Diabetes mellitus in the Russian Federation: dynamics of epidemiological indicators according to the Federal Register of Diabetes Mellitus for the period 2010–2022
I. I. Dedov,
M. V. Shestakova,
O. K. Vikulova,
A. V. Zheleznyakova,
M. A. Isakov,
D. V. Sazonova,
N. G. Mokrysheva https://doi.org/10.14341/DM13035
Abstract
BACKGROUND. The clinical and epidemiological characteristics of diabetes mellitus (DM) and the quality of its therapy are the key prognostic dominant that determines the organizational aspects of the diabetic service. The continuous dynamic monitoring of DM has been carried out in the Russian Federation (RF) since 1996 through the activities of the Federal Register of Diabetes Mellitus (FDR).
AIMS. The aim of our study was to analyze the epidemiological characteristics of DM in the RF (prevalence, morbidity, mortality), the prevalence diabetic of complications, the state of carbohydrate metabolism (level of HbA1c) and the dynamics of the structure of glucose-lowering therapy (GLT) according to the FDR.
MATERIALS AND METHODS. The database of FRD (https://www.diaregistry.ru/), 85 regions of the RF. The data are presented as of 01.01.2023 and in dynamics for the period 2010–2022.
RESULTS. The total number of DM patients in the RF as of 01.01.2023 was 4 962 762 (3.31% of the population), including: Type 1 (T1) — 5.58% (277.1 ths), T2 — 92.33% (4.58 million), other DM types —2.08% (103 ths). The dynamics of prevalence over the 13-year period (2010→2022) was 146.0→191.0/100 ths people with T1, and 2036.2→3158.8/100 ths people with T2; morbidity in T1 12.3→8.2/100 ths population, in T2 260.1→191.4/100 ths population; мortality: T1 2.1→2.4/100 ths population, T2 41.2→86.1/100 ths of the population. The main cause of death was cardiovascular: in T1 38.6% cases, in T2 — 50.9%. Life expectancy (average age of death of patients): T1 was 52.7 years, the dynamics in males 50.9 → 50.7 years, females 62.1→56.0 years; in T2 — 74.2 years, males 69.5→70.4 years, females 74.2→76.1 years. The dynamic of DM duration from onset to the death: in T1 15.4→19.9 years; in T2 11→11.4 10.2→11.8 years. The proportion of patients with laboratory-measured HbA1c <7% in the dynamics of 2010–2022: with DM1 24.4%→29%, with DM2 41.5%→42.2%, with HbA1c ≥9.0%: with DM1 29, 4% → 20.4%, with DM2 13.8 → 9.0%.The incidence of diabetic complications as of 01.01.2023 in T1 and T2 patients: neuropathy 41.3% and 23.7%, nephropathy (CKD) 22.8% and 19.1%, retinopathy 28.9% and 12.3%, respectively. The structure GLT in T2 patients as of 01.01.2023: monotherapy — 41.6%; combination of 2 GLM — 30.0%, 3 GLM — 5.8%, insulin therapy in 18.3%.
CONCLUSIONS. The information-analytical system FDR is a key tool for systematizing the most important epidemiological and clinical characteristics of DM based on data from real clinical practice, which allows optimizing the algorithm of patient management and improving the quality of care for diabetes.
About the Authors
I. I. Dedov
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Ivan I. Dedov - MD, PhD, Professor.
Moscow
Competing Interests:
none
M. V. Shestakova
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Marina V. Shestakova - MD, PhD, Professor, Academician of Russian Academy of Medical Sciences.
Moscow
Competing Interests:
none
O. K. Vikulova
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Olga K. Vikulova - MD, PhD, Associate Professor.
11 Dm. Ulyanova street, 117036 Moscow, 8 (499) 124-10-21
Competing Interests:
none
A. V. Zheleznyakova
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Anna V. Zheleznyakova - MD, PhD.
Moscow
Competing Interests:
none
M. A. Isakov
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Mikhail А. Isakov - PhD in Biology.
Moscow
Competing Interests:
none
D. V. Sazonova
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Daria V. Sazonova – MD.
Moscow
Competing Interests:
none
N. G. Mokrysheva
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Natalya G. Mokrysheva - MD, PhD, Professor.
