Epidemiology of Epidemiology of Diabetes Mellitus(DM) in Diabetes Mellitus(DM) in

SiberiaSiberiaEugene ShubnikovEugene Shubnikov, ,

MDMDCenter for Center for

Endocrinology Endocrinology «SibDiab»«SibDiab»

Novosibirsk, RussiaNovosibirsk, Russia

readings

ObjectivesObjectives To Outline the Incidence of Type 1 DM To Outline the Incidence of Type 1 DM

among Children in Novosibirsk Area, Russiaamong Children in Novosibirsk Area, Russia To Describe To Describe thethe P Prevalencerevalence of DM and of DM and

Impaired Glucose Tolerance (IGT) among Impaired Glucose Tolerance (IGT) among Adult Population of Novosibirsk City, Adult Population of Novosibirsk City, Russia.Russia.

To Discuss the Prevalence of DM among To Discuss the Prevalence of DM among Native Polulation of Chukotka Pepublic of Native Polulation of Chukotka Pepublic of Russia.Russia.

Map of Russia

Novosibirsk

Chukotka

MoscowSIB

ERIA

Siberian IDDM RegistrySiberian IDDM Registry

Case Identification is Based on:Case Identification is Based on:

1. Review of Hospital Records at 1. Review of Hospital Records at Novosibirsk City’s HospitalsNovosibirsk City’s Hospitals

2. Review of Out-Patient Clinic’s 2. Review of Out-Patient Clinic’s Data at Novosibirsk CityData at Novosibirsk City

Siberian IDDM RegistrySiberian IDDM Registry

Consists of:Consists of:

Novosibirsk Area IDDM Novosibirsk Area IDDM RegistryRegistry

Novosibirsk City IDDM RegistryNovosibirsk City IDDM Registry

Novosibirsk DistrictNovosibirsk District

Novosibirsk area-178 300 sq.km.

Novosibirsk City 477 sq. km.

Incidence of IDDM per Incidence of IDDM per 100000 Children before 100000 Children before

Age of 15 for 1980-1996 Age of 15 for 1980-1996

01234567

Boys Girls

NovosibirskAreaNovosibirskCity

Incidence of IDDM by Age Incidence of IDDM by Age GroupsGroups

0

2

4

6

8

10

0-4years

5-9years

10-14years

NovosibirskareaNovosibirskCity

Time Trends in IDDM Time Trends in IDDM Incidence Incidence

0

2

4

6

8

Boys Girls BothSexes

1980-19891990-1999

Family History InformationFamily History Information

From 715 Cases Diagnosed From 715 Cases Diagnosed before Age 15, our Data Base before Age 15, our Data Base Includes Information on:Includes Information on:

19 Families where Child and One 19 Families where Child and One Parent Suffer from IDDMParent Suffer from IDDM

10 Families where Two Siblings 10 Families where Two Siblings Suffer from IDDMSuffer from IDDM

HypothesisHypothesis

Taking into Account Small Taking into Account Small Number of Multiplex Families, Number of Multiplex Families, the Increase in Risk at Puberty the Increase in Risk at Puberty and Increasing IDDM and Increasing IDDM Incidence, we Suppose that Incidence, we Suppose that Some Unknown Casual Agents Some Unknown Casual Agents are Playing an Important Role are Playing an Important Role at IDDM Pattern in Siberiaat IDDM Pattern in Siberia

Map of Russia

Novosibirsk

12

Prevalence of DM According Prevalence of DM According to Screening Datato Screening Data

First Standardized Study of a First Standardized Study of a Representative Sample of Russian Representative Sample of Russian Men and Women 25-64 years in Men and Women 25-64 years in Novosibirsk City in the Frame of Novosibirsk City in the Frame of WHO «MONICA» WHO «MONICA» ProjectProject..

1985 WHO Criteria for Diagnosis of 1985 WHO Criteria for Diagnosis of DM and IGTDM and IGT

Data was Compared to DM Registry Data was Compared to DM Registry Data at the same AreaData at the same Area

The Prevalence The Prevalence Estimates for IGT and DM Estimates for IGT and DM

in Per Centin Per Cent

0

2

4

6

8

10

12

14

16

DM IGT

25-3435-4445-5455-64

The Prevalence Estimates The Prevalence Estimates for Previously Diagnosed and for Previously Diagnosed and

New Cases of DM New Cases of DM

02468

101214161820

Men Women

PreviouslyDiagnosedNew

CHUKOTKA ALASKA

Number of DM Patients among Number of DM Patients among Chukotka Native PopulationChukotka Native Population

0

2

4

6

8

10

12

14

16

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Nu

mb

er o

f C

ases

Years

SIRENIKI

NEW CHAPLINOANRAKINNOT

LORINO

Prevalence of DM among Prevalence of DM among Chukotka Natives According to Chukotka Natives According to

Screening DataScreening Data

We Confirmed just One Case of DM We Confirmed just One Case of DM in an Eskimo Woman(Diagnosed in an Eskimo Woman(Diagnosed Previously) during the Screening, Previously) during the Screening, that was 0,5% of Examined Female that was 0,5% of Examined Female Population.Population.

There were no DM Cases in Examined There were no DM Cases in Examined Male Population.Male Population.

The Age Distribution of IGT The Age Distribution of IGT Prevalence among Chukotka Prevalence among Chukotka

Natives Natives

Sex Agegroup

25-34 35-44 45-54 55-64

Men Number 1 1 0 0

Women Number 0 2 2 4

Bothsexes

In % 1,0% 3,2% 2,0% 5,7%

Owerweigh among Owerweigh among Chukotka Natives Chukotka Natives (Screening Data)(Screening Data)

Body Mass Index (BMI) was Body Mass Index (BMI) was Greater than 29 among 8,3% of Greater than 29 among 8,3% of Men and 29,4% of Women.Men and 29,4% of Women.

There were 17,9% of Men with There were 17,9% of Men with BMI Greater than 27 and 55,6% BMI Greater than 27 and 55,6% Women with BMI Greater than Women with BMI Greater than 25.25.

Changes in Diet among Chukotka Changes in Diet among Chukotka Native Adults during 10 yearsNative Adults during 10 years

32

26

10

12

21

41

13

15

Protein

Carbohydrates

Sugar

SFA

1991-1992

1982-1983

Farida R.Mamleeva et al., 1996

In per cent (%)

ConclusionConclusion

According to Our Investigations, the According to Our Investigations, the Incidence and Prevalence of DM in Incidence and Prevalence of DM in Siberia are Relatively low, Compare Siberia are Relatively low, Compare to other European and World to other European and World Populations.Populations.

We have Revealed the Increasing of We have Revealed the Increasing of DM Incidence and Prevalence at all DM Incidence and Prevalence at all Siberian Regions which Reflects Siberian Regions which Reflects Global DM’s Tendency. Global DM’s Tendency.