Diabetes mellitus

Number of people with diabetes

2024: Russia counted 10-12 million people with diabetes

In Russia, there are from 10 to 12 million patients with diabetes mellitus - and about half of them are not diagnosed. Such data are given in the materials of the Moscow State Medical and Dental University. A.I. Evdokimov (MGMSU), published in mid-April 2024.

According to estimates by the World Health Organization (WHO), in 2014, the incidence of diabetes among adults aged 18 years and older was 8.5%. In 2019, diabetes became the direct cause of 1.5 million deaths, while 48% of all deaths associated with this disease occur in people under the age of 70. Another 460 thousand deaths were caused by kidney diseases caused by diabetes. In addition, elevated blood glucose is responsible for about 20% of cardiovascular deaths.

In Russia, there are from 10 to 12 million patients with diabetes

WHO estimated that in 2021, 529 million people in the world had diabetes. In 2024, about 600 million people suffer from this disease, and by 2050 the number of such patients is expected to increase to almost 1.5 billion.

Today in Russia there are definitely from 10 to 12 million patients with diabetes. In the register itself, half. This suggests that every second patient we have not been diagnosed with. In Russia, 20% of the population aged 20 to 79 years have pre-diabetes [by the beginning of 2024]. This is 30 million people. Compared to 15 years ago, the number of patients with diabetes mellitus has tripled, "says Ashot Mkrtumyan, Head of the Department of Endocrinology and Diabetology, Faculty of Medicine, Moscow State Medical University.

It is noted that diabetes is one of the leading causes of blindness, kidney failure, heart attacks, stroke and amputation of the lower extremities. In low- and middle-income countries, the prevalence of diabetes is growing faster than in high-income countries.^[1]

2023: The detection rate of oncology and diabetes in Russia doubled in a year

The detection rate of cancer and diabetes mellitus in Russia in 2023 almost doubled in comparison with 2022, which was facilitated by medical preventive examinations. Deputy Prime Minister Tatyana Golikova announced this in February 2024 during the Forum of National Achievements. Read more here.

2022

Diabetes incidence in the US has risen by 20% in 10 years

In mid-August 2024, the University of Georgia released a new study that estimated the incidence of type 2 diabetes in the U.S. increased by nearly 20% between 2012 and 2022. The main risk factors are still older age, black race, low income and obesity.

The researchers used data from a nationally representative behavioral risk factor surveillance system, an ongoing health study involving more than 400,000 people. They found an increase in the incidence of diabetes among all socio-demographic groups, but black people were particularly affected by this disease: in this population, the incidence was just under 16%. In addition, one in five people aged 65 and over faces this disease: in the same age group, diabetes was diagnosed more than 10 times more often than in people aged 18 to 24 years, and in people aged 45 to 64 years - 5 times more often.

In the US, the incidence of diabetes over 10 years increased by 20%

The study also found that people on lower incomes were significantly more likely to have diabetes than those on higher incomes. High-income people were 41% less likely to have diabetes - 24% less likely to have diabetes.

The incidence of diabetes in the United States is growing every day, - the lead author of the study notes Sulakshan Neupane. - Medical costs and indirect costs, such as disability, total $412 billion. This is a huge amount, and it will only grow as diabetes is detected in more and more people.

The researchers remind that although some risk factors, such as age and race, cannot be changed, it is possible to reduce the risk of developing diabetes by modifying other factors, for example, maintaining an active lifestyle and getting rid of excess weight.^[2]

The number of new cases of diabetes in Russia increased by 15% over the year

At the end of 2022, about 5 million patients with diabetes are registered in Russia, but according to experts, their number is much more, about 2 times: more than 10.5 million. Such a gap between recorded and actual cases is largely due to the fact that diabetes is not detected in a timely manner. He may not show himself in any way for a long time. But this does not mean that this disease does not have a negative effect on the body.

From January to mid-November 2022, 345 thousand new patients with diabetes were registered in Russia, while for the entire 2021, about 300 thousand such patients were identified. Such figures on November 14, 2022 were cited by Natalya Mokrysheva, director of the National Medical Research Center for Endocrinology of the Ministry of Health of Russia, Corresponding Member of the Russian Academy of Sciences.

