World Diabetes Day

November 14

World Diabetes Day is celebrated on November 14, the birthday of the discoverer of insulin, Canadian scientist Frederick Banting, who, together with other scientists, was awarded the Nobel Prize in 1923. With the discovery of insulin, a new era began in the history of endocrinology, as it was possible to find a cure for a previously incurable disease and save the lives of hundreds of millions of people.

The rising prevalence of diabetes is a real threat worldwide. According to available data, diabetes mellitus affects more than 422 million patients worldwide, of which more than 199 million are women. The number of women with diabetes is projected to increase to 313 million by 2040. Two out of five women with diabetes (more than 60 million) are of reproductive age. Diabetes is the ninth leading cause of death in women worldwide, with 2.1 million women dying from diabetes each year. Women with type 2 diabetes are almost 10 times more likely to suffer from coronary artery disease. Women with type 1 diabetes have an increased risk of early miscarriage or having a baby with birth defects. That is why in 2017, at the initiative of the World Health Organization and the International Diabetes Federation, the theme of World Diabetes Day will be “Women and diabetes - our right to a healthy future.” The International Diabetes Federation initiated a worldwide campaign by the diabetes community to encourage all UN members to pay attention to the problem of diabetes in women and the specific needs of pregnant women and adolescent girls.

In the Republic of Belarus, at the end of 2016, 303,322 patients with diabetes mellitus were registered (65% female), of which 18,550 suffer from type 1 diabetes, including 2,095 children. Over the past 20 years, there has been an increase in patients with diabetes mellitus by 2.8 times, while the primary incidence from 1995 to 2016 increased by 4.4 times - from 69.6% 000 to 312.72% 000. Considering the significant increase in patients with diabetes mellitus type 2, observation before prescribing insulin therapy is currently carried out by local therapists (general practitioners) in accordance with the resolution of the Ministry of Health of the Republic of Belarus dated August 12, 2016 No. 96 “On approval of the Instructions on the procedure for medical examination.”

Based on the existing regulatory framework, patients with diabetes mellitus, citizens of our country, are provided with insulin and tableted glucose-lowering drugs free of charge at the expense of the republican (insulins) and local (tablets) budgets. Determining the need for insulin and other medications for the treatment of diabetes mellitus, as well as monitoring complications of the disease, is carried out taking into account the data of the republican register “Diabetes Mellitus”. Patients with diabetes are provided by the state with means of administering insulin and self-monitoring blood glucose levels (test strips, glucometers).

In the Republic of Belarus, domestically produced genetically engineered insulins meet the needs of patients by 88.6%. Order of the Ministry of Health of the Republic of Belarus dated October 16, 2017 No. 1196 expanded the indications for prescribing insulin analogs, including domestically produced ones (Glargine). Additionally, patients with type 2 diabetes mellitus who have suffered a myocardial infarction or cerebral infarction, as well as patients with type 1 diabetes mellitus with severe stages of chronic complications will receive insulin analogues.

As part of the implementation of the National Program for Demographic Security, all regional endocrinological dispensaries (departments) were equipped with long-term glycemic monitoring systems (CGMS).

In the Republic of Belarus, the insulin pump method is being actively introduced for children with diabetes mellitus, patients with type 1 diabetes mellitus of working age, as well as pregnant women with type 1 diabetes mellitus.

For the treatment of trophic ulcers in patients with diabetes mellitus, the human recombinant epidermal growth factor Eberprot-P, created using genetic engineering methods at the Manufacturer Center for Genetic Engineering and Biotechnology, Cuba, is actively used.

The increase in life expectancy and decrease in mortality of patients with diabetes in our country is the result of the introduction of an integrated approach to the organization of medical care for the population of the republic. One of the important areas of modern diabetology in our republic is training at the “School of Diabetes”. In the Republic of Belarus there are 229 inpatient and outpatient “Diabetes Schools”, in which about 50 thousand patients are trained annually according to a unified program approved by the Ministry of Health. The education system in the Republic of Belarus, which has been formed since the early 90s of the last century, has been highly praised by the World Health Organization and the International Diabetes Federation and is recommended as an example for states in the European region.

As a result of the measures taken at the state level, there is a positive trend in a number of demographic indicators. Thus, according to the republican register “Diabetes mellitus” for the entire period of existence of the database (2007-2016), the average age at the time of death (average life expectancy) in patients with type 2 diabetes mellitus was 72.8 years with type 2 diabetes mellitus (for men 70.0 years, for women – 74.6 years), which is higher than the general population indicators. The mortality rate of patients with diabetes over the past 10 years has decreased by 1.4 times: from 4.7 to 3.3 per 100 patients.

Among the priority areas in the development of diabetes care in the Republic of Belarus is improving continuity in work with related specialists (therapists, pediatricians, general practitioners), informing the general population about risk factors, possibilities for prevention and early detection of the disease, diagnosis and prevention of chronic complications, increasing motivation patients to self-control as part of systematic training at the “School of Diabetes”, the use of modern medical technologies in the diagnosis, treatment and monitoring of patients.

Chief freelance endocrinologist

Ministry of Health V.V. Valuevich

Chief freelancer pediatric endocrinologist

Ministry of Health A.V. Solntseva