Standards of specialized diabetes care. Edited by Dedov I.I., Shestakova M.V. (7th edition)

We are glad to present the 7th Edition of Standards of Diabetes Care.

These evidence-based guidelines were designed to standardize and facilitate diabetes care in all regions of the Russian Federation.

The Standards are updated on the regular basis to incorporate new data and relevant recommendations from national and international clinical societies, including World Health Organization Guidelines (WHO, 2011, 2013), International Diabetes Federation (IDF, 2011, 2012, 2013), American Diabetes Association (ADA, 2012, 2015), American Association of Clinical Endocrinologists (AACE, 2013), International Society for Pediatric and Adolescent Diabetes (ISPAD, 2014) and Russian Association of Endocrinologists (RAE, 2011, 2012).

Current edition of the ?Standards? also integrates results of completed randomized clinical trials (ADVANCE, ACCORD, VADT, UKPDS, etc.), as well as findings from the national studies of diabetes mellitus (DM), conducted in close partnership with a number of Russian hospitals.

Latest data indicates that prevalence of DM increased during the last decade more than two-fold, reaching some 387 million patients by the end of 2014. According to the current estimation by the International Diabetes Federation, 592 million patients will be suffering from DM by 2035. These observations resulted in the UN Resolution 61/225 passed on 20.12.2006 that encouraged all Member States "to develop national policies for the prevention, treatment and care of diabetes".

Like many other countries, Russian Federation experiences a sharp rise in the prevalence of DM. According to Russian State Diabetes Register, there are at least 4.1 million patients with DM in this country. However, the epidemiological survey conducted by the Federal Endocrinology Research Centre during 2002-2010 suggests that actual prevalence is 3 to 4 times greater than the officially recognized and, by this estimate, amounts to 9-10 million persons, comprising 7% of the national population.

Severe consequences of the global pandemics of DM include its vascular complications: nephropathy, retinopathy, coronary, cerebral and peripheral vascular disease. These conditions are responsible for the majority of cases of diabetes-related disability and death.

Current edition of the "Standards" emphasizes the patient-oriented approach in making decisions on therapeutic goals, such as levels of glycaemia and blood pressure. It also features updated guidelines on the management of vascular complications.

This text represents a consensus by the absolute majority of national experts, achieved through a number of fruitful discussions held at national meetings and forums. These guidelines are intended for endocrinologists and diabetologists, primary care physicians, cardiologists and other medical professionals involved in prevention and treatment of diabetes mellitus.

1. Дедов И.И., Краснопольский В.И., Сухих Г.Т., от имени рабочей группы. Российский национальный консенсус «Гестационный сахарный диабет: диагностика, лечение, послеродовое наблюдение». // Cахарный диабет. 2012;(4):4–10. [Dedov I, Krasnopol'skiy V, Sukhikh G. Russian National Consensus Statement on gestational diabetes: diagnostics, treatment and postnatal care. Diabetes mellitus. 2012;(4):4-10.] doi: 10.14341/2072-0351-5531

2. Дедов И.И., Петеркова В.А., Кураева Т.Л. Российский консенсус по терапии сахарного диабета у детей и подростков. // Cахарный диабет. 2010;(5):1–8. [Dedov I, Peterkova V, Kuraeva T. Rossiyskiy konsensus po terapii sakharnogo diabeta u detey i podrostkov. Diabetes mellitus. 2010;(5):1-8.] doi: 10.14341/2072-0351-6048

3. Дедов И.И., Шестакова М.В., Александров А.А., и др. Алгоритмы специализированной медицинской помощи больным сахарным диабетом (5-й выпуск). // Cахарный диабет. – 2011. – № 3 (приложение) – С. 2-72. [Dedov II, Shestakova MV, Aleksandrov AA, Galstyan GR, Grigoryan OR, Esayan RM, et al. Algorithms of Specialized Medical Care for Diabetes Mellitus Patients. Diabetes mellitus. 2011;14(3s):2-72.] doi: 10.14341/2072-0351-5612

4. Дедов И.И., Шестакова М.В., Александров А.А., и др. Клинические рекомендации «Алгоритмы специализированной медицинской помощи больным сахарным диабетом» (6-й выпуск). Под редакцией И.И. Дедова, М.В. Шестаковой (6-й выпуск). // Cахарный диабет. – 2013. –№1S – C. 1-121. [Dedov II, Shestakova MV, Aleksandrov AA, Galstyan GR, Grigoryan OR, Esayan RM, et al. Standards of specialized diabetes care. Edited by Dedov II, Shestakova MV (6th edition). Diabetes mellitus. 2013;16(1S):1-121.] doi: 10.14341/DM20131S1-121

5. Дедов И.И., Шестакова М.В., Аметов А.С., и др. Консенсус совета экспертов Российской ассоциации эндокринологов по инициации и интенсификации сахароснижающей терапии у больных сахарным диабетом 2 типа. // Cахарный диабет. 2011;(4):6-17. [Dedov I, Shestakova M, Ametov A, et al. Russian Association of Endocrinologists expert consensus document on initiation and intensification of antyhyperglycaemic therapy in type 2 diabetes mellitus. Diabetes mellitus 2011;(4):6-17. ] doi: 10.14341/2072-0351-5810

6. Дедов И.И., Шестакова М.В. Оптимизация и интенсификация инсулинотерапии при СД 2 типа (клинические рекомендации). // Cахарный диабет. 2010; (5): 9-16. [Dedov I, Shestakova M, et al. Optimizatsiya i intensifikatsiya insulinoterapii pri sakharnom diabete 2 tipa (klinicheskie rekomendatsii). Diabetes mellitus 2010;(5):9-16. ] doi: 10.14341/2072-0351-6049

7. Клинические рекомендации. Кардиология. / под ред. Беленкова Ю.Н., Оганова Р.Г. - М: ГЭОТАР-Медиа, 2007. 640 с. [Klinicheskie rekomendatsii. Kardiologiya. Ed by Belenkov Yu.N., Oganov R.G. Moscow: GEOTAR-Media; 2007. 640p.]

