Diabetes mellitus in Russian Federation: prevalence, morbidity, mortality, parameters of glycaemic control and structure of glucose lowering therapy according to the Federal Diabetes Register, status 2017

Abstract

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.

Inclusion of Ipragliflozin into the Vital and Essential Drugs List: Budget Impact Analysis

“…Так, частота назначения данной группы препаратов в 2016 г. составила 0,3%, а в 2017 г. -0,7% [1]. Основываясь на этих данных, популяция пациентов в модели ежегодно увеличивалась на 8335 человек.…”

“…The size of population of patients with type 2 diabetes receiving SGLT-2 included in the Vital and Essential Drugs list for the basic budget impact analysis, abs. [1]. Также не учитывалась возможность повышения дозы ипраглифлозина с 50 мг до 100 мг в день.…”

“…МЕДИЦИНСКИЕ ТЕХНОЛОГИИ | ОЦЕНКА И ВЫБОР № 4 (38) ВВЕДЕНИЕ Сахарный диабет (СД) -одно из самых распространенных заболеваний в мире. По данным Федерального регистра сахарного диабета (ФРСД), общая численность пациентов с СД в РФ на конец 2017 г. составила 4 498 955 человек (3,06% населения РФ), из них у 4,15 млн человек (92,1%) был диагностирован СД 2 типа [1]. В связи со значительным экономическим ущербом, высокими показателями заболеваемости, инвалидности, преждевременной смертности лиц трудоспособного возраста СД был включен в перечень социально значимых заболеваний Постановлением Правительства РФ от 1 декабря 2004 г.…”

“…Данная группа препаратов в силу механизма действия влияет не только на уровень HbA1c, но и на снижение веса и артериального давления [3,4]. Однако частота назначения иНГЛТ-2 в РФ составляет только 0,7%, что, в том числе, связано с их высокой стоимостью [1]. В 2019 году был зарегистрирован новый препарат, относящийся к иНГЛТ-2 -ипраглифлозин.…”

Association of Proteins Modulating Immune Response and Insulin Clearance during Gestation with Antenatal Complications in Patients with Gestational or Type 2 Diabetes Mellitus

“…Statistics of the IDF for 2017 demonstrate up to 204 million women aged between 20 to 79 years live with different types of diabetes, while up to 21.3 million newborns have symptoms of hyperglycemia, which is 85.1% of cases was stipulated by GDM [8,9]. According to the statistical data in Russia for 2017, hyperglycemia complication during pregnancy contributes 36.5% of DF cases [10]. In turn, 87% of pregnant women with GDM are defined by the rising level of C-peptide and 93% by increased insulin resistance index, in contrast to uncomplicated gestation, where these indicators are 4% and 6%, respectively (p < 0.05) [9].…”