bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamics of incidence and prevalence of type 1 diabetes mellitus in children in the Russian Federation (2001-2007)
Authors: Shiryaeva Tatiana Yur'evna , Andrianova Ekaterina Andreevna , Suntsov Yury Ivanovich
Published: November 2013

Aim. To study dynamics of main epidemiological characteristics (incidence and prevalence) of type 1 diabetes mellitus (DM) in children in theRussian Federation (RF) and its Federal districts (FD) in 2001-2007. Materials and methods. Analysis of main epidemiological characteristics (incidence, prevalence, mortality) of type 1 DM in children of RF has beenunderway in the Institute of Pediatric Endocrinology, ERC, since 2001 based on results of questionnaire studies. The questionnaires regularly distributedamong Health Committees of RF subjects (primary sources of information) are designed to collect data on the size, age and sex compositionof childrens populations affected by DM1 and the number of newly diagnosed cases as per the end of each reporting year. The data obtainedare compared with those stored in the State Diabetes Registry (secondary source of information). Results. Major trends in the dynamics of epidemiological characteristics of type 1 DM in children of RF are similar to those worldwide. Mean annualgrowth rate is 2,8%. The incidence of DM1 remains highest in the North-West FD (15,66 per 100 000 children) followed by Central andVolga FDs (12,82 and 10,6 respectively) where its is close to the average value FDr RF (11,01). The incidence of DM1 continues to decrease in theSouthern FD (6,61% per year) and undergoes up-and-down fluctuations in Ural and Siberian FDs. It steadily grows in the Far East FD. TheNorth-South gradient of DM1 morbidity across the territory of RF has persisted during the study period. Conclusion. Monitoring main epidemiological characteristics of type 1 diabetes mellitus in children of RF is an integral component of the organizationof medical and preventive aid to these patients that creates a basis for predicting morbidity, planning measures for its control, and improvinggeneral quality of healthcare provided to diabetic children
Efficiency of insulin analogs in young patients with type 1 diabetes mellitus debut during pubertal period
Authors: Bolotskaya Lyubov' Leonidovna , Suntsov Yury Ivanovich , Kazakov Igor Vladislavovich , Shestakova Marina Vladimirovna , Dedov Ivan Ivanovich
Published: November 2013

Aim. To identify factors responsible for the early development of microvascular complications in patients with type 1 diabetes mellitus (DM1)and to evaluate dependence of their prevalence on the type of insulin. Materials and methods. The study carried out from May 2002 to November 2007 included a random sample of patients with DM1 over 10 years in duration(n=5895, 100%, >=20 years) from the Central, Volga, Ural, Siberian, North-West and Southern federal districts. All patients underwentexamination of eye fundus and feet, measurement of microalbuminuria, creatinine, urea, serum lipid spectrum and HbА1с. Results. Mean HbА1с level in patients of group 1 (using insulin analogs) was significantly lower than in group 2 (using homan insulin) (Me 8,5?0,2%;9,7?0,4% SD* respectively) p>0,01. Mean daily insulin dose in group 1 and 2 was >1,0 and
Specific features of physical development in children and adolescents with type 1 diabetes mellitus
Authors: Panfilova Viktoriya Nikolaevna , Taranushenko Tatiana Evgen'evna , Terent'eva Oksana Alexeevna , Petrova Maria Nikolaevna
Published: November 2013

Aim. To evaluate variations of principal parameters of physical development in children and adolescents with type 1 diabetes. Materials and methods. The study included 356 children with DM1. Their height, body weight, and body mass index were compared with the respective valuesfrom percentile tables recommended by WHO and US Centre for Disease Control and Prevention. For each patient, height deviation from the mean valuewas expressed as SDS. For the assessment of physical development, the place of each parameter in one of the 7 centile intervals was determined. Harmonicityof physical development was estimated from the difference between normal intervals on the centile scale after measurement of height and body weight.Results.Most patients (55,7%) were found to harmonically develop during the 9 year-long study, 30% had excess body weight despite average height. DM1was associated with reduced SDS values for the height and parallel increase of body weight especially in the disease over 10 years in duration. The HbA1c levelin low-height patients was significantly elevated compared with high-height ones. Negative effect of long-term metabolic decompensation on the growth of thechildren became apparent since the third year of the disease. Body weight was a more stable parameter independent of the degree of compensation.Conclusion: Children and adolescents with DM1 experience deterioration of yearly height dynamics with increasing length of the disease. Growth characteristicsare related to the degree of compensation of carbohydrate metabolism.
Diabetes mellitus: development of technologies in diagnostics, treatment and prevention
Authors: Dedov Ivan Ivanovich
Published: November 2013

