Background: The data of the register is the main source of up-to-date information about patients with diabetes mellitus (DM). It’s very important for improving the quality of medical care organization.

Aims: to analyze the main epidemiological DM characteristics in Russian Federation (RF) (prevalence, incidence, mortality) in children and adolescents, to assess the dynamics of these parameters for the period 2013 – 2016, to analyze the status of compensation for carbohydrate metabolism, therapy of DM1, prevalence of diabetic complications and the reasons for hospitalizations in these age groups.

Materials and methods: The database of Federal DM registry of 81 regions was included in the online system.

Results: The total number of patients under the age of 18 with DM in RF on 31.12.2016 was 33081 people, there were 95,9% (31727 people) with DM1 and 4,1% (1354 patients) with DM2. The prevalence of DM1 in 2013–2016 in children: 81.0 – 91.4 / 100 ths., in adolescents – 212,8–209,5 / 100 ths. The DM1 incidence/100 thousand population in 2016 in children was 14,2/100 ths., in adolescents 10,0/100 ths. HbA1c levels in DM1 was in children: <7,5% in 32%, 7,6–9,0% in 33%, >9% in 35% of the patients; in adolescents <7,5% in 25%, 7,6–9,0% in 30%, >9% in 45% of the patients. Among complications in children and adolescents with DM1, diabetic neuropathy is the most often recorded (in 10,9% of cases and 40,8%, respectively); among DM2 patients, diabetic neuropathy is registered in 4,7% and 8,8% in children and adolescents, respectively. There are associated diseases in DM2 patients – arterial hypertension and dyslipidemia. 43,8% of children and 49,2% of adolescents were hospitalized in the anamnesis, most hospitalizations in 2016 (children 71,9%, adolescents 67,1%) were due to diabetes.

Conclusions: It is established that in the dynamics of 2013–2016 the prevalence of DM1 in children continues to increase, with relatively stable indicators in adolescents. According to the register, during last two years there has been a decrease in the incidence of DM1 and, on the contrary, an increase in the prevalence/incidence of DM2 in children. Significant interregional differences in the level of incidence/prevalence have been established, especially in regions located in various geographic regions of the RF. The frequency of diabetic complications in children and adolescents with diabetes varies. There is an association of hospitalizations with higher HbA1c level. In the structure of therapy of this age group the ratio of insulin therapy in syringes-pens and pump therapy is 80.9% / 15.1% according to the register.

Background: Cost-of-Illness Analysis (COI) constitutes the basis for the decision-making process on the budget and allocation in a modern health care system. Considering the wide prevalence of type 2 diabetes mellitus (Т2DM), it is important to perform COI in the Russian Federation (RF).

Aim: The aim of the secondary objective FORSIGHT-Т2DM study was to conduct Cost-of-Illness Analysis (COI) of Т2DM in the Russian Federation in relation to taking into consideration the presence of complications and concomitant diseases.

Materials and methods: COI of Т2DM was performed using the data obtained in Russian multicenter observational, pharmacoepidemiologic cross-sectional study of diabetes care for assessing routine healthcare pattern of T2DM in the Russian Federation (FORSIGHT-Т2DM). Information for each patient was collected from primary medical records and By asking patients to fill out a questionnaire. Total costs were calculated as the sum of direct medical costs (DCm), direct non-medical costs (DCn) and indirect costs (IC).

Results: The final analysis included data from 2014 patients with T2DM residing in 45 cities of RF. Total direct medical costs (DCm) of treating Т2DM and its complications and comorbidities amounted to 105 337 rubles ($2742) per patient per year; direct non-medical costs (DCn) amounted to 24 518 rubles ($638) per patient per year; indirect costs (IC) amounted to 149 754 rubles ($3898) per patient per year. The total cost of T2DM in RF in 2014 year amounted to 279 609 rubles ($7278) per patient. The total cost of T2DM in RF in 2014 amounted to 279 609 rubles per patient.

Conclusions: More than half (53,5%) of the total cost of T2DM is the loss of GDP due to patients’ disability. The DCm constitute 37,7% of the total cost of the disease, of which 57% is spent on treatment of T2DM complications and concomitant diseases, while only 10% is spent on glucose-lowering therapies.

