Background: Diabetic retinopathy (DR) is one of the most common causes of blindness in patients with diabetes mellitus (DM) that is why its necessary to study the epidemiological characteristics of this complication. Aims: The aim of the study was to evaluate the epidemiological characteristics of DR and blindness in adult patients with type 1 (T1) and 2 (T2) diabetes in Russian Federation (RF) for period 201316years. Materials and methods: Database of Federal Diabetes register, 81st regions included in the online register. Indicators were estimated per 10,000 adult DM patients (18years). Results: In 2016 the DR prevalence in RF was T1 38,3%, T2 15,0%, with marked interregional differences: 2,666,1%, 1,146,4%, respectively. The DR prevalence within 20132016 years was: T1 3830,93805,6; T2 1586,01497,0. Trend of new DR cases/per year increased: T1 153,2187,8; T2 99,7114,9. The structure of new cases of DR in 2016: non-proliferative stage (T1 71,4%, T2 80,3%), pre-proliferative stage 16,4%, 13,8%, proliferative 12,1%, 5,8%, terminal 0,2%, 0,1%, respectively, these data indicated the earlier detection of DR. The mean age of DR diagnosis increased: T1 by 1,2 years, T2 by 2,6. The average DM duration of DR determine increased T1 9,613,1 years, T2 6,09,1. The prevalence of blindness tends to decrease: T1 92,390,8; T2 15,415,2/10.000 DM adults. The amount of new cases of blindness/per year increased: T1 4,34,6; T2 1,21,4. The mean age of blindness increased: T1 39,141,6 years, T2 64,467,4; the mean duration of diabetes before blindness occur (from the time of DM diagnosis) increased: T1 20,221,2 years, in T2 10,711,3. We observed growth of DR treatment (laser surgery, vitrectomy, anti-VEGF medication) but the frequency of use in T2 patients is about 2 times less than in T1. Conclusions: There was a decrease in the overall incidence of eye damage in diabetes (DR and blindness) in the analyzed period in RF. DR and blindness develops at advanced age and with a longer duration of diabetes. As the main directions of eye care development in diabetes it is necessary to standardize primary care in the regions, to unify the examination algorithms and methods of early diagnostic, to increase the continuity and interaction of endocrinologists and ophthalmologists in managing patients with diabetes in order to prevent the development of new cases of vision loss.
A pandemic expansion of diabetes mellitus (DM) observed nowadays across the globe is increasingly acknowledged as a disaster by all peoples of the world. Statistical analysis indicates an annual increase in prevalence of DM in Russian Federation that had reached 3 779 423 registered patients by 01.01.2013. Besides the humanitarian aspects, DM poses severe economic challenges for this country ? challenges that stem both from high mortality and growing disability rate due to limb loss, decrease in visual acuity and need for hemodialysis, plaguing many DM patients. Aim. To produce an epidemiological evaluation based on the dynamics of prevalence of diabetic retinopathy in the Russian Federation ? nationwide and in individual regions ? across the last 13 years. Materials and Methods. Current survey included patients from various regions of the Russian Federation that were examined during epidemiological missions conducted by the federal Endocrinology Research Centre (2000?2009), as well as National Programmes ?Health? (2007) and ?Diabetes ? Learn In Advance? (2012?2013). Results. In the Russian Federation registered more than 630,000 patients with different stages of diabetic retinopathy. The prevalence of diabetic retinopathy among adults (18 years and older) with type 1 diabetes is 35.25%, while in type 2 diabetes - 16.67%. On average, this means that almost one in five patients (17.63%) with diabetes have certain eye problems. Conclusion. In summary, our data indicate a dramatic growth in the rate of diabetic ocular complications, with a particular increase in proliferative diabetic retinopathy, complicated cataract and neovascular glaucoma. These findings call for an even closer attention to early diagnostics, adequate management and, above everything else, timely prevention of ocular pathologies in patients with DM.
Aim. To estimate the prevalence of type 2 diabetes mellitus (T2DM) among the population of Moscow Region, as well as the actual prevalence of diabetes complications in individuals already diagnosed with DM. Materials and Methods. 2403 inhabitants of Stupinksy and Domodedovsky areas aged 30 to 70 years were selected by means of random sampling for the estimation of T2DM prevalence. Another 600 individuals inhabiting Pushkinsky and Serpukhovsky areas were randomly selected for the estimation of the prevalence of DM complications (including patients with T2DM). Clinical screening was performed by the mobile diagnostic team. Results. HbA1c level was tested in all participants. The cut-off point for the diagnosis of DM was set for . HbA1c>6.5% according to the WHO guidelines (2011). 204 individuals (8.49%) met this criterion and were selected for further evaluation by OGTT with the following Results. 28.04% were positive for glycemic disorders, including T2DM (8.53%), IGT (17.07%), IFG (2.44%). The highest prevalence of T2DM was found in the elder group (60?70 years old). The prevalence of diabetic retinopathy was estimated at 26.06%, being 2 times higher among T2DM patients than previously calculated for Moscow Region by the Russian State Diabetes Register (13.2%). The microalbuminuria stage of diabetic nephropathy was diagnosed in 46.1% of diabetes patients, being 5 times more prevalent than previously estimated for Moscow Region by the Russian State Diabetes Register (5.84%). Conclusion. The actual prevalence of T2DM in Moscow Region is markedly higher than the registered. The prevalence of diabetes complications is also significantly underestimated. Most patients do not achieve . HbA1c targets (
We present two atypic clinical cases of ?middle? proliferation in patients with proliferative stage of diabetic retinopathy. Both patientsunderwent hospitalization in Department of diabetic retinopathy and ophthalmic surgery of Endocrine Research Centre, Moscow.We conducted full-scale endocrine and ophthalmologic examination, including A/B scanning.?Middle? proliferation in diabetic retinopathy should be considered a severe disorder and managed in conjunction of endocrine andophthalmologic approaches. Adequate and timely compensation of diabetes mellitus combined with vitreoretinal surgery may substantiallyimprove prognosis in such patients and reduce the risk of incapacitation.
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