Diabetes mellitus is a most serious socio-medical and economic problems facing health authorities throughout the world. A major threat is vascularcomplications of the disease. The currently available diagnostic tools, up-to-date means for monitoring glycemia, introduction of innovative insulinpreparations and hypoglycemic agents, development of high-technology therapeutic modalities may greatly improve disease prognosis, reduce the frequencyof chronic complications, related disablement and mortality rates. The targeted control of major risk factors, viz. hyperglycemia, hypertension,and dyslipidemia, during the patients lifetime starting from the onset of diabetes remains the most promising strategy for the prevention of diabeticcomplications. An indispensable condition for efficacious management of diabetes is the elaboration of active screening programs for the early diagnosisof complications and optimal organization of the clinico-diagnostic process in the framework of multidisciplinary approach.
Clinical and psychological aspects of hypoglycemia in patients with diabetes mellitus
Authors: Mel'nikova Olga Georgievna , Mayorov Alexander Yur'evich
Published: November 2013

This paper reviews key aspects of hypoglycemia in patients with diabetes mellitus. The description and classification of hyoglycemias are presented inconformity with criteria of American Diabetes Association, European Agency for Evaluation of Medicinal Products, Canadian Diabetes Association,and Russian Algorithm of specialized care for diabetic patients. The main factors responsible for the development of hypoglycemia and its clinicalpicture are considered. A detailed characteristic of abnormal sensitivity to hypoglycemia is given. Psychological aspects of the effects of hypoglycemiaon the quality of life and achievement of target parameters of glycemic control are analysed.
The role of metformin in the modern strategy of treatment and prevention of type 2 diabetes mellitus
Authors: Smirnova Olga Mikhailovna
Published: November 2013

Metformin is a major antihyperglycemic agent used for the treatment of DM2. Analysis of the mechanism of its action is presented. Cardioprotectiveand anticancer activities of metformin are discussed. Results of multicentre studied of metformin are described.
New indications for exenatide therapy of type 2 diabetes mellitus
Authors: Vikulova Olga Konstantinovna , Shestakova Marina Vladimirovna
Published: November 2013

Obesity associated with the enhanced risk of cardiovascular disorders plays a key role in the evolvement and progression of type 2 diabetes mellitus(DM2). Incretin mimetics are the sole class of hypoglycemic agents that not only effectively correct hyperglycemia but also reduce body weight. Exenatide(Byetta) is the first drug of this class approved for the use as monotherapy. This paper presents a detailed review of the available data on thescope of exenatide effects and the results of its clinical studies that confirm high efficiency of Byetta used for both monotherapy and combined therapyof DM2.
The use of the VersaJet hydrosurgical system in patients with diabetic foot syndrome
Authors: Doronina Lyudmila Petrovna , Mitish Valeriy Afanas'evich , Galstyan Gagik Radikovich
Published: November 2013

The management of chronic lesions in DM patients implies a multifactor approach, its important component being the adequate treatment of thewound bed. The new hydrosurgical technology for the purpose based on the VersaJet system poses a number of technical problems and requires assessmentof its applicability and efficiency in patients with different forms of diabetic foot syndrome. Results of the work with this system (62 patients)revealed its advantages, such as reduction of treatment duration and the number of repeat treatments, higher probability of wound healing at sitesdifficult to access (heel, tendon projection regions, etc.). It is concluded that the VersaJet system may be recommended for the use in surgical departmentsproviding specialized medical aid to patients with DM and pyonecrotic foot lesions.
The role of insulin analogs in the achievement of compensation and improvement of quality of life in children and adolescents with type 1 diabetes mellitus
Authors: Kuraeva Tamara Leonidovna
Published: November 2013

Despite substantial progress in the treatment of type 1 diabetes mellitus achieved by the end of the last century due to the advent of human insulins,intensive insulinotherapy, means of glycemia self-control, and active patient self-management education, compensation of the diseases in childrenand adolescents remains a challenging problem. This paper is focused on the use of insulin analogs in these patients and main difficulties encounteredby pediatricians in the correction of therapy.
Comparative efficacy assessment for various insulin regimens in patients with type 2 diabetes mellitus, ischaemic heart disease and frequent hypoglycemic events
Authors: Kudinov Vladimir Ivanovich , Nichitenko Maria Sergeevna , Chesnikova Anna Ivanovna , Zolotareva Natalya Vladimirovna
Published: November 2013

