The glucose-lowering therapy structure in special groups of type 2 diabetes mellitus patients based on data from the Moscow region register

BACKGROUND: Data of real clinical practice in diabetes mellitus (DM) register allow to evaluate features and trends in structure of glucose-lowering therapy (GLT). AIM: Тo analyze of structure of GLT received by patients with type 2 diabetes mellitus (T2DM) in Moscow region for 2018 and to evaluate its dynamics over 15 years. METHODS: Analysis of GLT structure was carried out on basis of data from register of patients with DM in Moscow region, which is part of National register of diabetes mellitus in Russian Federation. In March 2018 it contained data on 211,792 T2DM patients of Moscow region. Structure of GLT administration was evaluated according T2DM duration, patient’s age and presence of cardiovascular diseases (CVD). Dynamics of GLT is analyzed from 2004 to 2018 yrs. RESULTS: In 2018 non-insulin glucose-lowering drugs (NIGD) prescription prevailed (78.3%), insulin therapy was prescribed in 18.5% of patients, 3.2% of patients did not receive drug therapy. Most commonly prescribed NIGD were metformin (69.3%) and sulfonylurea (51.3%). Older patients more often than younger did not use GLT at all and less frequently received insulin therapy and iDPP-4. Insulin therapy was prescribed twice as often in patients with CVD compared with patients without CVD (29.6% and 15.5%). NIGD monotherapy has been less commonly used in patients with CVD (67.3% and 81.2%). Glucagon-like peptide-1 receptor agonists (GLP-1 RA) were prescribed to patients with CVD GLP-1 RA – in 0.1% of cases, without CVD in 0.3% of cases, and sodium-glucose cotransporter 2 (SGLT2) inhibitors in 1.1% and 0.6%. correspondently. CONCLUSION: Metformin was most commonly prescribed drug in GLT structure for T2DM patients in the Moscow region in 2018 yr. Percentage of new drugs in the structure of GLT increased mainly due to iDPP-4, and secondly due to SGLT2 inhibitors. New classes of GLT were more often prescribed to patients of younger age, with diabetes duration up to 10 years, overweight or obese. Administration of NIGD with proven cardiovascular protection in presence of CVD is almost two times less than for those without CVD

A versatile fluorescence lifetime imaging system for scanning large areas with high time and spatial resolution

"Published in SPIE Proceedings Vol. 9286"We present a flexible fluorescence lifetime imaging device which can be employed to scan large sample areas with a spatial resolution adjustable from many micrometers down to sub-micrometers and a temporal resolution of 20 picoseconds. Several different applications of the system will be presented including protein microarrays analysis, the scanning of historical samples, evaluation of solar cell surfaces and nanocrystalline organic crystals embedded in electrospun polymeric nanofibers. Energy transfer processes within semiconductor quantum dot superstructures as well as between dye probes and graphene layers were also investigated.This work was financially supported by the European Regional Development Fund (ERDF) through Programa Operacional Factores de Competitividade (COMPETE: FCOMP-01-0124-FEDER-014628) and the Portuguese Fundacao para a Ciencia e Tecnologia (FCT) through the projects "Functional structuring, inter-particle interaction and energy transfer in ensembles of nanocrystal dots" (PTDC/FIS/113199/2009), Ultra-fast spectroscopy on the dynamics and relaxation of Dirac electrons in graphene" (PTDC/FIS/101434/ 2008) and "Low dimensional nanostructures for nonlinear optical applications" PTDC/CTmNAN/114269/2009

Dynamic monitoring of HbA1c in Russian regions: data comparison of mobile medical center (Diamodul) and national diabetes register of Russian Federation

