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The article provides the current epidemiological characteristics of viral hepatitis B and C and the existing problems of registering parenteral viral hepatitides in Russia. It justifies the need for introducing a uniform federal registry of patients with viral hepatitis B and C and shows prospects for its introduction.
On July 26, 2010, the Office of the Federal Register and the Government Printing Office (GPO) launched “Federal Register 2.0,” a web version of the daily Federal Register. As of now, the site is only a prototype; therefore, “Federal Register 2.0” is not yet an official legal edition of the Federal Register, and it will not become official until the Administrative Committee of the Federal Register (ACFR) issues a regulation granting “Federal Register 2.0” official legal status. Once “Federal Register 2.0” becomes official, the website will allow the public to receive notice of proposed agency regulations, link to a separate website to submit comments on the proposed rules, and track the status of regulations online in one easy-to-access location. The creation of “Federal Register 2.0” signifies a major change to the format and use of the Federal Register as the primary method of lawmaking for the executive branch. Before such a substantial change is made, requiring input and advice from all three branches of government would substantially aid the transition.\nTo many, the Federal Register may go unnoticed and even be taken for granted. During the 111th Congress, members of Congress introduced only a few bills that would change the administrative procedure laws associated specifically with the Federal Register. Also, very few cases dealing with the notice and comment requirements for agency regulations have come before the Supreme Court. This could lead one to believe that executive branch lawmaking is straightforward and does not require the intervention of the other branches of government. In the absence of action from the legislative branch, the creation and official implementation of “Federal Register 2.0” raises a few questions. The first question is whether it is appropriate for the department that makes general policies regarding the format of submissions to the Federal Register to be able to submit its own proposed regulation to itself and therefore oversee the notice and comment requirements over its own regulation. Another question is whether having the processes of the Federal Register in an electronic medium will lead to increased litigation in the courts. Finally, with the potential for more openness and participation in government, will “Federal Register 2.0” and the agencies be able to handle the probable increase in use, or will it become necessary for Congress to step in and reform the notice and comment rules?\nThis article will try to answer these questions, and will first look at the history of the legislation that initiated and regulates the Federal Register and the associated methods of creating administrative law. The answers to the questions will be found both in this history as well as in the changes our own society has made in the years since the passage of the legislation that created the Federal Register, the Federal Register Act of 1935.
BACKGROUND. The clinical and epidemiological characteristics of diabetes mellitus (DM) and the quality of its therapy are the key prognostic dominant that determines the organizational aspects of the diabetic service. The continuous dynamic monitoring of DM has been carried out in the Russian Federation (RF) since 1996 through the activities of the Federal Register of Diabetes Mellitus (FDR). AIMS. The aim of our study was to analyze the epidemiological characteristics of DM in the RF (prevalence, morbidity, mortality), the prevalence diabetic of complications, the state of carbohydrate metabolism (level of HbA 1c ) and the dynamics of the structure of glucose-lowering therapy (GLT) according to the FDR. MATERIALS AND METHODS. The database of FRD (https://www.diaregistry.ru/), 85 regions of the RF. The data are presented as of 01.01.2023 and in dynamics for the period 2010–2022. RESULTS. The total number of DM patients in the RF as of 01.01.2023 was 4 962 762 (3.31% of the population), including: Type 1 (T1) — 5.58% (277.1 ths), T2 — 92.33% (4.58 million), other DM types —2.08% (103 ths). The dynamics of prevalence over the 13-year period (2010→2022) was 146.0→191.0/100 ths people with T1, and 2036.2→3158.8/100 ths people with T2; morbidity in T1 12.3→8.2/100 ths population, in T2 260.1→191.4/100 ths population; мortality: T1 2.1→2.4/100 ths population, T2 41.2→86.1/100 ths of the population. The main cause of death was cardiovascular: in T1 38.6% cases, in T2 — 50.9%. Life expectancy (average age of death of patients): T1 was 52.7 years, the dynamics in males 50.9 → 50.7 years, females 62.1→56.0 years; in T2 — 74.2 years, males 69.5→70.4 years, females 74.2→76.1 years. The dynamic of DM duration from onset to the death: in T1 15.4→19.9 years; in T2 11→11.4 10.2→11.8 years. The proportion of patients with laboratory-measured HbA 1c <7% in the dynamics of 2010–2022: with DM1 24.4%→29%, with DM2 41.5%→42.2%, with HbA 1c ≥9.0%: with DM1 29, 4% → 20.4%, with DM2 13.8 → 9.0%.The incidence of diabetic complications as of 01.01.2023 in T1 and T2 patients: neuropathy 41.3% and 23.7%, nephropathy (CKD) 22.8% and 19.1%, retinopathy 28.9% and 12.3%, respectively. The structure GLT in T2 patients as of 01.01.2023: monotherapy — 41.6%; combination of 2 GLM — 30.0%, 3 GLM — 5.8%, insulin therapy in 18.3%. CONCLUSIONS . The information-analytical system FDR is a key tool for systematizing the most important epidemiological and clinical characteristics of DM based on data from real clinical practice, which allows optimizing the algorithm of patient management and improving the quality of care for diabetes.