Aims. To study influence of combined treatment with human insulin analogues (insulin aspart and insulin detemir) on glycemic control,insulin resistance and development of ischaemic heart disease (IHD) in patients with type 2 diabetes mellitus (T2DM) and frequenthypoglycemic events in comparison with that of human insulins (soluble and isophane). Materials and methods. 54 patients (mean age 61.2?0.7) with T2DM and IHD participated in this study. All included patients experiencedfrequent mild and moderate hypoglycemic events (3+ episodes per week). We analyzed frequency and severity of hypoglycemia,parameters of glycemic and lipid metabolism, number of ischaemic episodes per day, duration and depth of ST depression, circadianindex, incidence of different types of arrhythmia and conduction abnormalities as measured by Holter ECG monitoring.All patients were subdivided into two groups by random sampling: 21 patient (first group) carried on with human soluble insulin andisophane in an optimized basal-bolus regimen. In 33 patients, comprising second group, treatment was changed for combination ofinsulin aspart (NovoRapid?, Novo Nordisk, Denmark) and insulin detemir (Levemir?, Novo Nordisk, Denmark). Follow-up periodwas set to 6 months. Results. In patients with frequent hypoglycemic experience different types of arrhythmia and heart conduction abnormalities wereobserved in 75.9% of cases. Most patients had complex types of arrhythmic disorders (70.4%) with ventricular extrasystole being themost common one. Signs of myocardial ischaemia were registered in 48.1% of patients.After 6 months of follow-up patients from the second group demonstrated a statistically significant decrease in fasting and postprandiallevels of glycemia (p=0.000001). Both groups also had a significantly lower rate of hypoglycemic events. Moreover, in the second groupall episodes of hypoglycemia were mild and occurred only in 36.4% of cases. Additionally, after 6 months of treatment with humaninsulin analogues ventricular extrasystoles were registered only in 24.2% of patients, while rate and duration of ischaemic episodesdropped to 4.25?1.51 (p=0.012, comparing with first group). Conclusion. Treatment with human insulin analogues NovoRapid? and Levemir? is associated with 1.6% decrease in HbA1c levels.Mild hypoglycemia was 72.2% less frequent, as compared with rates in the group on human soluble and isophane insulin, while moderateand severe hypoglycemic events were not observed at all. In turn, decrease in frequency and severity of hypoglycemia was associatedwith substantial improvement in cardiovascular status due to lower number and duration of ischaemic episodes (including painlessvariant) and lower frequency of heart rhythm disorders.
Diabetes mellitus and pyoinflammatory diseases of ENT organs
Authors: Biryukova Elena Valer'evna , Gurov Alexander Vladimirovich , Yushkina Marina Alekseevna
Published: November 2013

Current review addresses diagnostic issues and treatment of patients with diabetes mellitus (DM) and pyoinflammatory diseases ofENT organs. We discuss etiologic and pathogenetic factors affecting course of pyoinflammatory processes in ENT organs of diabeticpatients
Commentary on prevention of cardiovascular complications in diabetes mellitus as novel inidicationfor Diabeton MR
Authors: Vikulova Olga Konstantinovna
Published: November 2013

Current article presents commentary on official inclusion of cardiovascular prophylaxis in indications for Diabeton MR therapy. The paper features extensive review of data from ADVANCE (Action in Diabetes and Vascular Disease: PretarAx and DiamicroN Modified Release Controlled Evaluation) trial and its comparative analysis with other major randomized studies of intensive glycemic control in patients with type 2 diabetes mellitus.
Modern antihyperglycemic therapy: safety and efficacy of glimepiride
Authors: Ruyatkina Lyudmila Alexandrovna , Sorokin Maksim Yur'evich
Published: November 2013

Current review analyzes pharmacological and clinical aspects of glimepiride from perspective of the evidence-based medicine. We aimedto determine position of glimepiride within modern antihyperglycemic dialectics of safety and efficacy. We also address cardioprotectiveproperties of glimeperide due to its anti-atherogenic activity, capacity to correct endothelial dysfunction and hemostatic system, as wellas absence of inhibitory effect on ischemic preconditioning.
Features of proliferative process in patients with diabetic retinopathy
Authors: Lipatov Dmitriy Valentinovich , Kuz'min Anatoliy Gennad'evich , Tolkacheva Anna Anatol'evna , Chistyakov Timofey Alexandrovich
Published: November 2013

We present two atypic clinical cases of ?middle? proliferation in patients with proliferative stage of diabetic retinopathy. Both patientsunderwent hospitalization in Department of diabetic retinopathy and ophthalmic surgery of Endocrine Research Centre, Moscow.We conducted full-scale endocrine and ophthalmologic examination, including A/B scanning.?Middle? proliferation in diabetic retinopathy should be considered a severe disorder and managed in conjunction of endocrine andophthalmologic approaches. Adequate and timely compensation of diabetes mellitus combined with vitreoretinal surgery may substantiallyimprove prognosis in such patients and reduce the risk of incapacitation.
Kidneys cytomembranes stability in pregnant women with type 1 diabetes and pregnancy outcomes depending on the method of insulin delivery
Authors: Alimetova Zulfiya Raisovna , Valeeva Farida Vadutovna
Published: November 2013

