**3. Register analysis results and discussion**

64 Type 1 Diabetes – Complications, Pathogenesis, and Alternative Treatments

Ministry of Health statistical data (Anonymous, 2006). The integrity of the register, i.e., the data on the number of patients who have received insulin, was assessed based on the information provided by the primary care doctors (district endocrinologists) to the regional diabetic registers. Consequently, the regional endocrinologists were responsible for updating the data and endorsing it to the central level. Accordingly, by assuming that the data were encoded into the regional registers with various degrees of completeness, significant limitations were noted in the assessment of the prevalence of insulin-dependent diabetes as well as in further epidemiological evaluations. Considering the fact that Ukraine has a national, free-of-charge insulin supply to the patients who require it, the Ministry of Health data reflect the number of these patients to the fullest extent. However, the Ukrainian Ministry of Health receives only non-personalized data that are difficult to verify. A comparison of the data from the 2006 Diabetes Register with the 2005 data on the insulintreated patients from the Ministry of Health (considered 100%) revealed certain similarities: the fraction of the patients included in the register was 91.1%, based on the number of the patients according to the Ministry of Health data. However, in the Kharkiv region, only 58.6% of the Ministry of Health patients were in the register. It was assumed that the Kharkiv region data in the register could be incomplete, and hence, was not used in the

Therefore, the analysis was carried out using the T1D criteria used by the epidemiologists– researchers for the European diabetes population databases (Kyvik et al., 2004; Soedamah-Muthu, 2006). The patients were selected based on the following conditions: T1D primary care diagnosis; age at the time of being included in the register ≥15 years; place of residence

The prevalence of T1D in the Ukrainian regions was determined as of the end of 2004. The T1D prevalence was calculated using the official data on the adult population of the corresponding regions (Anonymous, 2006), and 95% confidence interval (CI) was determined using arcsine transformation (Altman et al., ed-s., 2003). Multiple comparisons of T1D regional prevalence were subsequently carried out using the modified (Liakh & Gurianov, 2004) L. Marascuilo mathematical procedure (Marascuilo, 1966). The MedStat statistical package was used for the calculations (Liakh & Gurianov, 2004). Logistic regression analysis was used to determine the influence of the explanatory variables on the resulting variable (Bland, 2000). For each input variable, we evaluated the estimated logistic regression coefficient with the standard error, estimated as the odds ratio (OR) with a CI for its actual value and associated *p* value, and performed a Wald test (testing the null hypothesis on the congruency of the OR of the "disease" associated with the increase of this variable by 1). We used this information to determine whether each variable was related to the outcome of interest, and to quantify the extent of such a relationship (Bland, 2000). The

We have evaluated the prevalence of proliferative retinopathy (PR), arterial hypertension (AH), and mortality risks in the retrospective cohort of T1D (27,896 patients); these data was

Statistica 5.5 (StatSoft Inc., 1999) package was used in this set of calculations.

analysis of T1D prevalence among adults.

and gender; and data on diagnoses before the age of 30 years.

**2.1 T1D cases selection** 

**2.2 T1D prevalence assessment** 

**2.3 T1D outcomes assessment** 

The analysis of the register of diabetic patients has allowed for the first time to assess the adult prevalence of T1D in Ukraine in comparison with important clinical (daily insulin dose, mortality, and complications) and some paraclinical (GADA) characteristics of the disease (Khalangot et al., 2009 c; Khalangot et al., 2009 d; 2010).