The objective of the study: to analyze the impact of response activities to the COVID-19 pandemic on the system of tuberculosis care provided to the population of the Russian Federation based on the data of the Federal Register of TB Cases (FRTBC). Subjects and methods. Using regression analysis of data obtained from the forms of federal and sectoral statistical observation, regression equations were drawn up, and estimated indicators were determined for each month of 2020. The estimated indicators were compared with the data obtained from monthly reports downloaded from FRTBC from January to June 2020. Results. The shortfall in the registration of all cases of tuberculosis treatment relative to estimated indicators in May-June 2020 amounted to 24.4-24.7%, including 24.8% for new cases and relapses. That is very close to the value estimated by the World Health Organisation (25%). The number of tuberculosis cases detected post mortem increased by 37.1%. The number of detected pediatric tuberculosis cases at the age of 0-14 and 15-17 years old decreased by 31.4 and 28.2%, respectively. In June 2020, there was an increase in almost all recorded indicators that was due to the intensified tuberculosis detection activities. Conclusions. FRTBC allows performing prompt monitoring of the impact of response activities to the COVID-19 pandemic on the system of tuberculosis care provided to the population. After a period of a significant decrease in the number of registered tuberculosis patients in April and May 2020, in June, as anti-epidemic activities related to COVID-19 were slowed down, the number of registered patients tended to reach the previous level and approach their estimated values.
The creation of the Federal Register in 1935 was crucial in enhancing transparency in American national government and its accountability under law. This historic action during the troubled New Deal era established a core institutional framework that endures as the nation begins a new century and as public administration struggles with an era of new institutionalism. Drawing on archival records and interviews, this article examines the political, administrative, and legal factors that led to the Register's creation. In particular, it sheds light on the little known but pivotal role played by Justice Brandeis in an extrajudicial capacity in this process. Brandeis's actions derive, in part, from his lifelong concern for fostering government openness and ensuring accountability under law from government bureaucracy. Without his intervention, it is unlikely the Federal Register Act would have been enacted at the time and in its important institutional form.
A new, fully-automated process has been developed at NIST to derive ground truth for document images. The method involves matching optical character recognition (OCR) results from a page with typesetting files for an entire book. Public domain software used to derive the ground truth is provided in the form of Perl scripts and C source code, and includes new, more efficient string alignment technology and a word- level scoring package. With this ground truthing technology, it is now feasible to produce much larger data sets, at much lower cost, than was ever possible with previous labor- intensive, manual data collection projects. Using this method, NIST has produced a new document image database for evaluating Document Analysis and Recognition technologies and Information Retrieval systems. The database produced contains scanned images, SGML-tagged ground truth text, commercial OCR results, and image quality assessment results for pages published in the 1994 Federal Register. These data files are useful in a wide variety of experiments and research. There were roughly 250 issues, comprised of nearly 69,000 pages, published in the Federal Register in 1994. This volume of the database contains the pages of 20 books published in January of that year. In all, there are 4711 page images provided, with 4519 of them having corresponding ground truth. This volume is distributed on two ISO-9660 CD- ROMs. Future volumes may be released, depending on the level of interest.