Objective. To evaluate of kidney cytomembranes stability during pregnancy and its outcomes in patients with diabetes mellitus type on type 1 with different stages of diabetic nephropathy (DN) according to the route of insulin administration. Materials and Methods. We study 100 pregnant women with type 1 diabetes with the introduction of insulin in the mode of multiple subcutaneous injections (MSII) and with portable dispenser with a continuous subcutaneous insulin infusion (CSII). DN stage determined by the level of albumin in the daily urine. Cytomembranes stability assessment conducted on daily excretion of ethanolamine and phospholipids with urine in each trimester. Pregnancy outcomes were analyzed in 52 patients with type 1 diabetes. In the group of pregnant women with delivery at term 38-40 weeks we also analyzed the status of newborns. Results. Indicators of cytomembranes stability of kidneys in pregnant women on CSII consistent with those in healthy pregnant women (p>0.05) the whole pregnancy, regardless of the level of daily urinary albumin excretion. There were no differences in cytomembrana stability of kidneys between the group of patients on MSII with normal albumin excretion (NAU) and the control group regardless to the gestational age (p>0.05). With the introduction of insulin in the mode of MSII on the stage of microalbuminuria (MAU) in the 3rd trimester we found the increase of ethanolamine excretion as compared to control groupy (U=8,00, p=0.012) and the group on CSII with a similar stage of nephropathy (U=2.00, p=0.033). In patients with proteinuria (PU) in the group on the MSII in the third trimester phospholipids excretion is increased with a daily urine (U=27,5, p=0.03 and U=22,00, p=0.07 for patients MSII and CSII, respectively). The use of an insulin pump allowed to prolong gestational period, even in severe proteinuric stage of nephropathy. Manifestations of diabetic fetopathy as macrosomia, hypoglycemia in the fetus at birth time mothers using CSII mode were less common than with MSII (p=0.01 and p=0.04, respectively). In the CSII group no resuscitation was needed, as opposed to 20% of children whose mothers used the MSII. Conclusion. The administration of insulin using portable dispenser the of mode CSII during pregnancy in patients with type 1 diabetes, even at the initial stage of the DN the cytomembranes stability is saved, pregnancy outcomes are improved.
Diabetes, obesity and cancer: risk and anti-risk factors
Authors: Bershteyn Lev Mikhaylovich
Published: November 2013

Observable diabetes and obesity epidemics may result in alteration of cancer morbidity and mortality. This increasingly recognized problem is reviewed here from the perspective of interplay between factors that differently modify association of diabetes mellitus with malignant neoplasms. Heterogeneity and familial aspects of diabetes and obesity, genomic traits, anti-diabetic medications and weight-reducing treatment are important examples of such factors. Addressing them might promote development of efficient preventive measures.
Targeting risk factors: a feasible way for prevention of vascular complications in type 2 diabetes mellitus
Authors: Kononenko Irina Vladimirovna , Smirnova Olga Mikhailovna
Published: November 2013

The article addresses challenges in the prevention of microvascular complications in type 2 diabetes mellitus (T2DM) and discusses necessity of multifactorial approach to management of these conditions. We present results of a large-scale ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation) trial that elucidates the combined influence of antihypertensive and of intensive glucose-lowering therapy on the risk of development of micro- and macrovascular complications of T2DM
Efficacy and safety of treatment with human insulin analogues in daily management of insulin naive patients with type 2 diabetes mellitus: results of multicenter 52-week observational study A1chive
Authors: Shestakova Marina Vladimirovna
Published: November 2013

Modern insulin analogues allow safe improvement of glycemic control (not accompanied with increase in body mass or rate of severe hypoglycemic events) and its efficient maintenance during long period of time. In this paper we present results of multicenter 52-week prospective observational study A1chive (Russian cohort, n=9342), designed to assess safety and efficacy of treatment with human insulin analogues (Levemir?, NovoMix? 30 and NovoRapid? (Novo Nordisk) in daily management of insulin naive patients with type 2 diabetes mellitus. Prescription of human insulin analogues resulted in clinically and statistically significant improvement of glycemic control irrespective of initial insulin regimen. Therapy by various regimens (Levemir?, NovoMix? 30 or Levemir? + NovoRapid?) under conditions of daily clinical practice leads to marked improvement in glycemic control as measured by HbA1c (-2.9% in 12 month) with no evidence for negative influence on tolerability and short-term safety of the treatment. Furthermore, decrease in HbA1c levels was associated with pronounced and stable decrease in fasting and postprandial glucose levels (-5.0 mmol/L and -5.7 mmol/L, respectively). By the end of the follow-up all regimen groups reported improvement of QoL by treatment satisfaction criterion.
Serum lipid profile in native populations (evens, nanais, ulchis) of the Amur region diagnosed with type 2 diabetes mellitus
Authors: Ryabova Tatiana Ivanovna , Sirotin Boris Zalmanovich
Published: November 2013

Aim. To determine serum lipid profile in native populations (Evens, Nanais, Ulchis) of the Amur region diagnosed with type 2 diabetes mellitus. Materials and methods. 297 Evens, 792 Ulchis, and 1,274 Nanais aged 30-70 years and older were examined. Total cholesterol, triglyceride, andhigh-density lipoprotein were measured with a Sapphire autoanalyzer (Japan) using Olveks Diagnosticim enzymatic kits (including reference sera).LDL levels were calculated by W.Fridewold formula (TC-HDL-TG/2.2) in millimol/l. Glucose tolerance test to verify type 2 DM was performed withthe measurement of blood glucose level by the glucose oxidase method. Previously diagnosed DM2 was taken into account. The results were estimatedbased on WHO criteria (1999). The study was carried out in winter time. Conclusion. Changes of the serum lipid profile in DM2 female aborigines of the Amur region were consistent with the literature data. Specifically, theyshow higher TC, TG,, HDL and lower LDL levels compared with DM-free women of the same population. The lowest levels of TC, TG, HDL, andLDL were documented in female Evens. Nanais and Ulchis with DM2 had similar lipid profiles.
The role of common genetic markers in susceptibility to type 1 diabetes and autoimmune thyroid diseases
Authors: Repina Ekaterina Alexandrovna
Published: November 2013