Moscow
Competing Interests:
none
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1. Figure 1. Total number of patients with diabetes mellitus in the Russian Federation as of 01.01.2023 | |
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2. Figure 2. Type 1 diabetes prevalence per 100,000 population, 85 regions of the Russian Federation, 01/01/2023 | |
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3. Figure 3. Type 2 diabetes prevalence per 100,000 population, 85 regions of the Russian Federation, 01/01/2023 | |
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4. Figure 4. Dynamics of the prevalence of patients with diabetes mellitus types 1 and 2, the value of the indicator per 100 thousand population, 85 regions of the Russian Federation, 2010–2022 | |
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5. Figure 5. Dynamics of the incidence of diabetes mellitus type 1 and 2, the value of the indicator per 100 thousand population, 85 regions of the Russian Federation, 2010–2022 | |
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6. Figure 6. Dynamics of the number of patients with type 1 and type 2 diabetes in the Russian Federation, in absolute terms, 2010–2022 | |
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7. Figure 7. Dynamics of mortality in absolute terms in patients with type 1 and type 2 diabetes, 85 regions of the Russian Federation, 2010–2022 | |
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8. Figure 8. Dynamics of mortality in patients with type 1 and type 2 diabetes, the value of the indicator per 100 thousand population, 85 regions of the Russian Federation, 2010–2022 | |
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9. Figure 9. Structure of mortality in patients with type 1 and type 2 diabetes in the Russian Federation (by direct cause of death), according to the Federal Diabetes Registry, 2022. Cardiovascular pathology is marked in red, other causes in blue. | |
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10. Figure 10. Actual age at death and life expectancy. Mean age of death in patients with type 1 and type 2 diabetes according to the Federal Diabetes Registry, 2010–2022 (actual data for 84 regions) as of January 1, 2023 | |
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11. Figure 11. Duration of the incidence of diabetes mellitus from the onset of the disease to the mean age of death. | |
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12. Figure 12. Dynamics of the level of glycated hemoglobin (HbA1c) in patients with diabetes mellitus according to the Federal Register of Diabetes Mellitus in the Russian Federation 2010–2022 | |
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13. Figure 13. Distribution ranges for the level of glycated hemoglobin in patients with diabetes mellitus, 85 regions of the Russian Federation, all age groups. A — HbA1c laboratory value for 2010–2022; Б — surrogate HbA1c 2017–2022. | |
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14. Figure 14. Distribution ratio of laboratory and surrogate glycated hemoglobin (HbA1c) in patients with type 1 and type 2 diabetes mellitus, 85 regions of the Russian Federation, all age groups, 2017–2022 | |
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15. Figure 15. The structure of hypoglycemic therapy for type 2 diabetes mellitus in the Russian Federation in the dynamics of 2017–2022. | |
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16. Figure 16. Scheme of therapy depending on the duration of type 2 diabetes mellitus at a one-time cut on 01/01/2023 | |
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17. Figure 17. Dynamics of prescribing different classes of hypoglycemic drugs for type 2 diabetes mellitus in the Russian Federation, 2010–2022 | |
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18. Figure 18. The structure of hypoglycemic therapy (as part of monotherapy, double and triple combinations) in patients with type 2 diabetes mellitus at a one-stage cut as of 01/01/2023 in the Russian Federation. | |
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19. Figure 19. Proportions of prescriptions of dipeptidyl peptidase-4 inhibitors, sodium-glucose cotransporter-2 inhibitors, and type 1 glucagon-like peptide receptor agonists in patients with type 2 diabetes mellitus in the general cohort and in high cardiovascular risk groups at a one-stage cut as of 01.01.2023. | |
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20. Figure 20. Dynamics of the structure of insulin therapy (analogues, recombinant human insulins (RHI), their combination) in patients with type 1 and type 2 diabetes, 2010–2022 | |
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21. Figure 21. Dynamics of the structure of insulin therapy (analogues, recombinant human insulins (RHI), their combination, 2010–2022) and insulin pump therapy data (2016–2022) in children and adolescents with type 1 diabetes (under 18 years of age) by data from the Federal Diabetes Registry. | |
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22. Figure 22. Distribution of the frequency of complications in diabetes mellitus types 1 and 2 in the Russian Federation as of 01/01/2023 in the general age group. | |
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23. Figure 23. Dynamics of the frequency of complications in type 1 and type 2 diabetes mellitus in the Russian Federation, 2010–2022, in adult patients (over 18 years of age). | |
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24. Figure 24. Number of new cases of blindness per year, all cases of blindness at the end of the year, and proportion (%) of blindness from all cases of diabetic retinopathy and from new cases of diabetic retinopathy per year in adults with type 1 and 2 diabetes over time 2010–2022 | |
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25. Figure 25. Incidence and number of cases of end-stage chronic kidney disease (C5) in adult patients with type 1 and 2 diabetes, new cases per year, and all patients with C5 in absolute terms, as well as in percentage of new and all cases chronic kidney disease (CKD) in dynamics 2010–2022 | |
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26. Figure 26. Total number of amputations and new amputations per year (in absolute terms) and the percentage of amputations from all cases of diabetic foot syndrome (DFS) and from new cases of DFS per year in adult patients with type 1 and 2 diabetes over time 2010 –2022 | |
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27. Figure 27. Distribution by amputation rate (% of patients) in adult patients with type 1 and type 2 diabetes in 2010–2022 | |
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For citations:
Dedov I.I., Shestakova M.V., Vikulova O.K., Zheleznyakova A.V., Isakov M.A., Sazonova D.V., Mokrysheva N.G. Diabetes mellitus in the Russian Federation: dynamics of epidemiological indicators according to the Federal Register of Diabetes Mellitus for the period 2010–2022. Diabetes mellitus. 2023;26(2):104-123. https://doi.org/10.14341/DM13035
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