BACKGROUND: Glikogemoglobin (HbA1c) is a key clinical marker for evaluating the effectiveness of glucose-lowering therapy for patients with diabetes mellitus (DM) and the quality of diabetic care. AIMS: to conduct dynamic monitoring of the quality of glycemic control in DM patients based on a comprehensive examination in mobile medical center (Diamodul) during repeated visits to the regions in 2019 compared with visits of Based Federal program “Diabetes Mellitus” (2005–2010) and data of the National diabetes register (NDR). MATERIALS AND METHODS: The object of the study: patients with T1DM and T2DM examined in Diamodul in 2019 in Voronezh region (Vr), Krasnodar region (Kr) (n = 600), there were “dynamic” group of re-examined (Vr n = 224; Kr n = 113), “random” group of new patients (Vr n = 72; Kr n = 191); group of adult patients from NDR with indicated HbA1c in 2019 (n = 2410067). RESULTS: According to Diamodul, the HbA1c levels are significantly worse than they were reported to NDR: the proportion of patients achieved HbA1c <7% for T1DM is 13.3% and 11.7%; T2DM – 25.1% and 28.6%, in Kr and Vr, respectively; in NDR: T1DM – 37.4%, T2DM – 52.2%. The average HbA1c values in the Diamodul are higher than in NDR by 0.95% for T1DM, 1.41% for T2DM patients. The proportion of patients with HbA1c≥9% decrease in dynamic of examinations through years in T1: in Vr from 53.1% in 2005 and 55.8% in 2010 to 42.9% in 2019, in Kr from 53.2% in 2006 to 43.8% in 2019; also there were decreases in the average HbA1c values in Vr from 9.3% in 2005 and 9.4% in 2010 to 8.8% in 2019; in Kr from 9.1% in 2006 to 8.7% in 2019. In T2DM patients with the best parameters of DM control in a whole, the positive trends were less pronounced and are assessed as non-deterioration: the proportion of HbA1c≥9 % in Vr: 34.7%–34.7%–36.4%, in Kr 40.1%–28.4%; average values of HbA1c: 8.2%–8.4%–8.5% and 8.6%–8.4%, respectively. CONCLUSIONS: The data of the research clearly indicates the need for 100% inclusion of HbA1c in the examination standards in all DM patients at the primary level at least 1 time per year, in order to monitor the real clinical situation, the effectiveness of glucose-lowering therapy and its timely intensification to prevent development of complications

The city of Yakutsk: a case of study for human brown adipose tissue in extremely cold conditions

The discovery of the presence of functional brown adipose tissue (BAT) also in healthy humans [1-3] has focused the attention of the scientific community on the possibility to expand body BAT content as a therapeutic strategy for the treatment and prevention of obesity and the associated metabolic disorders. Indeed, white-to- brown adipocyte transdifferentiation, leading to “browning” of the adipose organ, has been shown to reduce body weight and improve metabolic parameters in obese and insulin-resistant animal models. BAT from subject exposed daily to extremely cold outdoor temperatures has never been studied through morphological techniques. In this context, an exciting case of study are the citizens of Yakutsk, an East- ern Siberian population exposed to the annual average temperature of -10 °C, that peaks up to -50°C during winter. In autoptic fat biopsies from a 54-year-old patient living in Yakutsk BAT is present in the perirenal and para-aortic fat specimens. Importantly, the mean adipocyte area of the subcutaneous fat from this patient is significantly lower than the mean area of subcutaneous adipocytes obtained from age- and sex-matched Italian patients. Statistical analysis of data obtained from the Territorial Organ of the Federal State Statistics Service of the Republic of Sakha (Yakutia), the Yakut Republican Medical Information and Analytical Center of the Ministry of Health of Yakutia showed a correlation between home heating and type-2 diabetes incidence during the years from 1994 to 2013, a period in which the indoor temperature increased significantly. The nutritional values of food consumed during these years also changed in parallel with the worsening of inhabitants metabolic health conditions. Taken together these data suggest a possible link between the metabolic condi- tions of inhabitants of Yakutia and the living temperature experienced

Epidemiology of cardiovascular diseases among patients with diabetes mellitus according to the federal diabetes register of the Russian Federation (2013–2016)