This review generalizes current data on the genes responsible for combined susceptibility to type 1 diabetes and autoimmune thyroid diseases. Analysisof the role of common genetic markers facilitates understanding their contribution to the development of each of the two or several concomitantautoimmune diseases affecting a single patient
Sakharnyy diabet i gormonal'naya enterologiya: put' v prekrasnoe daleko?
Authors: Aleksandrov Andrey Alexeevich
Published: November 2013

The gastrointestinal tract produces hormones that influence glucose-induced pancreatic insulin secretion. One of them is glucagon-like peptide 1.Its synthetic analog, liraglutide, has properties that promote metabolic control in patients with type 2 diabetes mellitus and have beneficial effecton the risk factors of cardiovascular complications.
The influence of diabetic autonomous neuropathy on myocardial remodeling in type 1 diabetes mellitus
Authors: Bondar' Irina Arkad'evna , Koroleva Elena Anatol'evna , Chudinova Olga Grigor'evna
Published: November 2013

Aim. To assess the influence of diabetic autonomous neuropathy (DAN) on left ventricular myocardial remodeling in type 1 diabetes mellitus. Materials and methods. The study included 78 patients (30 men and 48 women) with DM1 (mean age 28.9?8.3 years, DM1 duration9.7?7.5 years). DAN was diagnosed by standard ECG tests (Valsalva and breathing tests). The patients were examined using echocardiographywith the measurement of the thickness of interventricular septum (IVS) and left ventricle posterior wall (PW), end diastolic and systolic size (EDS and ESS) of the left ventricle, left ventricular myocardial mass (MM), MM index and relative wall thickness (RWT). LV hypertrophy(LVH) was diagnosed at MM index ?134 g/m2 in men and ?110 g/m2 in women; concentric and excentric types of LV hypertrophy wererecorded at RWT ?0.45 and
On pathogenesis of arterial hypertension in type 2 diabetes mellitus
Authors: Volkov Violen Stepanovich , Rudenko Evgenia Vladimirovna , Rokkina Svetlana Anatol'evna , Poselyugina Olga Borisovna
Published: November 2013

Aim. To study the functional state of arterioles in patients with type 2 diabetes mellitus and concomitant arterial hypertension (AH) and evaluatethe role of sodium in mechanisms of elevation of arterial pressure (AP) in this pathology. Materials and methods. 163 patients of whom 83 had DM2 with AH and 80 essential hypertension. They were examined by dopplerography of themicrocirclatory bed, measurement of arterial blood flow and daily sodium urinary excretion. Results. Patients with essential AH showed increased arteriolar circulation rate and enhanced reactivity of microvessels. These parameters werereduced in patients with DM2 and AH who consumed large amount of table salt. Conclusion. Mechanisms of development of essential AH and AH in DM2 are significantly different.
Association of -23 HphI, a polymorphic marker of the INS gene, with type 1 diabetes mellitus
Authors: Nikitin Aleksey Georgievich , Lavrikova Elena Yur'evna , Seregin Yury Alexandrovich , Zil'berman Lyubov' Iosifovna , Tsitlidze Nana Mikhailovna , Kuraeva Tamara Leonidovna , Peterkova Valentina Alexandrovna , Dedov Ivan Ivanovich , Nosikov Valery Vyacheslavovich
Published: November 2013

Aim. To analyse frequency distribution of alleles and genotypes of -23 HphI, a polymorphic marker of the INS gene, for evaluation of its associationwith DM1. Materials and methods. The study included two group of subjects: healthy ones and DM1 patients. Genotyping was performed by real time amplification. Results. Comparative analysis demonstrated association between -23 HphI polymorphic marker of INS gene, and type 1 diabetes mellitus. Conclusion. The use of the case-control method revealed association of -23 HphI, a polymorphic marker of the INS gene, with type 1 diabetes mellitus.
Effect of glycosoaminoglycans on the clinical course of diabetic nephropathy at the stage of microalbuminuria in patients with type 2 diabetes mellitus
Authors: Semenova Iya Vladimirovna , Chugunova Lyudmila Alexandrovna , Il'in Alexander Viktorovich , Knyazeva Anna Petrovna , Chirkova Lidia Dmitrievna , Shestakova Marina Vladimirovna , Dedov Ivan Ivanovich
Published: November 2013