Over the past three years, our joint efforts have led to the fact that the detection rate of patients with diabetes mellitus in the regions of the country has increased significantly and, accordingly, their registration with medical registration has improved. As a result, the number of patients with diabetes mellitus has grown, both in the register (patients with diabetes mellitus - approx.) TASS And in the estimates of Rosstat. But we cannot argue that we have a true picture for this disease, since at least half of the patients simply do not know about their diabetes mellitus, since they have not been properly examined, "Mokrysheva said.

Thus, the increase in the number of new patients with diabetes in 2022 will be at least 15%. The National Medical Research Center noted that they do not interpret the statistics: an increase in the incidence rate is caused by an improvement in the detection rate of patients with diabetes in the regions. According to Mokrysheva, at least half of the patients do not know about their diabetes, since they have not been properly examined.

Earlier, Alexander Mayorov, President of the Russian Diabetes Association, Head of the Diabetes Forecasting and Innovation Department of the Institute of Diabetes at the National Medical Research Center of Endocrinology, noted that the number of patients with diabetes registered in the Russian Federation is about 5 million people, another 5 million do not know about their disease.

In November 2022, LDPR deputies Vladimir Koshelev, Yaroslav Nilov and Stanislav Naumov proposed to allocate 100 billion rubles for the implementation of the future federal project "Fight Diabetes" in 2023-2025 (that is, almost 34 billion rubles a year). The proposed amendments to the bill on the federal budget will be considered during the second reading in the State Duma. Currently, 10 billion rubles have been reserved for the implementation of the fedproject in 2023^[3]

2021

WHO: 529 million people with diabetes live in the world

In 2021, on a global scale, approximately 529 million people had diabetes. Such data are given in a study by the World Health Organization (WHO), the results of which were released on June 22, 2023.

According to estimates from the Global Disease Burden Research Program (GBD), almost 460 million people worldwide were diagnosed with diabetes in 2019. The disease is the eighth leading cause of death and disability globally. Thus, taking into account WHO data, the increase in the number of diabetics over two years was approximately 15%. In most cases, patients are diagnosed with type 2 diabetes.

Diabetes remains one of the biggest threats to public health in modern times, and it will skyrocket in every country, age group, and gender in the next three decades, creating a major challenge for health systems around the world, said Dr. Shivani Agarwal of the Albert Einstein College of Medicine in New York.

The study says the COVID-19 pandemic has exacerbated diabetes disparities around the world. According to the authors of the report, patients with diabetes are twice as likely to develop severe infection and death as people without diabetes, especially among ethnic minorities.

In Russia, according to estimates, the prevalence of diabetes is up to 4%. According to information published by the Ministry of Health in September 2022, every 15th Russian, or 10.5 million people, suffers from this disease. The WHO study also notes that diabetes is ahead of most diseases in the world, posing a serious threat to people and health systems. One of the main reasons for the increase in the prevalence of diabetes is obesity.^[4]

In Russia, counted 48 thousand children with diabetes

On November 11, 2021, it became known that in Russia there are 48 thousand children with type 1 diabetes, including more than 4 thousand in Moscow. Such data are provided by Kommersant with reference to official statistics. In total, 264 thousand patients in Russia with a diagnosis of type 1 diabetes mellitus.

The publication says that parents of children with type 1 diabetes are forced to independently purchase continuous glucose monitoring devices (NMG), although they are included by the Ministry of Health in the standard of care and are required 85.5% children with such a diagnosis.

On March 1, 2021, an updated standard of medical care for children with type 1 diabetes mellitus came into force. It included continuous glucose monitoring systems for the first time. The cost of sensors for such systems is about 9 thousand rubles per month per patient.

According to the monitoring of the WORDI organization by the beginning of 2021, in 53% of the families surveyed, children use continuous glucose monitoring systems purchased at their own expense. Another 42% of parents replied that they could not afford supplies for the systems and were forced to use test strips for a glucometer. Only 5% of respondents consider it convenient to use a glucometer.

The position of the chief freelance endocrinologist of Russia Valentina Peterkova assumes that 50% of children with diabetes will be provided with insulin pumps, by 2021 this figure is about 20%. Since 2019, supplies for pumps began to be issued free of charge, since 2021, the installation of insulin pumps has been included in the Campus Management compulsory medical insurance. 

