■ AbstractAIM: The aim of the study was to identify the prevalence of diabetic retinopathy (DR) and diabetic cataract (DC) in type 1 and type 2 diabetic patients within the Russian Federation. Also, the stage of DR at the time of its identification and the proportion of new cases diagnosed with DR or DC were to be determined. METHODS: A random sample of 7,186 adult patients with diabetes was screened for DR and DC using fundoscopy and fundus photography. Levels of HbA1c, total cholesterol, triglycerides, creatinine and urinary albumin excretion rate were assessed. RESULTS: In diabetic patients, the prevalence of DR and DC was 45.9% and 30.6%, respectively. These complications appeared significantly more frequently in patients with type 1 diabetes than in type 2 diabetes. The prevalence of background, preproliferative and proliferative DR among diabetic patients was 28.1%, 8.1%, and 6.7%, respectively. Patients with DR were older, had a longer duration of diabetes, higher HbA1c, elevated plasma total cholesterol, increased triglicerides, and higher systolic BP, compared with patients without DR. Microalbuminuria and proteinuria were more prevalent among patients with DR compared with non-DR patients. CONCLU-SIONS: The results showed that diabetic retinopathy and cataract are wide-spread complications among diabetic patients in Russia. However, the disease course is more aggressive and accelerated in patients with type 1 diabetes than in those having type 2 diabetes. Therefore, it is important to prevent DR by identifying diabetes and signs of retinopathy at the earliest possible stage of progression for timely and adequate retina laser coagulation or surgical treatment, compensation of carbohydrate and lipid metabolism, and normalization of blood glucose and pressure.Keywords: type 1 diabetes · type 2 diabetes · diabetic retinopathy · diabetic cataract · proliferative retinopathy · coagulation · glaucoma · eye fundus Introduction iabetic retinopathy (DR) is a specific vascular complication of diabetes resulting from retinal vessel damage caused by poor blood glucose control, with subsequent changes to the fundus of the eye. These changes can be in the form of micro-aneurysms, hemorrhages, hard and soft exudates, proliferation of newly-formed vessels, retinal detachment, and the development of secondary rubeotic glaucoma [1]. DR is one of the most common and serious vascular complications in diabetes, and one of the leading causes of total loss of sight [2]. The clinical signs of DR are classified into background, preproliferative, and proliferative stages [3]. Modern classifications subdivide DR into five stages of diabetic retinopathy: non-proliferative (DR I), preproliferative (DR II), proliferative (DR III), partial or total retinal detachment (DR IV), diabetic retinopathy and secondary neovascular glaucoma (DR V). DR I is a reversible stage characterized by blood vessel changes in the ocular fundus such as microaneurysms, hemorrhages, hard exudates, and maculo- International data show that 30-60% of diabetic ...
The objective of this work was to study the actual prevalence of diabetes mellitus complications and evaluate the quality of health care provided to the patients with these problems in different regions of Russia. A random sample of 11 240 patients with diabetes mellitus (DM) was obtained from a total of 20 regions of the Russian Federation. The study protocol included evaluation of visual function, the state of peripheral nervous system and lower extremities, renal and cardiovascular functions; in addition, HbA1c, creatinine, total cholesterol and triglyceride levels were measured along with albuminuria. It was found that the actual prevalence of major diabetic complications is 20-50% higher than the registered one. The overwhelming majority of the patients were shown to be chronically decompensated. This finding holds for 85.5% of the children, 92.6% of the adolescents, 83.9% and 74.8% of the adult patients with types 1 and 2 DM respectively. The HbA1c level in patients living in rural areas was 33.7-42.1% higher than in residents of regional urban centres. Fewer than 14.4% and 0.6% of the patients with type 2 DM used insulin and its analogs respectively. Overall, the study demonstrated rather poor quality of medical and preventive aid provided to diabetic patients and the necessity of its improvement.
This article presents the pharmacoeconomic rationale for the treatment of giardiasis in adult patients. Giardia is one of the most common pathogenic eukaryotic microorganisms and the most common cause of diarrhea in the world. Currently, there are a number of drugs recommended for the treatment of giardiasis that differ in terms of effectiveness and safety, as well as the cost of therapy. Therefore, it is necessary to conduct a clinical and econo-mic analysis in order to comparatively assess the quality of drug therapy for giardiasis. The use of treatment regimens for giardiasis using the domestic drug "Sausalin" is economically feasible given the high level of eradication and the safety profile of the new drug. When conducting a repeated course of therapy for one patient with the drug "Sausalin", the savings is up to 25% in comparison with the "Ornisid". The effectiveness of the original drug "Sausalin" is discussed.
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