BACKGROUND: Therapy for type 1 diabetes mellitus (T1DM) is still largely an unsolved clinical problem. Despite the introduction into clinical practice of modern insulin preparations, devices for its administration, as well as continuous monitoring of glucose levels, the goals of therapy are often not achieved. At the same time, the International Diabetes Federation (IDF) notes an increase in the prevalence and incidence of T1DM in children and adolescents in the world. The Federal Register of Diabetes Mellitus (FRDM) is a dynamically updated database of patients with diabetes, which allows assessing prevalence and incidence rates, achievement of glycemic control goals and the incidence of diabetes complications. AIM: analyze the epidemiological data of T1DM (prevalence, morbidity) in children and adolescents (patients from birth to 18 years of age) in Moscow according to the FRSD data and to assess their dynamics, as well as the dynamics of achieving the goals of glycemic control and the incidence of T1DM complications in 2015-2020. MATERIALS AND METHODS: The object of the study is a sample from the database of the Moscow segment of the FRDM of a cohort of patients with type 1 diabetes under 18 years of age who were registered for the period 01.01.2015-01.01.2021. Epidemiological prevalence and incidence rates are calculated per 100,000 of the relevant population. RESULTS: the number of children and adolescents with type 1 diabetes in Moscow as of 01.01.2021 was 4024 people (2962 children and 1062 adolescents). Over the period from 2015 to 2020, there was an increase in the prevalence of T1DM (possibly due to an increase in the quality of data registration in the FRSD) and a decrease in the incidence of both children and adolescents. There was also a decrease in the level of HbA1c and the proportion of patients with HbAc1> 8.0% among children with T1DM. Both children and adolescents with T1DM showed a decrease in the incidence of diabetic coma and ketoacidosis with a simultaneous increase in the incidence of severe hypoglycemia, as well as a decrease in the incidence of retinopathy and nephropathy. However, the incidence of neuropathy decreased among children and increased among adolescents. CONCLUSION: The data obtained on the dynamic management of adolescents with T1DM are the basis for considering the development of a profile program for their dynamic observation, taking into account the need for psychological and social support for patients and their families.
Public and professional concerns over the registered nurse shortage and its effect on quality of care have led to 18 state and 2 federal initiatives to ensure safe hospital nurse staffing. Policy analysis of registered nurses safe staffing legislation introduced by the Congress suggests that its implementation is not likely to achieve all of its stated goals. An alternative policy approach is introduced.
The third generation of agricultural biotechnology looms large as plant-made pharmaceuticals (PMPs) and plant-made industrial products (PMIPs) both promise new, cheaper, and more plentiful pharmaceutical drugs and industrial products, such asplastics, cosmetics, enzymes, and epoxies. At the same time, they threaten the US food supply through adventitious presence (e.g., inadvertent mixing) of PMPs/PMIPs with the traditional food supply -- a concern brought home by the StarLink and Prodigene controversies in the past few years. This paper explores the third generation of agricultural biotechnology by looking at the products being developed and field tested and the regulations being implemented to address environmental release of PMPs and PMIPs. We next address the overwhelming public response to Federal Register notices concerning field release of PMPs and PMIPs and consider both the unprecedented volume of responses and their content, which reveals public and industry debate in terms of how to define science, governmental trust, and emotional response to the new technologies. We conclude by considering implications for not only PMPs and PMIPs, but also agricultural biotechnology in general.
This report serves to inform the congressional debate over rulemaking by analyzing different ways to measure federal rulemaking activity. The report provides data on and analysis of the total number of rules issued each year, as well as information on other types of rules, such as "major" rules, "significant" rules, and "economically significant" rules.
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On July 12, 1974, the National Research Act (Pub. L. 93-348) was signed into law, thereby creating the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. One of the charges to the Commission was to identify the basic ethical principles that should underlie the conduct of biomedical and behavioral research involving human subjects and to develop guidelines which should be followed to assure that such research is conducted in accordance with those principles. In carrying out the above, the Commission was directed to consider: (a) the boundaries between biomedical and behavioral research and the accepted and routine practice of medicine, (b) the role of assessment of risk-benefit criteria in the determination of the appropriateness of research involving human subjects, (c) appropriate guidelines for the selection of human subjects for participation in such research and (d) the nature and definition of informed consent in various research settings. The Belmont Report attempts to summarize the basic ethical principles identified by the Commission in the course of its deliberations. It is the outgrowth of an intensive four-day period of discussions that were held in February 1976 at the Smithsonian Institution's Belmont Conference Center supplemented by the monthly deliberations of the Commission that were held over a period of nearly four years. It is a statement of basic ethical principles and guidelines that should assist in resolving the ethical problems that surround the conduct of research with human subjects. By publishing the Report in the Federal Register, and providing reprints upon request, the Secretary intends that it may be made readily available to scientists, members of Institutional Review Boards, and Federal employees. The two-volume Appendix, containing the lengthy reports of experts and specialists who assisted the Commission in fulfilling this part of its charge, is available as DHEW Publication No. (OS) 78-0013 and No. (OS) 78-0014, for sale by the Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402. Unlike most other reports of the Commission, the Belmont Report does not make specific recommendations for administrative action by the Secretary of Health, Education, and Welfare. Rather, the Commission recommended that the Belmont Report be adopted in its entirety, as a statement of the Department's policy. The Department requests public comment on this recommendation.