Speaking about the causes of type 1 diabetes, experts primarily call the genetic predisposition to autoimmune diseases, and little is known here.  Someone considers the increase in morbidity as a result of the deterioration of the environmental situation. They also talk about epigenetics (from the Greek. "Epi" - "over," a study of the change in gene activity under the action of mechanisms that do not affect the primary structure of DNA) and epigenetics of nutrition.^[5]

2020: At the beginning of the year, 5.1 million patients with diabetes were registered in Russia

The number of patients diagnosed with diabetes mellitus increased in 2019 among adults - by 4.7%, among children - by 5.3%. At the beginning of 2020, 5.1 million diseases of diabetes mellitus were registered in the adult population in Russia and almost 50 thousand in children, said Russian Deputy Prime Minister Tatyana Golikova.

Golikova noted that 5 million (98%) of them were taken under dispensary supervision. Among children, 48.8 thousand diseases were registered, almost 48 thousand (98.3%) were taken under dispensary supervision, the Deputy Prime Minister added.

"The increase in the number of diabetes patients indicates that diagnosis is improving. Diabetes began to be detected earlier, which automatically led to an increase in the number of patients with this disease. Also, people began to pay more attention to their health and initiate the diagnosis of diabetes themselves. However, an important factor in the incidence of diabetes is poor diet and an unhealthy lifestyle, "she stressed

.

2019: 4.8 million in Russia

As of 2019, in Russia, according to the Ministry of Health, there were already 4.8 million patients with diabetes, including about 1 million with insulin-dependent diabetes.

The number of patients with diabetes is constantly growing, over the past 5 years the number of patients has increased by 23%.

In 2019, the number of newly diagnosed diabetes mellitus in Russia increased by 27% compared to 2010.

2016:415 million worldwide

At the beginning of 2016, according to WHO, there were 415 million diabetics in the world - and in 12 years their number will double. There are many patients suffering from this disease in Russia: about 4 million people.

Diabetes mortality

2023: Deaths from diabetes in Russia increased by 14.4% over the year to 48,469 people

In August 2024, it became known that mortality from diabetes mellitus in Russia in 2023 increased by 14.4%, reaching 48,469 people, which is 2.7% of the total number of deaths in the country. This follows from the report of Rosstat. In the context of mass diseases, which caused more than 1% of deaths, this figure is the most significant increase.

According to RBC, the increase in mortality from diabetes occurs against the background of an overall decrease in mortality in the country by 7.1%, to 1.764 million people, which is largely due to a sharp decrease in the number of deaths from COVID-19. However, despite the decrease in overall mortality, diabetes was an exception, which caused alarm among experts.

Mortality from diabetes mellitus in Russia in 2023 increased by 14.4

A surge in deaths from diabetes was previously observed in 2020, when the figure increased by 26% and reached a peak of 51.8 thousand deaths. However, then, over the next two years, the number of deaths from diabetes decreased. Experts attribute the increase in mortality in 2023 to several factors, including the consequences of the COVID-19 pandemic, an increase in the number of people with obesity and an improvement in the detection of the disease.

According to statistics, every thirteenth Russian suffers from diabetes, while forecasts show that by 2045 the prevalence of this disease in the world may increase by 51%. Earlier, experts pointed to the high mortality rate of patients with diabetes from cardiovascular complications, which is also confirmed by Rosstat data.

Diabetes is a chronic metabolic disorder that is divided into two main types: type I diabetes (insulin-dependent) and type II diabetes (non-insulin-dependent). The bulk of patients suffer from type II, which is characterized by a reduced sensitivity of cells and tissues of the body to insulin. According to the National Medical Research Center of Endocrinology of the Ministry of Health, more than 5.277 million people with non-insulin-dependent diabetes are registered in Russia.^[6]

Servier will pay millions for the death of 2 thousand people from the drug for diabetics

At the end of March 2021, a French court fined one of Servier the country's largest pharmaceutical companies 2.7 million euros, finding her guilty of deception and manslaughter of about 2 thousand people. Servier has been accused of concealing potentially fatal side effects of a sufficiently popular diabetic drug. Mediator More. here

Symptoms of diabetes

Common signs of diabetes include:

• increased thirst and increased urination at night,
• dryness of the skin,
• a constant feeling of hunger,
• unexplained weight loss,
• cramps of the calf muscles,
• tingling and numbness in the limbs,
• visual impairment,
• itching of the skin and mucous genitals,
• severe weakness and fatigue,
• poor wound healing and
• recurrent urinary tract infections.