Aim. To evaluate clinical efficiency of sulodexide (glycosoaminoglycan) for the treatment of patients with type 2 diabetes mellitus (DM2) and diabeticnephropathy (DN) at the stage of microalbuminuria (MAU). Materials and methods. A total of 30 patients with DM2 and MAU were examined 15 of whom were given sulodexide (200 mg daily) for 6 months.The following parameters were measured before, 3 and 6 months after the onset of therapy: HbA1c level, biochemical characteristics, highly sensitiveCRB, MAU in morning urine samples, soluble intercellular and vascular cell adhesion molecules-1, blood coagulation and anticoagulation factors(PTI, fibrinogen, thrombin time, coagulation factors VII, VIII, X, Willebrand factor), tissue plasminogen activator, and its inhibitor. Results. Sulodexide produced significant positive effect on albumin excretion in urine. It exerted antithromotic and profibrinolytic action and improvedendothelial function. Taken together, these properties of sulodexide give reason to recommend it as a protector of different vascular segments. Conclusion. Significant positive effect of sulodexide on albumin excretion in urine coupled to its multifactor activity, convenience of therapeutic application,low risk of complications, good tolerability, and safety in aged patients with DM2 permit to consider it as a promising tool for the treatmentof DM2 with MAU.
Obesity - a risk factor of renal pathology in patients with type 2 diabetes mellitus
Authors: Savel'eva Svetlana Alekseevna , Kryachkova Alexandra Alexandrovna , Kurumova Kseniya Olegovna , Shamkhalova Minara Shamkhalovna , Kutyrina Irina Mikhailovna , Shestakova Marina Vladimirovna
Published: November 2013

Aim. To study association between obesity and renal pathology in patients with type 2 diabetes mellitus (DM2). Materials and methods. The study included 106 patients with CD2 (41 men and 65 women) of mean age 60.0?7.0 years. Exclusion criteria wereduration of DM2 less than 5 years and manifest diabetic nephropathy (DN) (glomerular filtraton rate (GFR) below 60 ml/min/m2, albuminuria over2 g/24 hr). Anthropometric parameters measured included body mass index (BMI). Serum creatinine, uric acid, lipid spectrum, hormones of adiposetissue (leptin and adiponectin) were determined. Severity of renal pathology was estimated from GF and albumin excretion in urine. The patients were categorized into 2 groups: with obesity (BMI>=30 kg/m2) and without it (BMI
Effectiveness of total-contact cast immobilization: Overview of randomized clinical studies conducted in foreign clinics and originaldata
Authors: Udovichenko Oleg Viktorovich , Bublik Evgenia Viktorovna , Maksimova Nadezhda Viktorovna , Pryakhina Kira Yur'evna , Ermolaeva Olga Sergeevna , Spruit Piter , Galstyan Gagik Radikovich
Published: November 2013

Aim. To evaluate effectiveness of unloading immobilization bandages manufactured from Soft Cast and Scotchcast materials. Materials and methods. The study included all patients (n=39) with diabetic foot ulcers treated with the use of total-contact cast technology (TCC)from 01.10.2007 to 01.03.2009. 31 patients presented with neuropathic foot ulcers and 8 with neuroischemic ulcers (in the absence of critical foot ischemia).26 and 13 were managed using non-removable and removable casts respectively. All were given standard local treatment of ulcers, supplementedby antibacterial therapy in 20 patients. Results. Treatment resulted in the healing of ulcers in 31 (79%) patients during 40.5?32.9 days (M?SD) (median 27, min 7, max 11 days). In 28(72%) of them, healing required 12 weeks to complete. TCC had to be removed in 8 (21%) patients because of low efficiency or complications. Newulcers or abrasions related to the use of TCC developed in 10 patients but treatment was discontinued only in one of them. We distinguished a subgroupof 12 patients comparable in terms of major characteristics (plantar stage 1A and 2A neuropathic ulcers according to Texas University classification)and unloading method (non-removable cast throughout the treatment period) with patients included in earlier randomized studies. In this subgroup,healing of 100% ulcers was completed within 12 weeks (median 22 (13-74) days). Conclusion. 1. Efficiency of TCC in our practice is comparable with that in earlier publications. 2. The use of TCC is indicated not only for thetreatment of uninfected plantar neuropathic ulcers but also in some cases of neuroischemic and non-plantar ulcers. 3. Skin lesions from TCC is oflittle clinical significance and can be avoided by specialized education of the medical personnel involved in TCC manufacture.
Optimization of surgical treatment of cataract in patients with diabetes mellitus
Authors: Lipatov Dmitriy Valentinovich , Chistyakov Timofey Alexandrovich , Kuz'min Anatoliy Gennad'evich
Published: November 2013