the electronic code of federal regulations e cfr is the codification of the general and permanent rules published in the federal register by the executive departments and agencies of the federal government it is divided into 50 titles that represent broad areas subject to federal regulation the electronic code of federal regulations is updated daily the electronic code of federal regulations and its accompanying xml data is not yet an official format of the code of federal regulations only the pdf and text versions of the annual code of federal regulations have legal status as parts of the official online format of the code of federal regulations the xml structured files are derived from sgml tagged data and printing codes which may produce anomalies in display in addition the xml data does not yet include image files users who require a higher level of assurance may wish to consult the official version of the code of federal regulations or the daily federal register on fdsys gov
AIM: As no current estimates for the prevalence and causes of blindness in Germany are available, the database of Germany's largest welfare institution (covering 9.5 million people in the federal state of Northrhine) assessing eligibility for an allowance payable to blind people was used to investigate the prevalence and the specific causes of blindness and visual impairment. METHODS: Data from a representative sample of 5100 cases out of 20 365 cases were extracted, entered into an electronic database and statistically analysed. Blindness and severe vision impairment were defined as visual acuity equal to or below 20/1000 and 20/400, respectively, in the better-seeing eye. RESULTS: The mean age of the overall sample was 72±22 years and the mean visual acuity of the better seeing eye was 20/800. The prevalence of blindness and severe vision impairment in Northrhine was estimated to be 47.91 per 25,000 [corrected] persons. Most registered visual impairment was due to age-related macular degeneration (AMD; 41%), followed by glaucoma (15%) and diabetic eye disease (10%). Sixty-five per cent of registered blind people were women, 56% of them over the age of 80 years. Registered children and teenagers had the relative worst visual acuity (hand movement) and patients with retinal dystrophies had the relative best visual acuity (20/200) within the whole cohort (p<0.001). Standardised prevalence of blindness and severe visual impairment for Germany is estimated to be 44.4/100.000 (57.94 for women and 30.78 for men). CONCLUSIONS: Prevalence of blindness and severe vision impairment for Germany compare well to other European countries. AMD is the most prevalent cause of registered blindness and severe vision impairment, and prevalence in women is higher. Generally, prevalence increases with age. Provision of support and welfare services need to be organised accordingly.
BACKGROUND: The enormous social lesion caused by high prevalence of diabetes mellitus (DM) determines the state importance of clinical and epidemiological monitoring organization. AIMS: To analyze epidemiological characteristics (prevalence, mortality, morbidity), the level ofHbA1c, evaluate the therapy in Russian Federation in 20132017. METHODS: We have used the database of the Russian Federal Diabetes register 81 regions included in the online register system. RESULTS: The total number of patients with DM was 4,498m. (3.06% RF population), including: Type 1 (T1) 5,7% (0,26 m), T2 92,1% (4,15m), other DM types 1,9% (83,8 ths). Distribution male/female: T1 53.5%/46.5%, T2 29%/71%, other DM types 24%/76%. The proportion of men decreases with aging. Number of patients 65 years was 2.293.520, including T1 21.97ths (3.6%), T2 2m271.5ths (54.7%). The prevalence 20132017 per 100,000 population was as follows: T1 159,8169,6; T2 2455.32775.6; other DM types 51,265,8. Morbidity: T1 9,87,0; T2 226,7185,2; other DM types 7,812,4. The structure of causes of death 20132017: T1: diabetic coma 2,01,5%, myocardial infarction 4,04,4%, cerebral circulation disorders 8,27,6%, cardiovascular