If a person discovers these symptoms, you need to see a doctor as soon as possible.

Two types of diabetes

Role of the pancreas

The pancreas helps digest food, thanks to excreting enzymes, and also produces insulin so that the body's cells can properly use their main source of energy - glucose.

In type 1 diabetes mellitus, pancreatic beta cells that produce insulin are affected. And ultimately, the iron loses its ability to produce this vital hormone.

In type 2 diabetes, the pancreas can still produce some insulin, but it is not sufficient for the body to function fully.

Proper insulin dosing is very important to keep blood glucose levels in a safe range.

Diabetes mellitus is characterized by a chronic course and violation of all types of metabolism: carbohydrate, fatty, protein, mineral and water-salt. Approximately 20% of patients with diabetes develop renal failure.

Insulin

Main article: Insulin

Type 1 diabetes mellitus

Type 1 diabetes mellitus most often develops in childhood and adolescence, but may first appear in adulthood.

Type 2 diabetes mellitus

Type 2 diabetes mellitus, as a rule, develops in people over 40 years old and occurs 4 times more often than type 1.

Type 2 diabetes mellitus (SD2) is a metabolic disease characterized by chronic hyperglycemia, which develops as a result of an increasing decrease in insulin production by pancreatic cells, and a violation of insulin interaction with tissue cells - insulin resistance. The prevalence of chronic heart failure in patients with type 2 DM, as of December 2020, ranges from 24% to 40%.

From the late 1980s to the late 2010s, the disease acquired the scale of a pandemic: since 2000, the number of patients in the world has tripled and is predicted to continue to grow in subsequent years. In total, at the beginning of 2019, there are about 425 million people suffering from SD2 in the world. In Russia, their number reaches about 4 million, however, according to the results of the NATION epidemiological study, about half of people do not know about their diagnosis. So the real figure could be double that.

As of December 2020, in Russia, the real number of patients with type 2 DM is about 9 million people (≈ 6% of the population) ^[7] 22.

Type 2 diabetes mellitus is associated with the work of several dozen genes, one of which is a TCF7L2 - a transcription factor (regulates the expression of other genes), which triggers a complex cascade of reactions leading to the growth and development of pancreatic cells that synthesize insulin. The investigated rs7903146 polymorphism in this gene is associated with a predisposition to type 2 diabetes mellitus. At the same time, the CT genotype increases the risk by 1.5 times, and TT - by 2.5 times.

Glucose is the main source of energy for all tissues of the body, it enters the cell only under the influence of insulin, which regulates the process of storing glucose in the tissues of the liver, muscles and adipose tissues. In diabetes mellitus, insulin is not enough to provide all tissues with glucose, which leads to a high level of it in the blood, but a low level in cells and tissues. In order to somehow satisfy cellular hunger, the body begins to break down fats and proteins. This often leads to the depletion of the body and the accumulation of protein breakdown products. Excess glucose begins to be excreted by the kidneys - sugar appears in the urine. Together with glucose, the kidneys remove a huge amount of fluid, this leads to severe thirst, dehydration and imbalance of the electrolytes.

In type 2 diabetes, a person overeats and moves little, glucose levels are regularly high and cells produce a lot of insulin to absorb it. A large amount of glucose is converted into fatty acids, the liver and muscles cannot store such an amount of glycogen. Adipose tissue grows, it produces more leptin (the satiety hormone, which tells the body that the reserves are replenished), but sensitivity to leptin decreases, as the body adjusts to high levels of the hormone. A person continues to overeat, glucose enters again and the cells cease to respond to insulin, thus insulin resistance is produced. If you adjust the metabolism in time, changing the diet and resorting to physical activity, the muscles will begin to absorb more glucose, and the adipose tissue will be consumed. If you do not resort to these measures in a timely manner, type 2 diabetes mellitus develops: constantly increased insulin production leads to depletion of pancreatic cells and the insulin level drops, as a result, a person has a low level of insulin, and the cells become immune to it.

