to high migration.