Diabetes during the Russian transition.

AIMS

To study trends in diabetes awareness and care in post-transition Russia, at a time of increased all-cause and diabetic mortality and disrupted health care.

METHODS

Trends in diabetes awareness (a self-reported doctor diagnosis) and diabetic treatment were recorded over eight rounds (1994-2003) of the Russia Longitudinal Monitoring Survey, a 38 centre panel study, in respondents aged over 18 (over 7000/round). Logistic regression was used in 2 individual years (1994 and 2003) to study the determinants of diagnosis further.

RESULTS

Throughout the study, diabetes awareness was three times more frequent in women (6%) than men (2%). Awareness was lower in rural and less-educated respondents, and these geographic and socioeconomic differences widened during the study. High body mass index predicted diabetes awareness in women, but did not explain gender or socioeconomic differences. More than half those reporting a diabetic diagnosis reported receiving no conventional medical treatment, and insulin use was less frequent than in Western populations.

CONCLUSIONS

The prevalence of diabetic awareness was much lower than studies of diabetes prevalence based on biochemical criteria (9%), and there were unexplained gender and socioeconomic variations. Reported treatment rates were low. Unrecognised and undertreated diabetes may underlie a substantial burden of potentially preventable morbidity in Russia.