Endocrine Abstracts

Vologda is situated in the North-Western region of Russian Federation. It is mostly rural – about 30% of population lives in remoted villages. One can compare Vologdàs region with Greece – same amount of land area (approximately 140000 m2), but the population density is 10 times less (8 per km2 and 85 per km2 respectively). The Vologdàs region population is approximately 1151000, the amount of Diabetes patients is 42 000 (3,7% of overall population). The territory is divided into 28 subregions with endocrine care available in 5 subregions. That is why there is an issue of equal access to specialized care for people with diabetes. Vologdàs Regional Diabetes Center was established in 2016. Diabetes center is armed with Diamobile on which multidisciplinary team (consisted of Endocrinologist, Cardiologist, Neurologist, Ophthalmologist, Podiatrist and nurse-educator) reaches every part of the region. 50000 consultations were made by multidisciplinary team. During the consultation patient`s treatment plan, diet and physical activity are revised. Special attention is paid to the detection of Diabetes complications. Center specialists are cooperating with the main Vologdàs, Moscow`s and Saint Petersburg`s hospitals. The Diabetes registry is maintained by general practitioners and endocrinologists. Before the Center opening the data about Diabetes patients in the region was scarce and inconsistent. Thanks to the multidisciplinary team every bit of data acquired is included into Diabetes registry now, which led to better understanding of prevalence, morbidity and mortality, complications and Diabetes drug`s distribution throughout the region. The results of data processing are clearly indicating the improvement of medical care quality. There is a great improvement in Diabetes compensation – 15% of patients have 1% reduction in HbA1c level per 1 year. Type 2 Diabetes Mellitus patients` life expectancy has increased from 72 to 74 years (Vologda region total population average –70,7 years). The percentage of patients treated with insulin is about 23%, the proportion of insulin analogues – 90%. 78% of type 2 Diabetes Mellitus patients have metformin as monotherapy or as a part of combination therapy. Consistent with current guidelines the main emphasis is on life quality improvement and avoiding cardiovascular mortality using SGLT2 inhibitors and GLP-1 agonists.

In the COVID-19 era there is an urgent need for switching to online visits. The most important future direction for Center is partial shift to online consultations. In order to achieve this goal a special application is being developed.