insufficiency 18,516,4%, chronic renal failure 6,16,0%; T2 0,20,2%, 4,54,5%, 12,712,2%, 29,028,6%, 1,21,8%, respectively. Mortality: T1 2.3; T2 68.4, other DM types 0,8. Life expectancy (average age of death of patients): T1 male 50.350.2, female 60.257.2; T2 69.870.3, 75.175.9 respectively. The number of patients with targetHbA1clevel 7%: T1 22.334.0%, T2 38.052.4%;HbA1c9.0%: T1 29.221.1%, T2 12.68.8%. The most commonly prescribed classes of glucose lowering medications (GLM) in 2017: in monotherapy Metformin (57.3%), Sulfonilurea (SU) (41,1%); in combination of 2 GLM: Metformin+SU 92,58% Metformin+iDPP-4 5.63%; 3 or more GLM: Metformin+SU+iDPP-4 83,9%, Metformin+SU+iSGLT-2 8.98%. The proportion of patients on aGPP-1 therapy is 0.01%. CONCLUSIONS: We observed the growth of prevalence of DM in Russian Federation and decrease in registered morbidity rate; an increase in life expectancy in T2; decrease in mortality due to diabetic coms and stable mortality rate from cardiovascular events (heart attack, stroke, cv deficiency), gangrene, chronic renal failure in both types of DM; a steady improvement in glycemic control. In the structure of T2 therapy the oral GLMs are dominated, especially Metformin and SU. In the dynamics the prescription of Metformin, insulin, iDPP-4, iSGLT-2 has increased, the proportion of SU has decreased.
BACKGROUND . One of the priority directions in the development of the health care system is to reduce the medical and social damage caused by the increase in the prevalence of diabetes mellitus (DM). From this point of view, the development of a diabetes register is very important as the main information and analytical platform for clinical and epidemiological monitoring of diabetes in the Russian Federation (RF). AIMS . The aim of our study was to analyze a dynamic (2016–2020) of the epidemiological characteristics of diabetes mellitus in the Russian Federation (prevalence, morbidity, mortality), the prevalence of complications, the level of HbA 1c and the dynamics of the structure of glucose-lowering therapy (GLT) according to the Federal Diabetes Register (FDR). MATERIALS AND METHOD s. The database of FRD (http://diaregistry.ru) 84 regions of the RF. The data are presented in dynamics 2016→2020. RESULTS . The total number of DM patients in the RF as of 01.01.2021 was 4,799,552 (3.23% of the population), including: Type 1 (T1) — 5.5% (265.4 ths) , T2 — 92.5% (4.43 million), other DM types — 2.0% (99.3 ths). The dynamics of prevalence was 168.7→180.9/100 ths people with T1, and 2709 → 3022/100 ths people with T2; morbidity in T1 10.5→7.7/100 ths population, in T2 219.6→154.2/100 ths population. Age and sex characteristics: the proportion of men in T1 — 54%, in T2 — 30%; the max proportion of patients with T1 at the age of 30–39 years, T2 65–69 years. Mortality: T1 3.0 → 2.7/100 ths population, T2 87.7→93.9/100 ths of the population, the main cause of death was cardiovascular: in T1 38,1% cases, in T2 — 52,0%. Life expectancy (average age of death of patients): T1 was 53.2years, the dynamics in males 50.7 → 50.5years, females 58.7→55.2years; in T2 — 73.5 years, males 70.2→70.1years, females 75.7→75.4 years. The dynamic of DM duration until the death: in T1 17.4→19.0 years; in T2 11→11.4 years. The incidence of diabetic complications in T1 and T2 patients: neuropathy 43.3% and 24.4%, nephropathy (CKD) 25.9% and 18.4%, retinopathy 31.7% and 13.5%, respectively. The proportion of patients with HbA 1c <7%: in T1 32.3%→36.9%, in T2 51.9%→52.1%, with HbA1c ≥ 9.0% in T1 23.1%→18.7% , in T2 8.9%→8.0%. The structure GLT in T2 patients: glucose lowering medications (GLM) — 76.2% (monotherapy — 44.1%; combination of 2 GLM — 28.9%, 3 GLM — 3.2%), insulin therapy in 18,8%, without drug therapy in 4.9%. CONCLUSIONS . The performed analysis demonstrates the importance of dynamic assessment of epidemiological characteristics and monitoring of clinical data on patients with diabetes through a registry for assessing the quality of diabetes care and the prospects for its development.