Aim. To compare different methods for surgical treatment of cataract in patients with diabetes melli-tus (DM) and substantiate the choice of its optimalmodality. Materials and methods. Analysis included data on 209 patients (221 eyes) treated from January 2008 to December 2009 in the Department ofRetinopathy and Ophthalmosurgey, Endocrinological Research Centre. Diabetic cataract was managed using UNIVERSAL-II, LEGACY EVEREST,and INFINITI phacoemulsifiers. Parameters studied included time of ultrasound (US) ex-posure, US power, and retinal characteristics in the earlypostoperative period. In addition, analysis included data on the location of lens opacity in 1047 patients (1897 eyes) with diabetic cataract. Results. Relatively low corrected and uncorrected visual acuity in the early postoperative period was attributable to concomitant DM-related retinalpathology. Analysis of lenticular opacity showed that it in the first place affected collagen fibers beneath the posterior capsule. The use of torsional USin INFINITI for cataract phacoemulsification produced almost 4-fold reduction in the exposure time of ocular tissues. As a result, the postoperativeoedema was significantly smaller than in patients undergoing combined treatment (AQUALASE hydromonitoring and OZIL ultrasound system). Conclusion. Combination of ultrasound and hydromonitoring phacoemulsification for the treatment of cataract in DM patients reduces exposure timeof ocular tissues and postoperative oedema which creates prerequisites for faster recovery of visual acuity after surgery. Functional results of surgicaltreatment of diabetic cataract can be further improved by early diagnosis of lens opacity and the use of US and hydromonitoring phacoemulsificationtechniques.
Pharmacoeconomic aspects of the treatment of diabetic foot syndrome
Authors: Kalashnikova Marina Fedorovna , Maksimova Nadezhda Viktorovna , Udovichenko Oleg Viktorovich , Suntsov Yury Ivanovich
Published: November 2013

Treatment of patients with diabetic foot syndrome (DFS) is a major medico-social problem facing public health services. One of its important aspectsis high cost of the treatment. In connection with this, not only medical but also economic issues pertinent to DFS have recently been widely discussedin different countries. Clinico-economic analysis of the use of new medicinal products, therapeutic modalities, and established medical technologiesis of primary importance for making decisions concerning allocation of available financial resources. The present review of foreign publications focuseson the studies providing additional arguments in favour of modern efficacious methods for the management of DFS. The review is intended to motivateclinicians and health officials to revise current approaches to the treatment of DFS patients in this country.
Markers of apoptosis in patients with type 1 diabetes mellitus at the onset of the disease
Authors: Pekareva Elena Vladimirovna , Nikonova Tatiana Vasil'evna , Gorelysheva Vera Anatol'evna , Zvereva Yana Stanislavovna , Stepanova Svetlana Mikhailovna , Prokof'ev Sergey Alexandrovich , Smirnova Olga Mikhailovna
Published: November 2013

Aim. This work was to study activation markers of apoptosis (CD95, CD95L) on peripheral blood lymphocytes of patients with type 1 diabetes mellitus (DM1) at the onset of the disease. Materials and methods. A total of 33 patients (25 men and 8 women) divided into 2 groups were available for biochemical, genetic, and immunological examination. Results. Those with the ?classical? onset of DM1 had significantly fewer CD95-expressing lymphocytes and more CD95L+ lymphocytes than control subjects. Carriers of genes responsible for high risk of DM1 showed especially large number of lymphocytes expressing CD95L. Conclusion. It is conjectured that DM1 is characterized by the suppression of mechanism controlling apoptosis of activated lymphocytes that may promote prolongation of the immune response.
Necrobiosis lipoidica in diabetic patients: pathogenetic and clinical features
Authors: Semenova Daria Alexandrovna , Tokmakova Alla Yur'evna
Published: November 2013

Necrobiosis lipoidica (NL) is a chronic skin disease (dermatosis) associated with various metabolic disorders including carbohydrate metabolism.In the last years, NL has been increasingly frequently diagnosed by practitioners probably due to the rise in type 2 diabetes mellitus morbidity in thegeneral population. Moreover, association of NL with autoimmune thyroid diseases, Crohns disease, ulcerative colitis, sarcoidosis, and vitiligo hasbeen documented. Such cases may be attributed to phenotypic and functional defects of cellular immunity.
The efficacy of therapy with DPP-4 inhibitors combined with insulin in patients with type 2 diabetes mellitus
Authors: Ametov Alexander Sergeevich , Karpova Ekaterina Vladimirovna
Published: November 2013