Causes of the disease

2023: Malnutrition has caused 70% cases of type 2 diabetes

In mid-April 2023, American experts from Tufts University released the results of a study suggesting that the cause of the development of 70% cases of type 2 diabetes mellitus on a global scale is malnutrition.

The named ailment, also known as insulin-resistant diabetes mellitus, is a chronic disease in which the body is unable to effectively use insulin produced in sufficient quantities by pancreatic cells. Moreover, the most common risk factors are obesity and an increased body mass index. Type 2 diabetes mellitus is the leading cause of death worldwide and has huge socio-economic consequences.

The authors of the study analyzed data on the nutrition of citizens in 184 countries for the period from 1990 to 2018. At the same time, the influence of a number of dietary factors was assessed: insufficient consumption of whole grains, fruits, nuts, yogurt, seeds and vegetables, as well as excessive consumption of refined wheat and rice, meat, sugary drinks, fruit juices and potatoes. These data were compared with the incidence rate of type 2 diabetes mellitus.

The study showed that insufficient consumption of whole grains led to the majority of new cases of the development of the disease in question worldwide - 26.1%. This is followed by excessive consumption of refined wheat and rice (24.6%), processed meat (20.3%) and unprocessed red meat (20.1%). In this case, geographical heterogeneity is traced. In densely populated countries, for example, Poland and Russia, excessive consumption of red meat and potatoes often leads to the development of type 2 diabetes. And in Latin America and the Caribbean, the disease is provoked by excessive consumption of sugary drinks and a lack of whole grains.^[8]

Diagnosis of diabetes mellitus

2024

Scanner presented that diagnoses diabetes, heart disease and Alzheimer's disease by eye

In mid-October 2024, American researchers presented an ophthalmoscope that allows you to detect diabetes mellitus and heart disease from an eye scan. Read more here.

Diagnosis of diabetes started by voice

In mid-September 2024, scientists presented an AI-based algorithm for voice analysis to diagnose diabetes mellitus in adult patients. The model detected type 2 diabetes mellitus with an accuracy of 66% among women and 71% among men, and was 93% consistent with the diabetes risk score based on a questionnaire, a generally accepted screening tool.

The Colive Voice project involved volunteers from around the world, but so far the results of the study are limited to a sample of adult English-speaking patients from the United States, both with and without type 2 diabetes. Going forward, the researchers plan to reach more diverse patient groups in terms of language and socio-demographic background.

Diabetes began to be diagnosed by voice

To train the model, participant vote records (average duration 25 seconds) were used, as well as significant health data including age, sex, body mass index (BMI) and blood pressure values. Algorithms were trained and cross-tested for men and women separately. The justification for the method was Hooke's law, according to which changes in the voltage, mass or length of the vocal cords, mediated by different blood glucose, can lead to a change in the frequency of their fluctuations.

The AI algorithm analyzed different vocal characteristics, such as changes in pitch and voice intensity, to reveal differences between people with and without diabetes. To do this, the researchers used two methods: at the qualifying stage, an analysis of 6,000 vocal characteristics was carried out, and then a deep learning approach was used, which used a refined set of 1024 key characteristics.

The authors note that much more reliable evidence is needed to use the algorithm in real clinical practice, because many other parameters, such as age, smoking, sex, body structure, as well as emotional and psychological factors, can affect the voice and distort the results of the analysis.^[9]

In a medical facility

The special insidiousness of type 2 diabetes mellitus is that the disease begins gradually, proceeds with a small number of symptoms. Due to the long asymptomatic period, patients see a doctor very late, when 50% of them have complications due to this disease. Therefore, it is very important to take a blood glucose test according to the Campus Management compulsory medical insurance policy annually as part of a preventive medical examination or the 1st stage of medical examination. If the disease is suspected, the therapist will issue a referral to the endocrinologist for compulsory medical insurance. The initial consultation of the endocrinologist includes examination of the patient, clarification of disturbing complaints and hereditary predisposition to endocrinological diseases, development of an examination plan.