BACKGROUND: The epidemiological study of diabetic foot (DF) is very important because of high risk lower limbs amputations in patients with diabetes mellitus (DM). AIMS: The aim of the study was to evaluate the DF prevalence in adult patients with type 1 (T1) and 2 (T2) diabetes in Russian Federation for period 201316years. METHODS: We have used the database of the Russian Federal Diabetes register, 81st regions included in the online register. Indicators were estimated per 10,000 adult DM patients (18years). RESULTS: In 2016, the prevalence of DF in RF was T1 4,7%, T2 1,9%, with marked interregional differences: 0,1519,9%, 0,0710,3%, respectively. The DF prevalence in RF decreased: T1 506,3473,6, T2 214,60194,8. The incidence of new DF cases/per year was stable in adults with T1: 20,820,4/; increased in T2 13.214.2. The mean age of DF diagnosis increased by 2years for both DM types. The average DM duration of DF determine increased T1 15.419.0years, T2 7.410.1years. Proportion of DF forms: neuropathic with trophic ulcer 41.6%, neuropathic form (Charcot's foot) 17.9%, the neuroischemic 28.3%, ischemic 12.2%, in T2: 41.6%, 7,4%, 32,4%, 18,5%, respectively. The amount of new cases of amputations/per year in dynamics: T1 10,512,4, T2 9,610,9, with marked interregional differences 0.132.9% in T1, 0.04-6.0% in T2. The mean DM duration before amputation increased in T1 18.421.3years, in T2 9.19.9. The average amputation age: T1 51.7years, T2 66.2years. There was marked decrease in proportion of major amputations: T1 43,637,0%, T2 52.245.5 by redistribution in one toe amputations T14,010.0%, in T22,89.1%. CONCLUSIONS: The dynamic of new DF cases in adult patients in Russian Federation is stable at T1, in T2 tends to increase. The interregional differences in frequency of DF and amputations may be due to differences in the quality of specialized care, the lack or shortage of diabetic foot cabinets, treatment of patients with DF in general surgical practice in a number of regions, which is recognized as a less effective strategy. A positive fact that proportion of high amputations declines, DF develops in later age and longer diabetes duration, that may reflect the increasing effectiveness of preventive lower limbs in diabetes.
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.
BACKGROUND: Chronic kidney disease (CKD) is one of the most severe complications of diabetes mellitus (DM), this determines the importance of the study of epidemiological characteristics of the disease. AIMS: To assess the epidemiological characteristics of CKD in adult DM patients with type 1 (T1), 2 (T2) in Russian Federation in 201316. METHODS: We have used the database of the Russian Federal Diabetes register, 81st regions included in online register. Indicators were estimated per 10,000 adult DM patients (18years). RESULTS: In 2016, the CKD frequency registration was T1 23%, T2 6.9% with marked interregional differences 1.5-49.9%, 0.623.5%, respectively. The CKD prevalence in dynamics 20132016 was 2171.42303.0 in T1 and 512.687.2 in T2. The incidence of new CKD cases increased 2 times in T1 (215.5 vs 104.2), and 3.7 times in T2 (190.4 vs 51.8). The analysis of distribution by CKD stages by KDIGO indicates the increase in the proportion of patients with low and moderate cardiovascular risk and end stage renal disease (ESRD) (with the initial stages of CKD, C1/2 A1) - 12.046.8% in T1; 10.050.4% in T2. The proportion of patients with a very high risk (stages C4/5 C3aA3 and C3bA2-3) progressively decreases: 13.46.7% in T1, 11.34.4% in T2. We observed relation between the CKD prevalence and DM duration. CKD develops in 5.1% patients if T15 years and in 48.0% if T130years; in T2 3.5% and 20.3%, respectively. The average age of CKD onset in T1 increased for 4,3yr (36,140,2), in T2 for 2,4yr (64,466,8), DM duration until CKD development increased in T1 11.814.2yr, in T2 7.68.2yr. CONCLUSIONS: There is a significant improvement in the quality of CKD diagnostics at the earlier stages, older age and a longer DM duration before CKD onset in both types while we observed the increasing trends in CKD prevalence in Russian Federation in the dynamics of 2013-2016. Advances in the management of patients with DM in recent years do not reduce the risk of CKD, but give us a delay in its development. The marked interregional differences frequency of registration of CKD might indicate some remaining problems in verification in a number of regions where the standard for mandatory assessment of albuminuria and glomerular filtration rate not implemented.