Leptin is an independent determinant of bone mineral density in men with type 2 diabetes mellitus.

To investigate the possible relationship of leptin to bone mineral density (BMD) in men with type 2 diabetes mellitus (T2DM), we screened 168 Belarusian men aged 45-65 years. Plasma total cholesterol (TC), high-density lipoprotein cholesterol, and triglyceride concentrations were assessed, and low-density lipoprotein cholesterol and very low-density lipoprotein cholesterol (LDL-C) were calculated. Hemoglobin A(1c), immune-reactive insulin (IRI), serum total testosterone, and sex hormone-binding globulin were also evaluated. BMD was evaluated using dual-energy X-ray absorptiometry. By univariate linear regression analysis, BMD was significantly correlated with body mass index (r = 0.23, P = 0.002) and leptin (r = 0.21, P = 0.006). By multivariate regression analysis adjusting for confounding factors, log leptin was independently correlated with BMD (β = 0.058, P = 0.001). Our study revealed that leptin is an independent determinant of BMD in patients with T2DM. Further research is necessary to confirm this association and to develop ways to correct abnormalities of bone metabolism in patients with T2DM

Epidemiology, education, and care for patients with diabetes in Belarus

More than 64 million people in the World Health Organization European Region are living with diabetes, and Belarus is no exception to the diabetes epidemic. This study was conducted as a part of the Joint Usage/Research Projects program for promoting collaborative research in regions affected by environmental radiation exposure. We reviewed locally available documents on the epidemiology and management of diabetes in Belarus. Over the past 20 years, there has been a 2.8-fold increase in the number of patients with diabetes mellitus in Belarus, and in response, an integrated approach for prevention and treatment has been implemented. Strategies unique to Belarus include the establishment of a diabetes registry, the monitoring of patients at local outpatient units called dispensaries, and the upgrading of diabetes education provided at Diabetes Schools. Despite the strategic developments made to diabetes services, further improvements are warranted, including better quality assurance of services at dispensaries, revision of patient education to take into consideration new treatments and technologies, and more epidemiological research

Report on SHAFE policies, strategies and funding

The objective of Working Group (WG) 4 of the COST Action NET4Age-Friendly is to examine existing policies, advocacy, and funding opportunities and to build up relations with policy makers and funding organisations. Also, to synthesize and improve existing knowledge and models to develop from effective business and evaluation models, as well as to guarantee quality and education, proper dissemination and ensure the future of the Action. The Working Group further aims to enable capacity building to improve interdisciplinary participation, to promote knowledge exchange and to foster a cross-European interdisciplinary research capacity, to improve cooperation and co-creation with cross-sectors stakeholders and to introduce and educate students SHAFE implementation and sustainability (CB01, CB03, CB04, CB05). To enable the achievement of the objectives of Working Group 4, the Leader of the Working Group, the Chair and Vice-Chair, in close cooperation with the Science Communication Coordinator, developed a template (see annex 1) to map the current state of SHAFE policies, funding opportunities and networking in the COST member countries of the Action. On invitation, the Working Group lead received contributions from 37 countries, in a total of 85 Action members. The contributions provide an overview of the diversity of SHAFE policies and opportunities in Europe and beyond. These were not edited or revised and are a result of the main areas of expertise and knowledge of the contributors; thus, gaps in areas or content are possible and these shall be further explored in the following works and reports of this WG. But this preliminary mapping is of huge importance to proceed with the WG activities. In the following chapters, an introduction on the need of SHAFE policies is presented, followed by a summary of the main approaches to be pursued for the next period of work. The deliverable finishes with the opportunities of capacity building, networking and funding that will be relevant to undertake within the frame of Working Group 4 and the total COST Action. The total of country contributions is presented in the annex of this deliverable

Testosterone is an independent determinant of bone mineral density in men with type 2 diabetes mellitus.

Although many reports have elucidated pathophysiological characteristics of abnormal bone metabolism in patients with type 2 diabetes mellitus (DT2), determinants of bone mineral density (BMD) in patients with DT2 are still controversial

INTEGRATIVE APPROACH TO THE ORGANIZATION OF SMART HEALTHY AGE- FRIENDLY ENVIRONMENTS BY THE DOCTOR OF GENERAL PRACTICE

Attention to the problem of integration in healthcare has arisen in Belarus as well as in many countries in the last 10-15 years. Life expectancy has increased by about 10 years over the past 50 years for both men and women. These changes create challenges and opportunities for us. Aging is causing widespread debate, leading to the development of new approaches in healthcare. The growing level of fragmentation of medical care for elderly necessitates a solution to this problem due to the emerging trend towards narrow specialization of help. An integrative approach involves the analysis of a holistic health care system, which includes several levels. Thus, various options of management models to control one`s health are the basis for creating an integrated smart healthy environment for the elderly. It is required to develop an algorithm for ensuring coordination and continuity of medical care for the elderly, taking into account their needs and local conditions (demography, morbidity and mortality structure, equipment of medical institutions with equipment and personnel, etc.), the creation of a unified educational, informational, organizational and technical system of smart healthy age-friendly environment that will provide older patients with access to relevant knowledge and skills to control their health status, as well as allow to establish information exchange of data between the patient and a team of specialists from various healthcare organizations. At the same time, the leading role in the integration processes is played by the organizations of primary health care for the elderly, which are the organizational and coordinating links in interaction with organizations that provide specialized medical and social care. If we want to ensure a fair treatment between generations and a good standard of living for all citizens, then there is a need for urgent action to implement a Smart Healthy Age-friendly Environments

Barriers to Prevention and Treatment of Type 2 Diabetes Mellitus Among Outpatients in Belarus

Objectives: This study aimed to determine the main barriers and reasons for non-adherence to preventive measures and treatment for type 2 diabetes mellitus among outpatients in Belarus.Methods: An anonymous questionnaire survey was conducted with 814 adults aged 18 years and over who visited outpatient health care units and hospitals in Belarus. The questionnaire was developed to analyze the perceived barriers that limit adherence to preventive measures and treatment for type 2 diabetes.Results: The proportion of respondents who reported doing daily physical activity was 53.2%, and 46.6% consumed at least 400 grams of fruit and vegetables per day. Among the 42.8% of respondents with a prescribed treatment for type 2 diabetes mellitus, 50.1% sometimes forgot to take their medicine. The specific barriers to treatment most frequently identified by survey respondents were “Financial situation” (23.5% of respondents), and “Fear of side effects” (25.2%). Those for lifestyle instructions were “Insufficient knowledge” (29.3%), “Financial situation” (27.9%), and “Lack of motivation” (21.7%).Conclusions: The study revealed that the main barriers to adherence were insufficient knowledge of diabetes and its treatment and an underestimation of the role of behavioral risk factors in health, combined with financial difficulties. We recommend that physicians should take a patient-centered approach to raising awareness of behavioral risk factors for type 2 diabetes mellitus, and suggest that the importance of adhering to preventative measures and treatment should be promoted in consultations in Belarus