During 2007-2012 years the ?Diabetes mellitus? sub-programme reached the performance targets with the following results. Development of the State Diabetes Register covering all regions of the Russian Federation. The Register facilitates the continuous evaluation and planning of diabetes care in this country, analysis of epidemiological dynamics (including incidence and mortality in diabetes population) and human resources management.Alteration of the demographics of the national diabetes population, specifically: - an increase in life expectancy among T1DM patients: up to 56.7 years (+3.8 years) in males and up to 60.8 years (+4.1 years) in females; an increase in life expectancy among T2DM patients: up to 72.4 years (+3.2 years) in males and up to 74.5 years (+2.9 years) in females; - a reduction in mortality of diabetes patients for 28.4%; Introduction of novel technologies for diagnostics, prevention and management of DM and its complications, that, in turn, allowed to: - decrease the incidence of diabetic nephropathy for 16.1% and extend the pre-dialysis period; - decrease the incidence of diabetic retinopathy for 11.4% and preserve vision in 86-91% patients who still develop this complication; - decrease the frequency of upper- and lower-level amputations for 24% and 28%, respectively, and to reduce the ulcer healing times 2.5 to 3-fold;Introduction of safe and highly efficient human recombinant insulin and its analogues in the regions of the Russian Federation, along with modern methods of insulin administration and outpatient blood glucose monitoring.Establishment of diabetes educational centres (more than 1100 in the regions of the Russian Federation) that resulted in substantial reduction of number and frequency of diabetes-associated hospital admissions.The sub-programme is estimated to have saved 6 727 596.9 thousand Russian rubles of the budgetary funds due to decrease in the incidence of microvascular complications. A total of 360 papers (including 35 in international medical journals), as well as 81 clinical guidance manuals and 23 monographs were published during the course of this sub-programme.

2. ДИАГНОСТИКА ЗАБОЛЕВАНИЯ ИЛИ СОСТОЯНИЯ (ГРУППЫ ЗАБОЛЕВАНИЙ ИЛИ СОСТОЯНИЙ), МЕДИЦИНСКИЕ ПОКАЗАНИЯ И ПРОТИВОПОКАЗАНИЯ К ПРИМЕНЕНИЮ МЕТОДОВ ДИАГНОСТИКИ 2.1 ЖАЛОБЫ И АНАМНЕЗ 2.2 ФИЗИКАЛЬНОЕ ОБСЛЕДОВАНИЕ 2.3 ЛАБОРАТОРНЫЕ ДИАГНОСТИЧЕСКИЕ ИССЛЕДОВАНИЯ 2.4 ИНСТРУМЕНТАЛЬНЫЕ ДИАГНОСТИЧЕСКИЕ ИССЛЕДОВАНИЯ 2.5 ИНЫЕ ДИАГНОСТИЧЕСКИЕ ИССЛЕДОВАНИЯ 3. ЛЕЧЕНИЕ, ВКЛЮЧАЯ МЕДИКАМЕНТОЗНУЮ И НЕМЕДИКАМЕНТОЗНУЮ ТЕРАПИИ, ДИЕТОТЕРАПИЮ, ОБЕЗБОЛИВАНИЕ, МЕДИЦИНСКИЕ ПОКАЗАНИЯ И ПРОТИВОПОКАЗАНИЯ К ПРИМЕНЕНИЮ МЕТОДОВ ЛЕЧЕНИЯ 3.1 ТЕРАПЕВТИЧЕСКИЕ ЦЕЛИ 3.1.1 Показатели контроля углеводного обмена (индивидуальные цели лечения) 3.1.2 Целевые уровни показателей липидного обмена 3.1.3 Целевые уровни показателей артериального давления 3.2 КОНТРОЛЬ УРОВНЯ ГЛЮКОЗЫ 3.3 НЕМЕДИКАМЕНТОЗНЫЕ МЕТОДЫ ЛЕЧЕНИЯ 3.3.1 Рекомендации по питанию 3.3.2 Рекомендации по физической активности 3.4 МЕДИКАМЕНТОЗНАЯ ТЕРАПИЯ 3.4.1 Общие принципы медикаментозной терапии 3.4.2 Инсулинотерапия 3.5 ХИРУРГИЧЕСКОЕ ЛЕЧЕНИЕ

According to the International Diabetes Federation, 10.9 million people have diabetes mellitus (DM) in Russia; however, only up to 4 million are registered. In addition, 11.9 million people have impaired glucose tolerance and impaired fasting glucose levels [1]. One of the significant risk factors for type 2 DM (T2DM) is obesity, which increases insulin resistance (IR). IR is the major pathogenetic link to T2DM. According to current concepts, there are three types of adipose tissue: white adipose tissue (WAT), brown adipose tissue (BAT) and ?beige?, of which the last two types have a thermogenic function. Some research results have revealed the main stages in the development of adipocytes; however, there is no general consensus regarding the development of ?beige? adipocytes. Furthermore, the biology of BAT and ?beige? adipose tissue is currently being intensively investigated, and some key transcription factors, signalling pathways and hormones that promote the development and activation of these tissues have been identified. The most discussed hormones are irisin and fibroblast growth factor 21, which have established positive effects on BAT and ?beige? adipose tissue with regard to carbohydrate, lipid and energy metabolism. The primary imaging techniques used to investigate BAT are PET-CT with 18F-fluorodeoxyglucose and magnetic resonance spectroscopy. With respect to the current obesity epidemic and associated diseases, including T2DM, there is a growing interest in investigating adipogenesis and the possibility of altering this process. BAT and ?beige? adipose tissue may be targets for developing drugs directed against obesity and T2DM.

Нормативные документы Сахарный диабет. 2015;(1):5-23

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