The main method of diagnosing the disease is laboratory tests. The presence of hyperglycemia (increased blood sugar) shows an increased (more than 6.1 mmol/L) glucose content in the capillary blood, which is taken on an empty stomach from the finger. But this indicator alone is not always enough to establish a diagnosis of diabetes.

Examination for suspected diabetes mellitus also includes determination of the level:

• glucose and ketone bodies in the urine, since they should not be normal in the urine. This can be determined using special test strips;

• glycosylated hemoglobin, which is significantly increased in diabetes mellitus;

• C-peptide and insulin in the blood. With type I diabetes mellitus, both indicators are significantly reduced, with type II - practically unchanged.

And also conducting a load test (glucose tolerance test): determining glucose on an empty stomach and 1 and 2 hours after taking 75 g of sugar dissolved in 1.5 glasses of boiled water. Diabetes mellitus is confirmed to be > 6.6 mmol/L at first measurement and > 11.1 mmol/L 2 hours after glucose load.

Mobile apps

2020: Smartphone app that detects diabetes released

In mid-August 2020, researchers from the University of California, San Francisco presented a new method for detecting diabetes mellitus. They used Azumio's public Instant Heart Rate app to record photopletismography measurements, to which they added a deep learning algorithm. Read more here.

Health implications of diabetes

Eye diseases

Diabetes disrupts the work of many organs, leads to irreversible consequences. These include serious diseases of the eye, the most significant of which are lesions of the retina and blood vessels of the eye: diabetic retinopathy and diabetic macular edema. As of 2023, about 652 thousand patients with eye lesions caused by diabetes mellitus were registered in Russia.

Diabetic retinopathy

Diabetic retinopathy is one of the leading causes of blindness in patients of working age, it accounts for 80-90% of all visual disability due to ^[10] of the ^[11]. Two-thirds of patients with type 2 diabetes have this ophthalmic complication 20 years after the onset of the underlying disease. Symptoms of the disease include shimmering "stars" in the eyes, discomfort and pain in the eyes, a decrease in visual acuity and the presence of a "veil" in front of the eyes, a decrease in vision in general (more often this symptom indicates severe stages of retinopathy).

2018: World's first autonomous system launched to diagnose diabetic retinopathy

In July 2018, the world's first autonomous AI-based diagnostic system was launched in the United States to detect diabetic retinopathy, a severe complication of diabetes mellitus that, without proper supervision and treatment, can lead to complete vision loss. The developer of the system, IDx, has developed its own algorithm for diagnosing retinopathy in adults over 22 with diabetes from fundus images. The University of Iowa became the first U.S. health organization to introduce the technology into clinical practice. Read more here.

Diabetic macular edema (DME)

Diabetic macular edema (DME) can develop at any stage of diabetic retinopathy and threatens irreversible vision loss. According to estimates in Russia, the number of patients with DME is about 230 thousand people. The main complaints of patients who accompany the development of DME are the deterioration of central visual acuity, the appearance of image distortions or spots in front of the eyes. The most common symptoms are blurred images, pinkish shades, distortion of the size and shape of objects, difficulty reading due to "falling out" of individual letters, increased photosensitivity, and the very quality of vision can change during the day - in the morning, as a rule, it is worse.

Treatment of ophthalmic complications of diabetes mellitus is often carried out throughout the patient's life after diagnosis, which cannot but affect the adherence to therapy. Deviating from the doctor's recommendations can lead to rather serious consequences.

Take your own Amsler test

The Amsler test looks like a lattice divided into small squares with a black dot in the middle. It is the simplest and fastest way to self-test the central visual field to prevent serious retinal disorders and assess treatment dynamics.

Normally, when performing the Amsler test, the visible image should be the same on both eyes, the lines should be even, without distortion, spots and curvatures. If changes are detected, you need to consult an ophthalmologist.

Perform the test regularly (even daily) to assess your vision and the possible appearance of the first symptoms of retinal disease. Visit an ophthalmologist on time, treat your eyes carefully and be attentive to any changes in vision - this will help maintain eye health and prevent the progression of the disease.

