Сахарный диабет (Sep 2018)
Trends in the epidemiology of diabetic retinopathy in Russian Federation according to the Federal Diabetes Register (2013–2016)
Abstract
Background: Diabetic retinopathy (DR) is one of the most common causes of blindness in patients with diabetes mellitus (DM) that is why it’s 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 2013–16years. 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: 2,6–66,1%, 1,1–46,4%, respectively. The DR prevalence within 2013→2016 years was: T1 3830,9→3805,6; T2 1586,0→1497,0. Trend of new DR cases/per year increased: T1 153,2→187,8; T2 99,7→114,9. 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 9,6→13,1 years, T2 6,0→9,1. The prevalence of blindness tends to decrease: T1 92,3→90,8; T2 15,4→15,2/10.000 DM adults. The amount of new cases of blindness/per year increased: T1 4,3→4,6; T2 1,2→1,4. The mean age of blindness increased: T1 39,1→41,6 years, T2 64,4→67,4; the mean duration of diabetes before blindness occur (from the time of DM diagnosis) increased: T1 20,2→21,2 years, in T2 10,7→11,3. 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.
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