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      Prevalence, awareness and control of diabetes in Russia: The Ural Eye and Medical Study on adults aged 40+ years

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          Abstract

          Purpose

          Non-communicable chronic diseases have become the leading causes of mortality and disease burden worldwide. With information about the frequency of diabetes as a major non-communicable chronic disease in Russia being scarce, we assessed the prevalence of diabetes and its associated factors in a rural and urban population in Russia.

          Methods

          The Ural Eye and Medical Study is a population-based study in the city of Ufa/Russia and in villages in a distance of 65 km from Ufa. Inclusion criterion was an age of 40+ years. All study participants underwent a standardized interview and a detailed general examination. Diabetes mellitus was defined by a plasma glucose concentration ≥7.0 mmol/L or self-reported history of physician diagnosis of diabetes.

          Results

          Out of a population of 7328 eligible individuals, 5899 individuals (2580 (43.7%) men) (participation rate:80.5%) participated (mean age:59.0±10.7 years (range:40–94 years)). Diabetes mellitus was present in 687 individuals (11.7%;95% confidence interval (CI):11.9,12.5). Awareness rate of having diabetes was 500/687 (72.8%;95%CI:69.0,76.0), with mean known duration of diabetes of 10.0±9.4 years. Known type 1 diabetes was present in 44 subjects and known type 2 diabetes in 358 subjects. Prevalence of undiagnosed diabetes was 3.2% (95%CI:2.7,3.6) in the study population. Among patients with diabetes, 59.1% (95%CI:55.4,62.8) received treatment for diabetes, among whom 237 (58.5%;95%CI:53.7,63.3) individuals had adequate glycemic control. In multivariable analysis, higher prevalence of diabetes mellitus was associated with older age ( P<0.001; odds ratio (OR):1.03;95%CI:1.01,1.04), higher body mass index ( P<0.001;OR:1.07;95%CI:1.04,1.10), lower prevalence of vigorous daily work ( P = 0.002;OR0.68;95%CI:0.53,0.87), positive history of arterial hypertension ( P = 0.03;OR:1.40;95%CI:1.03,1.89) and cardiovascular diseases ( P = 0.001;OR:1.60;95%CI:1.21,2.13) including heart attacks ( P = 0.01;OR:1.80;95%CI:1.15,2.81), higher serum concentration of triglycerides ( P<0.001;OR:1.51;95%CI:1.30,1.75), higher systolic blood pressure ( P = 0.01;OR:1.01;95%CI:1.01,1.02), higher number of meals taken daily ( P<0.001;OR:1.46;95%CI:1.25,1.69), and non-Muslim religion ( P = 0.02;OR:0.73;95%CI:0.56,0.94).

          Conclusions

          In this ethnically mixed, urban and rural Russian population aged 40+ years, the awareness rate of diabetes (72.8%) was relatively high, while the diabetes prevalence (11.7%) was comparable with that of other countries such as China and the USA. Factors associated with higher diabetes prevalence were similar in Russia and these other countries and included older age, higher body mass index and higher serum concentration of triglycerides, lower prevalence of vigorous daily work, arterial hypertension and cardiovascular diseases.

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          Most cited references9

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          A SELF-RATING DEPRESSION SCALE.

          W W Zung (1965)
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            Prevalence of type 2 diabetes mellitus (T2DM) in the adult Russian population (NATION study).

            To estimate type 2 diabetes mellitus (T2DM) prevalence in Russian adults.
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              Frequency and Associated Factors of Bone Fractures in Russians: The Ural Eye and Medical Study

              With information about frequency of bone fractures in Russia mostly missing, we assessed the frequency of previous bone fractures in a Russian population. The population-based study Ural Eye and Medical Study included 5899 (80.5%) out of 7328 eligible individuals (mean age: 59.0 ± 10.7 years; range: 40–94 years). The history of previous bone fractures was assessed in a standardized interview for 5397 (91.5%) individuals. Mean frequency of any previous bone fracture was 1650/5397 (30.6%; 95% confidence interval (CI): 29, 3, 31.8). In multivariate analysis, higher frequency of bone fractures was associated with male sex (P < 0.001; odds ratio (OR): 1.67; 95% CI: 1.41, 2.00), urban region (P < 0.001; OR: 1.45; 95% CI: 1.23, 1.72), higher prevalence of vigorous activity during leisure (P < 0.001; OR: 1.42; 95% CI: 1.20, 1.68), current smoking (P = 0.001; OR: 1.46; 95% CI: 1.16, 1.82) and higher prevalence of cardiovascular disease (P = 0.007; OR: 1.29; 95% CI: 1.07, 1.56), low blood pressure episodes with hospital admission (P = 0.001; OR: 2.08; 95% CI: 1.37, 3.16), tumbling (P < 0.001; OR: 2.58; 95% CI: 1.37, 3.16) and thoracic spine pain (P < 0.001; OR: 1.43; 95% CI: 1.18, 1.73). In women, menopause (P < 0.001; OR: 2.17; 95% CI: 1.47, 3.22) was additionally associated. The most common single-bone fractures involved leg and knee (229/5397; 4.2%), hand in general (n = 169; 3.1%) or hand wrist only (n = 97; 1.8%), arm (n = 94; 1.7%) and ankle (n = 67; 1.2%). Severe fractures included spine (n = 35; 0.6%), os sacrum (n = 10; 0.2%), skull (n = 6; 0.1%), pelvis (n = 5; 0.1%) and hip (n = 22; 0.4%). Most frequent combined fractures included as most important part the leg (n = 90; 1.7%), spine (n = 18; 0.3%), and hip (n = 18; 0.3). These data give hints on the epidemiology of bone fractures in Russia.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: InvestigationRole: MethodologyRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SoftwareRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SoftwareRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SoftwareRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SoftwareRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SoftwareRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SoftwareRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SoftwareRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SoftwareRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: ResourcesRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                22 April 2019
                2019
                : 14
                : 4
                : e0215636
                Affiliations
                [1 ] Ufa Eye Research Institute, Ufa, Bashkortostan, Russia
                [2 ] Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, Mannheim, Germany
                Public Library of Science, UNITED KINGDOM
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0002-9476-8883
                http://orcid.org/0000-0002-0569-1264
                http://orcid.org/0000-0002-2357-0968
                http://orcid.org/0000-0001-9299-8768
                http://orcid.org/0000-0003-2972-5227
                Article
                PONE-D-18-05352
                10.1371/journal.pone.0215636
                6476495
                31009496
                8c011f79-1378-4af8-9acc-01d287936c18
                © 2019 Bikbov et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 18 February 2018
                : 1 April 2019
                Page count
                Figures: 2, Tables: 4, Pages: 14
                Funding
                The author(s) received no specific funding for this work.
                Categories
                Research Article
                Custom metadata
                All relevant data are within the paper.

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