Brain aging

2022: Diabetes accelerates brain aging by 26%

In late May 2022, scientists at the University of New York at Stoney Brook demonstrated that normal brain aging accelerates by about 26% in people with advanced type 2 diabetes compared to people without the disease. The study authors assessed the association between normal brain aging and aging seen in type 2 diabetes and observed that in type 2 diabetes, neurodegeneration proceeds similarly to aging but faster.

One important consequence of this finding is that even typical brain aging may reflect changes in brain regulation of glucose by insulin. The findings also suggest that by the time type 2 diabetes is officially diagnosed, there may already be significant structural damage in patients in the brain. Sensitive ways to detect changes in the brain associated with diabetes are needed, scientists say.

There is already strong evidence linking type 2 diabetes to cognitive decline, however, as of May 2022, few patients undergo comprehensive cognitive assessment as part of clinical treatment. It can be difficult to distinguish between normal brain aging, which begins in middle age, and brain aging, caused or accelerated by diabetes. As of May 2022, no study directly compared neurological changes in healthy individuals over a lifetime with changes occurring in people of the same age with diabetes.

In order to determine the effect of diabetes on the brain beyond normal aging, the team of researchers used the largest available set of data on the structure and function of the brain throughout a person's life: UK Biobank data obtained from 20 thousand people aged 50 to 80 years. This set of information includes brain scans and brain function measurements and contains data from both healthy people and people diagnosed with type 2 diabetes. The scientists used the data to determine what brain and cognitive changes are characteristic of diabetes, not just aging, and then validated these findings by comparing them to a meta-analysis of nearly 100 other studies.

The analysis showed that both aging and type 2 diabetes cause changes in executive functions such as working memory, learning and thinking flexibility, as well as changes in the speed of information processing by the brain. However, in people with diabetes, executive function decreased by another 13.1% over age-related effects, and information processing speed decreased by another 6.7% compared to people of the same age without diabetes. A meta-analysis of other studies also supported this finding: people with type 2 diabetes consistently and markedly decreased cognitive performance compared to healthy people of the same age and same educational level.

The team of scientists also compared the brain structure and activity of people with and without diabetes using magnetic resonance imaging (MRI). Here, they found a decrease in brain gray matter with age, mostly in the ventral striatum region, which is crucial for brain executive functions. At the same time, in people with diabetes, an even more pronounced decrease in gray matter was observed in addition to typical age-related effects, by another 6.2% in the ventral striatum.

Taken together, the findings suggest that the pattern of neurodegeneration associated with type 2 diabetes largely coincides with that of normal aging, yet neurodegeneration accelerates. Moreover, these effects on brain function were more severe with increased duration of diabetes. In fact, diabetes progression was associated with a 26% acceleration in brain aging^[12]

Diabetes Control (Federal Program)

Main Article: Fighting Diabetes (Federal Program)

Diabetes treatment

Main Article: Diabetes Management

Blood glucose measurement systems

Main article: Blood glucose monitoring systems

Test strips for glucometers

Main article: Test strips for glucometers

Insulin injections

As of 2021, all patients with type 1 diabetes, as well as about 19% of patients with type 2 diabetes, need daily insulin injections to maintain their target blood sugar levels.

Insulin pumps

Main article: Insulin pumps

Artificial pancreas

Main article: Artificial pancreas

Other technologies in diabetes control

Main Article: Technologies for Diabetes Control and Management

Diet

Dried, roasted and crushed chicory root is very similar to coffee when brewed. Chicory contains the useful polysaccharide inulin and antioxidants, useful in diabetes mellitus and hypertension.

Chronicle

2023: Perm Polytechnic scientists develop mathematical model of microcirculation in the body of diabetes patients

On February 13, 2023, representatives of the Perm Polytechnic reported on the development that will help avoid dangerous complications of diabetes mellitus. 

As reported, the number of patients with diabetes mellitus is constantly growing. This disease often leads to dangerous complications. For example, disorders of the blood supply can provoke diabetic foot syndrome - pathological changes in the nervous system, arterial and microvascular beds and the bone-joint apparatus of the foot. Non-invasive experimental methods are used to diagnose them by February 2023. But similar clinical manifestations can be caused by various diseases. Biomechanics of the Perm Polytechnic University have developed a mathematical model of microcirculation in the body of patients with diabetes mellitus. It will allow you to predict the dangerous consequences of the disease and optimize diagnostics. The results of the study, scientists published in the "Russian Journal of Biomechanics" (2022). Specialists of the PSMU named after Academician E.A. Wagner also took part in the work. The study was carried out with the financial support of the Perm World-Class REC "Rational Subsoil Use." Read more here.

