Results of assessment of the efficacy of therapeutic and diagnostic aid to diabetic patients based on prospective studies

Aim.
Comparative assessment of the prevalence of diabetic complications (DC) and the main metabolic indices in adult patients with DM1 and DM2 in the periodfrom 2003 to 2009.
Materials and methods.
The study based on the Diabet Tsentr mobile module was designed to perform screening (2003) and rescreening (2009) for DC in severalregions of the Russian Federation. Laboratory analyses included measurement of blood HbA_1c, creatinine, urea, total cholesterol levels, and albumin in singlevoidurine samples. The patients underwent fundoscopy, evaluation of all forms of sensory responsiveness, measurement of arterial pressure, and ECG. The resultswere treated with the use of Statistica 6 software. They are presented as median, 25th and 75th percentiles (Me[25%;75%]). The difference between the groups wasregarded as statistically significant at p<0.05.
Results.
The prospective study reveled a significant decrease in the prevalence of diabetic cataract from 36.8 to 33.7%, diabetic retinopathy from 41.4 to 31.8%,nephropathy from 39.6 to 30.6%, arterial hypertension from 68.9 to 65.3, angina from 28.8 to 20.5%, myocardial infarction from 7.5 to 5.2% (=<0.05) amongadult patients. Mean HbA_1c level dropped by 0.8 and 0.5% in DM1 and DM2 patients respectively. Mean systolic pressure decreased by 10 and 2 mmHg in thetwo groups. The number of DM1 and DM2 patients with decompensate carbohydrate metabolism decreased by 12.5 and 7.3% respectively. The number of DM2patients in need of insulin and combined therapy increased up to 18.2 and 7.7%.
Conclusion.
Controlled epidemiologic studies are indispensable for obtaining reliable information about the prevalence of DM and its complications and for updatingregister data. Comparative assessment of the efficiency of diagnostic and therapeutic aid to the patients revealed positive dynamics of morbidity characteristics.

сахарный диабет, диабетическая ретинопатия, диабетическая нефропатия, диабетическая дистальная полинейропатия, гли- кированный гемоглобин, артериальная гипертония

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