BACKGROUND: Cardiovascular diseases (CVD) are the main cause of death for patients with diabetes mellitus (DM). AIMS: To evaluate the CVD epidemiology: coronary heart disease (CHD), myocardial infarction (MI) and cerebrovascular diseases in adult patients with type 1 (T1DM) and type 2 (T2DM) diabetes, compare dynamics with data of implementation of the Federal Program «Diabetes mellitus» in 2007–2012 and over the online period 2013–2016. MATERIALS AND METHODS: The database of the Federal Diabetes register (81 regions at 12.2017). We estimated prevalence and incidence rates/10 thousand (th) adult DM patients over 18 years. RESULTS: The prevalence of CVD for the period 2007 – 2016 significant decreased in CHD for T1DM from 14,9% to 3,5%, for T2DM from 20,1% to 11,7%; MI for T1DM from 5,7% to 1,3%, for T2DM from 7,6% to 3,5%; cerebrovascular diseases for T1DM from 4,9% to 1,7%, for T2DM from 7,6% to 4,3%, respectively. In 2013→2016 positive trends continued: MI for T1DM 8,2→5,9/10th patients, for T2DM 19,2→14,7/10th patients, respectively; CVD for T1DM 11,3→10,5, for T2DM 29,4→25,4/10th patients, respectively. There was a large heterogeneity of the prevalence of CVD in the regions. MI varied in patients for T1DM from 319/10 th patients to absence, for T2DM from 800 to 7/10 th patients; the development of cerebrovascular diseases for T2DM from 900 to less than 100/10 th patients, which is largely due to differences in their registration. A small number of cases may be due to insufficient filling of the database, the facts of a huge number require further analysis. The average age of development of MI had increased: for T1DM 51,2→53 years, for T2DM 63,5→65 years, cerebrovascular diseases for T1DM 52,3→52.5 years, for T2DM 65,2→66,5, respectively. CONCLUSIONS: The prevalence of CVD significantly decreased in the Russian Federation compared to 2007–2012, as well as for the period 2013–2016: the prevalence of CHD and cerebrovascular diseases declined, the number of new cases of MI decreased, the average age and duration of DM before the development of CVD significantly increased. These data reflect the results of the program for improvement medical care and prevention measures for patients with diabetes

Epidemiology of acute diabetes complications (coma) according to the Federal Diabetes register of the Russian Federation (2013–2016)

Background: Despite the improvement in the quality of diabetes care in the Russian Federation (RF), coma remain one of the causes of death in patients with diabetes. Aim: To assess dynamic of epidemiological characteristic of acute complications in adult patients with T1D and T2D in 2013–16. Materials and methods: The database of the Russian Federal Diabetes register (81 regions). The indicators of coma for 2013–16 were estimated for 10000 adult patients with diabetes (>18 years). Results: In 2016, the prevalence of coma in RF was 225.9 with T1D and 11.6/10000 adults with T2D. For the period from 2007 the prevalence of ketoacidotic coma decrease three times in T1D, 4 times for T2D.Totally in 2016, 165 new cases of coma for both types of diabetes were registered, an average of 0.4/10000 adults. Interregional differences in the prevalence of coma were observed 0–4.2/10000 adults. The frequency of new cases of coma has a tendency to decrease: 0,9→0,4/10000 adults: T1D 5.7→3.4, T2D 0.6→0.2/10000 adults. When evaluating the structure of coma, redistribution is evident in their form. So in 2016 the proportion of hypoglycemic coma increased to 40.7%, and ketoacidotic coma decreased to 56.6% in T1D. With T2D, the difference expressed in a lesser degree. The mean duration of diabetes at the time of coma development increased with T1D from 3.8→9.1 years, with T2D 3.5→7.0 years. The maximum frequency of development of coma is recorded with the diabetes duration more than 30 years, regardless of the type. The patients’ age at the time of coma development in T1D increased to 27.5 years old, and in T2D it was 60.4 years, it didn’t change significantly. The assessment of glycemic control showed a significant improvement: a decrease in the proportion of patients with HbA1c≥ 9.0% (23% with T1D, 8.8% with T2D), an increase with HbA1c <7% (32.4% and 51.7%, respectively). The average value of HbA1c in 2016 with T1D – 8.21%, with T2D – 7.48%. Conclusions: It is established that the dynamics of the frequency of development of coma in 2013–16 in adult patients with diabetes in the RF has a stable tendency to decrease: 1.5 times with T1D and more than 3 times with T2D. It can be assumed that this is due to the improvement in the quality of diabetes care and glycemic control in general, as well as the use of modern medicines. Attention is required to draw to the high frequency of coma in T1D, the development of coma with a longer duration of diabetes, an increase in the proportion of patients with hypoglycemic coma. Significant interregional differences in the frequency of coma registration require additional analysis