2021

Popular diabetic drug recalls due to cancer risk

In early January 2021, Nostrum Laboratories voluntarily recalls one batch of metformin hydrochloride sustained-release tablets because they were found to contain excessive levels of "probable human carcinogen." Read more here.

2017:45% of Russians risk getting diabetes in the next 10 years

Researchers at the Genotek Medical Genetic Center analyzed the results of 2500 DNA tests and revealed that 40% Russians have a risky version of the TCF7L2 gene, which increases the predisposition to type 2 diabetes mellitus by 1.5 times - the CT genotype. Another 5% was found to have a risky version of the same gene, which increases the predisposition to the disease by 2.5 times - the TT genotype. In combination with a body mass index of more than 25, the CT genotype increases the likelihood of developing the disease by at least 2.5 times, and the TT genotype by at least 4 times. According to statistics, out of 2,500 Russians studied, the increased body mass index has more than 30%. For the study, the results of DNA tests of men and women aged 18 to 60 years were used.

According to the Ministry of Health, the threshold for the incidence of type 2 diabetes has dropped to 30 years. As the World Health Organization predicts, diabetes will rank seventh among the causes of death by 2030. According to WHO, 2015 million patients with a diagnosis of type 2 diabetes mellitus were registered in Russia in 4.5, while every year the number increases by 3-5%, over the past 10 years the number of patients has increased by 2.2 million people. Doctors consider the official statistics to be greatly underestimated, as many patients do not seek help or turn too late. According to forecasts of the Institute of Diabetes of the Federal State Budgetary Institution "Endocrinological Scientific Center," the real prevalence of type 2 diabetes in Russia is 3-4 times higher than official data, that is, about 10-12 million people.

The ratio of the contribution of genetic and lifestyle factors, according to the specialists of the Institute of Diabetes, is 90% by 10%, but the predisposition to the development of type II diabetes mellitus may never be realized with the right approach to the prevention of the disease. To determine preventive measures, it is necessary to calculate how high the genetic risk is and how lifestyle factors affect it. The most important lifestyle factor in the case of diabetes mellitus is overweight, so it is important to add body mass index (BMI) data to the results of genetic analysis to calculate individual risks. To find out the body mass index, you need to divide the weight of a person in kilograms by his height in meters, squared, and then divide the weight by the result. The likelihood of diabetes mellitus increases 1.6 times with a BMI of 25-30, which is considered overweight in medicine. With a BMI of 30-35, the probability of developing the disease increases 3 times, with 35-40 - 6 times, and with a BMI above 40 - 11 times.

'A DNA test is needed to determine to what extent the problem concerns you. The presence of genetic markers that increase the risk of developing diabetes by 1.5 times and the presence of markers that increase it by 2.5 times is a different degree of risk and different preventive measures. And if an increased body mass index is added to this, then the probability increases by at least 1.6 times. It will be enough for someone to deny themselves a late dinner or dessert, and for someone, prevention will be a serious measure that completely changes the way of life. This study is aimed at drawing attention to the problem of diabetes mellitus in Russia and developing individual prevention measures based on the characteristics of the genome, "comments geneticist, General Director of the Genotek Medical and Genetic Center, Ilyinsky Valery.

'Human DNA does not change over time, but the trends on which our lifestyles depend change. With the prevalence of fast food and foods high in sugar, with the growing problem of low physical activity, diabetes mellitus as a disease is getting younger. Already, doctors say that it was previously diagnosed in elderly people over 60, but now it is increasingly detected in patients aged 30-35 years. The reason is a genetic predisposition, aggravated by an unhealthy lifestyle, "says Marina Stepkovskaya, candidate of medical sciences, therapist at the Genotek Medical Genetic Center

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November 14 - World Diabetes Day

November 14 marks World Diabetes Day.

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