8. Потемкин В.В., Старостина Е.Г. Руководство по неотложной эндокринологии. - М: Медицинское информационное агентство, 2008. 393 с. [Potemkin VV, Starostina EG. Rukovodstvo po neotlozhnoy endokrinologii. Moscow: Meditsinskoe informatsionnoe agentstvo; 2008. 393p.]

9. Рекомендации по лечению острого коронарного синдрома без стойкого подъема сегмента ST на ЭКГ. Российские рекомендации. - М: Медицинское информационное агентство, 2008. www.cadriosite.ru. [Rekomendatsii po lecheniyu ostrogo koronarnogo sindroma bez stoykogo pod'ema segmenta ST na EKG. Russian guidelines. Moscow; 2008. www.cadriosite.ru]

10. Сахарный диабет: диагностика, лечение, профилактика (под ред. Дедова И.И., Шестаковой М.В.). – М.: Медицинское информационное агентство, 2011. [Diabetes mellitus: diagnosis, treatment, prophilaxis. Ed by Dedov I.I., Shestakova M.V. Moscow: Meditsinskoe informatsionnoe agentstvo; 2011]

11. Сахарный диабет: острые и хронические осложнения (под ред. Дедова И.И., Шестаковой М.В.). — М.: Медицинское информационное агентство, 2011. [Diabetes mellitus: acute and chronic complications. Ed by Dedov I.I., Shestakova M.V. Moscow: Meditsinskoe informatsionnoe agentstvo; 2011.]

12. Шестакова М.В., Дедов И.И. Сахарный диабет и хроническая болезнь почек. – М.: Медицинское информационное агентство, 2009. 500 с. [Shestakova MV, Dedov II. Diabetes mellitus and chronic kidney disease. Moscow: Meditsinskoe informatsionnoe agentstvo; 2009. 500p.]

13. American Diabetes Association. Standards of medical care in diabetes – 2015. Diabetes Care 2015; 38; Suppl 1:S1-93.

14. Bassand JP, Hamm CW, Ardissino D, Boersma E, Budaj A, Fernandez-Aviles F, et al. Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: The Task Force for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of the European Society of Cardiology. European Heart Journal 2007 May;28(13):1598-1660. doi: 10.1093/eurheartj/ehm161.

15. Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia. Report of WHO/IDF Consultation. 2006.

16. Definition, Diagnosis, and Classification of Diabetes Mellitus and Its Complications: Report of a WHO consultation. Part 1: Diagnosis and Classification of Diabetes Mellitus (WHO/NCD/NCS/99.2). Geneva: World Health Organization; 1999.

17. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. WHO Guideline. 2013.

18. Garber AJ, Abrahamson MJ, Barzilay JI, Blonde L, Bloomgarden ZT, Bush MA, et al. American Association of Clinical Endocrinologists' Comprehensive Diabetes Management Algorithm 2013 Consensus Statement. Endocrine Practice. 2013;19(s2):1-48. doi: 10.4158/ep13176.csuppl

19. International Diabetes Federation. Diabetes Atlas 6th Edition. 2013.

20. International Diabetes Federation. Global Guideline for Type 2 diabetes. 2012.

21. International Diabetes Federation. Guideline for management of postmeal glucose. 2011.

22. International Diabetes Federation. Managing older people with Type 2 Diabetes. Global Guideline. 2013.

23. Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, et al. Management of Hyperglycemia in Type 2 Diabetes, 2015: A Patient-Centered Approach: Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2014;38(1):140-149. doi: 10.2337/dc14-2441.

24. Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, et al. Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered Approach: Position Statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2012;35(6):1364-1379. doi: 10.2337/dc12-0413

25. ISPAD Clinical Practice Consensus Guidelines 2014 Compendium. Pediatric Diabetes. 2014; 15(Suppl. 20): 1–290.

26. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Intern. Suppl. 2013; 3(1):1-150.

27. Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension. J Hypertens. 2013;31(7):1281-357. doi: 10.1097/01.hjh.0000431740.32696.cc.

28. Patel A, MacMahon S. Intensive Blood Glucose Control and Vascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med 2008;358(24):2560-2572. doi: 10.1056/NEJMoa0802987.

29. Ryden L, Grant PJ, Anker SD, Berne C, Cosentino F, Danchin N, et al. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: The Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). Eur Heart J. 2013;34(39):3035-87. doi: 10.1093/eurheartj/eht108.

30. Skyler JS, Bergenstal R, Bonow RO, Buse J, Deedwania P, Gale EAM, et al. Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA diabetes trials: a position statement of the American Diabetes Association and a scientific statement of the American College of Cardiology Foundation and the American Heart Association. Diabetes Care 2008;32(1):187-192. doi: 10.2337/dc08-9026.

31. Use of Glycated Haemoglobin (HbA1c) in the Diagnosis of Diabetes Mellitus. Abbreviated Report of a WHO Consultation (WHO/NMH/CHP/CPM/11.1). World Health Organization; 2011.

32. Wright RS, Anderson JL, Adams CD, Bridges CR, Casey DE, Ettinger SM, et al. 2011 ACCF/AHA Focused Update of the Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction (Updating the 2007 Guideline). Journal of the American College of Cardiology 2011;57(19):1920-1959. doi: 10.1016/j.jacc.2011.02.009.