Rationale: Healthcare access plays a significant role in the improvement and maintaining of glycemic control and quality of life in type 1 diabetes mellitus (T1DM) patients on continuous subcutaneous insulin infusion (CSII).

Aims: The aim of the study was to evaluate the feasibility of remote support in children and adolescents with type 1 diabetes mellitus (T1DM) and its effect on glycemic control and quality of life.

Materials and methods: In 40 children and adolescents (13±2,7 years, 18/22 m/f) on CSII with inadequately controlled T1DM (HbA1c≥7,5%) we evaluated the effectiveness of telemedical support (TS), as compared with conventional support (CS). Parameters of glycemic control (HbA1c, average glycemia, SD, etc.) and quality of a life were obtained on follow-up visits. Patients and their parents in ТМ group twice a month sent their insulin pump data using to CSII center and diabetologists sent back their advice via e-mail, phone or Skype. The primary end point was the change from the baseline HbA1c level and the proportion of patients achieving HbA1c of less than 7.5%.

Results: At 24 weeks, the baseline mean HbA1c (8.7% in the two study groups) had decreased to 7.7% in the TS group, as compared with 8.4% in the CS group (P<0,05). The proportion of patients who reached the HbA1c target (<7,5%) was greater in the TS group (50%) than in the CS group (20%, p<0,05). A number of quality of life indicators for both parents and children with T1DM at the end of the study compared to baseline significantly increased in the TS group compared with the TC group (p<0.05). During the study period rate of severe hypoglycemia and DKA in TS group (0 and 10 cases per 100 person-years) did not differ significantly from that in CS group (0 and 20 cases per 100 person-years, P>0,05).

Conclusion: In children with inadequately controlled T1DM, telemedical support proved to be feasible and resulted in significant improvement in glucose control (HbA1c, glucose variability) and quality of life without the increase in the incidence of DKA and severe glycemia.

Background: The treatment of Helicobacter pylori (HP) infection in patients with diabetes mellitus with chronic gastroduodenal disorders is a substantial problem because of its high incidence.

Aims: To compare between the effectiveness of triple and optimised consecutive regimens in anti-HP treatment in patients with type 2 diabetes mellitus with gastroduodenal disorders.

Materials and methods: The study included 54 patients with diabetes mellitus and 64 healthy individuals (the control group) aged 30–60 years. Gastroduodenal pathology was confirmed by gastroduodenoscopy; HР contamination was confirming using Marshall’s urease method or by finding bacterial antigen in excrements. We studied the dynamics of clinical manifestations using the GSRS scale and showed remission via endoscopy and the effectiveness of HР eradication. We also analysed the effects of anti-HР therapy regimens on the presence of small intestinal bacterial overgrowth syndrome (SIBOS) in patients with diabetes mellitus. SIBOS was diagnosed via the respiratory hydrogen method.

Results: The use of an optimised consecutive regimen resulted in HР eradication in 85.7% of patients with diabetes mellitus compared with a 65.3% eradication in patients on the triple therapy. Moreover, clinical improvement and endoscopy-confirmed remission were more frequently observed in patients on the optimised consecutive regimen. A statistically significant decrease in the number of patients with SIBOS was found only in patients who underwent the optimised consecutive therapy regimen.

Conclusions: This study showed that the optimised consecutive therapy regimen was more effective than the triple therapy in HP eradication.

Background: Cognitive impairment is a common complication of type 2 diabetes, greatly reduce the quality of life and daily functioning of patients, as well as have an impact on their compliance to therapy.

Aim: Explore the nature and frequency of cognitive impairment in patients with type 2 diabetes, their relation to carbohydrate metabolism.

Materials and methods: The study involved 113 patients with type 2 diabetes aged 40–70 years, with disease duration of more than 12 months; Control group consisted of 33 persons, stateless persons with type 2 diabetes, matched by age, sex, level of education, the presence of cardiovascular diseases such as hypertension and coronary heart disease. The complex included a survey of clinical and laboratory tests, instrumental, neuropsychological testing. To screen for cognitive impairment used by the Montreal Cognitive Assessment Scale (MоСа test), for the study of the frontal functions FAB (frontal dysfunction battery).

