The epidemiology of diabetes mellitus (DM) is a section of diabetology that includes the study of the basic laws of the formation of the epidemiological situation and the epidemiological conditions in relation to this disease, as well as environmental, social and biological factors that determine the dynamics of its main epidemiological characteristics. The end points of the epidemic process are the prevalence of cases of the disease, their frequency and mortality of patients with diabetes. Each of these characteristics is determined by many factors that can change their importance, priority and even lose it over time. The epidemiological approach to solving a number of diabetological problems is based on the same principles as the epidemiology of other noncommunicable diseases: cardiovascular, oncological and some others. The main ones: the object of study is the population (population); the study of the disease is carried out in vivo of its development and course; in the researcher’s field of vision, the whole set of factors that can be associated with the fact of the development of the disease.

The objective of this work was to study the actual prevalence of diabetes mellitus complications and evaluate the quality of health care provided to the patients with these problems in different regions of Russia. A random sample of 11 240 patients with diabetes mellitus (DM) was obtained from a total of 20 regions of the Russian Federation. The study protocol included evaluation of visual function, the state of peripheral nervous system and lower extremities, renal and cardiovascular functions; in addition, HbA1c, creatinine, total cholesterol and triglyceride levels were measured along with albuminuria. It was found that the actual prevalence of major diabetic complications is 20-50% higher than the registered one. The overwhelming majority of the patients were shown to be chronically decompensated. This finding holds for 85.5% of the children, 92.6% of the adolescents, 83.9% and 74.8% of the adult patients with types 1 and 2 DM respectively. The HbA1c level in patients living in rural areas was 33.7-42.1% higher than in residents of regional urban centres. Fewer than 14.4% and 0.6% of the patients with type 2 DM used insulin and its analogs respectively. Overall, the study demonstrated rather poor quality of medical and preventive aid provided to diabetic patients and the necessity of its improvement.

Objective. The objective of the present study was to elucidate the association between dimorfism -23HphI in the INS gene (rs689) and type 1 diabetes mellitus in several populations of the Russian Federation and to compare the frequency of alleles of this dimorphism in different populations. Material and methods. The case-control association was investigated in five populations of the Russian Federation, viz. Russian, Bashkir, Udmurtian, Yakutian, and Buryat ones. The DNA samples from 528 patients presenting with type 1 diabetes mellitus and 439 control subjects were available for the investigation, Polymorphism typing was performed using the RFLP-PCR technique. The degree of association of the trait of interest with the disease was estimated based on the odd ratio (OR) values. The calculations were made with the use of Statistica software package, version 6, www.statsoff.com and Microsoft Office Excel-2003. Results. The statistically significant association of type 1 diabetes mellitus with T allele and AA rs689 genotype was documented for the Russian, Bashkir, Udmurtian, and Yakutian populations. The protective marker in these populations were T allele and T+ genotype. A similar association was not found for the Buryat population characterized by the lowest diabetes morbidity rate. This population was significantly different from the remaining ones in the high frequency of A allele (87% vs 69-75%; p є [0.0002-0.004]) and AA genotype (77% vs 45-60%; p є [0.00006-0.01]). Conclusion. This study has demonstrated the inter-population differences in the frequency of rs689 alleles and the population-specific differences in the association of rs689 alleles with type 1 diabetes mellitus. It is concluded that the consideration of population-related peculiarities of clinical and genetic associations is an indispensable precondition for the further development of personalized medicine.