Trends in the epidemiology of diabetic retinopathy in Russian Federation according to the Federal Diabetes Register (2013–2016)

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

Numerical analysis of problems of self-action of electromagnetic waves in nonlinear wavequides and radiating systems

The investigation is concerned with electromagnetic waves in wavequides partially filled with nonlinear medium and antenna radiation field in plasma. The object of investigation is development of methods of solving the nonlinear wave equation and gaining of more profound knowledge about the physical processes taking place in the wavequides and antennas in plasma. In their studies the investigators have used computer-aided numerical simulation methods. The researchers have found solution to the nonlinear boundary-value problems, studied the hysteretic effects in the nonunidimensional structures and formation of waveguide channels in dense plasma, discovered autooscillations in the nonlinear bed, assessed the applicability of simple unimode simulators and analysed the influence of nonlinearity on the energetic characteristics of antennas and cones of coverage thereof. The investigators have developed new algorithm, programme and methods for evaluating the effect produced by plasma on the antenna performance. All have been promoted and the fact is supported by an appropriate promotion certificate. The obtained results may find application in such spheres as antenna engineering, design of super-high-frequency devices, radio and plasma physicsAvailable from VNTIC / VNTIC - Scientific & Technical Information Centre of RussiaSIGLERURussian Federatio

Atlas of Diabetes Register in Russian Federation, status 2018

The Federal Diabetes Register (FDR) has been conducting clinical and epidemiological monitoring of diabetes in the Russian Federation (RF) since 1996. Its methodological and organizational reference centre is Endocrinology Research Centre. FRD was created by Order of the Ministry of Health of RF №404 of December 10, 1996 as part of implementation of the Federal target program "Diabetes Mellitus". Over the 20-year period, the registry has played a key role in assessing the prevalence of diabetes and diabetic complications in the RF. Since 2014, the register has been transformed into online system as a unified federal database with an authorized code access. Personal data protection is carried out in accordance with the laws and regulations of the Russian Federation

Design, Simulation and Optimization of an Additive Laser-Based Manufacturing Process for Gearbox Housing with Reduced Weight Made from AlSi10Mg Alloy

The gas turbine engine’s (GTE) development aims for the increasing the efficiency, strength, reliability and safety of its components. To create competitive engines, housing parts and components with high functionality and reduced weight are needed. Especially difficult in the design and production are the gearboxes for aviation GTE. Traditional technologies based on precision casting or material forming operations have significant limitations due to the complexity of fulfilling multiple different requirements. Nowadays, one of the progressive production techniques is additive manufacturing. The article presents the results of computational and experimental studies that substantiate the applicability of laser additive technology to reduce the mass of body parts by up to 15% while ensuring their strength properties. The physical and mechanical characteristics of aluminum alloys acceptable for the manufacturing of housing parts were analyzed. The necessary characteristics of the powder alloy of the Al-Si system and the technological parameters of the L-PBF of the modified housing of the gear reducer are established. Using the finite element method (FEM) the L-PBF process was numerically simulated and the technological modes for synthesis of the AlSi10Mg alloy powder were optimized. With the help of a serial 3D printer ProX320DMP, the prototype of a gear housing was manufactured