Results: The study of cognitive impairment were diagnosed in 53,1 ± 9,2% of patients with type 2 diabetes, which is statistically significantly higher than in those in the control group 15,2 ± 12,2%. In patients with type 2 diabetes prevailed violations fronto-subcortical type with a reduction in short-term memory function, attention and constructive praxis. Cognitive impairment correlated with indices of carbohydrate metabolism (HbA1c, fasting glucose), disease duration 7 [5, 12] years and the patient's.

Conclusions: These data confirm the impact of hyperglycemia as a major pathogenic factor and duration of the disease on the formation and progression of cognitive impairment in patients with type 2 diabetes.

Modern representation of self-monitoring blood glucose can be characterised by new technologies introduced in recent years, including tools to identify trends and patterns of glycaemia (PatternAlert ™). These technologies simplify self-monitoring and help avoid errors in the interpretation of blood glucose levels in patients. This study examines the primary trends in the management and control of diabetes, as well as the strengths and weaknesses of the control of glycated haemoglobin (HbA1c). In addition, this study raises broader questions on self-control in patients with diabetes mellitus, which are beyond the issues of the normalisation of blood glucose levels.

Nonalcoholic fatty liver disease (NAFLD) is a group of obesity-associated pathological changes characterized by abnormal accumulation of lipids in cells of the liver parenchyma. NAFLD and associated conditions, namely insulin resistance and type II diabetes mellitus (DM2), as well as the possible risks of developing fibrosis and cirrhosis with a potential outcome in hepatocellular carcinoma, represent the primary health problems in developed countries, gradually replacing the importance of similar pathologies caused by the regular use of hepatotoxic doses of alcoholic beverages. Recent fundamental and clinical studies demonstrated the important role of the farnesoid receptor (FXR, NR1H4) in the regulation of the metabolism of glucose, lipids and bile acids. This review focuses on the molecular aspects of the pathogenesis of NAFLD, the role of FXR (NR1H4) in the biology of this disease, and the prospects for using different FXR (NR1H4) modulators for therapy of NAFLD and associated conditions such as metabolic syndrome and DM2, as well as a number of other FXR (NR1H4) – mediated diseases.

Chronic kidney disease (CKD) is a general concept that involves renal tissue regardless of the aetiology of the leading disease. CKD occurs in one out of every two patients with diabetes mellitus (DM) and appreciably limits the duration and quality of life. CKD can be diagnosed by glomerular filtration rate (GFR), which is recognised as the most representative indicator of the quantity and total workload of nephrons. However, the decrease in GFR occurs at an advanced stage of nephropathy and causes irreversible renal damage, which ultimately requires substitutive renal therapy and, thereby, increases the expense. In this regard, clinical trials have been conducted to identify the biomarkers of CKD reflecting renal damage at earlier stages of the disease. This article presents an overview of modern methods for the diagnosis of CKD and preclinical markers of kidney injury in patients with DM.

Oxidative stress (OS) plays an important role in embryo development, implantation, placentation, fetal development and labour. Diabetes mellitus (DM) is associated with an increase in OS processes. However, the expression of OS biomarkers in pregnant women with DM remains unclear. Based on a literature review, the features of the pro- and anti-oxidant systems of pregnant women with different types of DM have been established. Pregnancy in patients with DM has been shown to be characterised by an activation of OS processes. This leads to an overexpression of free radicals (peroxynitrite), toxic derivatives (malonic dialdehyde, 8-isoprostane) and specific enzymes (asymmetric dimethylarginine, catalase) and a decrease in the synthesis of antioxidants (superoxide dismutase, glutathione peroxidase and uric acid). The modified expression of these biomarkers is observed both in the blood and the placenta of pregnant women. These disorders can cause an unfavourable course of pregnancy, abnormal development of the placenta and development of adverse perinatal outcomes in pregnant women with DM. Nevertheless, given the inconsistency of data obtained, further scientific studies are needed to clarify this issue.