Recently, researchers started to pay increasingly more attention to the role of gastrointestinal hormones in regulation of insulin secretion, i.e. glucosehomeostasis. To-day, there are two approaches to the treatment of DM based on the use of GLP-1 effects. One takes advantage of DPP-4 inhibitorsthe other is combination of these agents with various drugs necessitated by heterogeneity of pathophysiological factors responsible for the developmentof DM2. The latter approach ensures multiple therapeutic effects on DM2 and its complications. Many on-going studies are focused on the use ofcombination of DPP-4 inhibitors and insulin. Vildagliptin (Galvus, Novartis Pharma, Switzerland) is presently the sole DPP-4 inhibitor approvedfor application with insulin in Russia.Aim. To estimate the efficacy and safety of DPP-4 inhibitor combined with long-acting insulin in the treatment of DM2. Materials and methods. The study group included 18 patients (2 men and 16 women) with DM2 treated with long-acting insulin (glargine, humulinNPH) for at least 3 months at a mean daily dose of 31.96?4.95 U. The age of the patients averaged 59.9?2.84 years (46-75), DM2 duration8.9?1.18 years (2-15). Parameters of comprehensive glycemic control (FG, PPG, HbA1c, LMWH - low-molecular weight heparins CGM-continuousglucose monitoring) were measured using a CGMS system in the beginning and end of the study. Functional activity of pancreatic betbeta-cells and insulinresistance (HOMA-IR), lipid metabolism, and anthropometric characteristics were estimated. Results. Combined therapy resulted in positive dynamics of carbohydrate metabolism within 12 weeks after onset. The functional activity of pancreaticbetbeta-cells significantly (by 157.96 U) improved by the end of the study. Changes of HOMA-IR were insignificant. CGM showed that prescription ofvildagliptin to the patients who failed to reach compensation of DM2 with long-acting insulin alone significantly improved glycemic control. Variabilityof glycemia remained unaltered during the entire period. Conclusion. Combined therapy of DM2 patients with vildagliptin and long-acting insulin for 12 weeks improved parameters of carbohydrate metabolismwithout hypoglycemic episodes changes, in fluctuation amplitude and body weight. The functional activity of pancreatic betbeta-cells was likewiseimproved.
Leading causes of death and concomitant pathology in patients with type 2 diabetes mellitus according to autopsy data
Authors: Terekhova Anna Leont'evna , Zilov Aleksey Vadimovich , Vertkin Arkadiy L'vovich , Mel'nichenko Galina Afanas'evna
Published: November 2013

Aims. The aim of this study was to estimate the prevalence rate of concomitant pathology and its influence on leading causes of death in patients withtype 2 diabetes mellitus according to clinical charts and pathologist's reports. Materials and methods. We have studied the database of Moscow City Hospital №50 in order to pick out confirmed cases of type 2 DM, treated inthe period from 2006 to 2008 years (302 patients, 9,97%). Prevalence rate of concomitant pathology and leading causes of death were then carefullystudied on this ground. Results. We examined clinical charts of 302 patients with type 2 DM - 219 female (72.5%) at the age of 76 [70;80] and 83 male at theage of 75 [68;80]. Cardiovascular pathology and cerebrovascular disease (acute cerebrovascular event and/or postinfarction encephalic cysts,discirculatory encephalopathy) (50.66%) showed high prevalence. Respiratory system diseases (25.8%), excessive body weight and obesity (21.5%),gallstone disease (19.86%), malignant neoplasm (16.2%), prostatic hyperplasia (found in 35 male patients, 42.17%), gynecologic pathology (foundin 23 female patients, 10.5%) and infectious inflammatory diseases of kidneys and urinary tract (8.6%) were also disclosed. Leading causes of deathwere found to be acute cerebrovascular events (28.8%), postinfarction cardiosclerosis (23.18%), acute/recurring myocardium infarction (19.54%)and malignant neoplasm (14.57%). High polypathy prevalence was discovered in studied cohort, and in one third of cases patients perished fromcombination of concurrent diseases.Conclusion: High prevalence rate of intercurrent diseases and polymorbidity in patients with type 2 diabetes mellitus substantiate the need for thoroughexamination at different stages of medical care, treatment of existing malfunctions, as well as preventive measures against complications.
Insulin resistance and its possible personal stress moderators
Authors: Motovilin Oleg G. , Surkova Elena V. , Mayorov Alexander Y. , Koksharova Ekaterina O. , Melnikova Olga G.
Published: November 2013

Background. Recently, insulin resistance (IR) has been actively investigated by experts in various fields. Here we aim to study the effect of stress on the development of IR.
Objective. To study the associations between IR and personal stress moderators (self-attitude, locus of control and coping strategies) as well as the related performance lifestyles.
Methods. The study included 63 patients (16 men; mean age, 48.2 11.7 years). Of these participants, 26 were diagnosed with type 2 diabetes mellitus, 10 with impaired glucose tolerance, 6 with impaired fasting glucose and 21 with normal glucose tolerance. The levels of HbA1c and IR ratio were determined using HOMA. Well-known psychological assessment questionnaires were used to assess the effect of personal stress moderators.
Results. There was a significant relationship between IR and personal stress moderators. A positive self-attitude was associated with a lower risk of IR (p 0.05), which can be explained by a decrease in the risk of developing stress. Assertive coping strategies were most pronounced in subjects with a low level of IR (p 0.05). Personal characteristics also determined an individuals lifestyle, which may have an impact on the increase in IR. There was an association between high levels of IR and unhealthy alimentary preferences (p 0.05). Such preferences were also associated with personal characteristics, such as external locus of control, less positive self-attitude and passive coping strategies (p 0.05). People with high IR rarely engage in a regular physical activity; there was a direct correlation between the frequency of physical activity and assertive coping strategies (p 0.01). Married participants had high levels of IR (p 0.05).
Conclusion. There were significant relationships between IR and personal stress moderators, such as self-attitude and coping strategies. Besides the direct effects on stress levels, personality traits may also indirectly increase the risk of IR by influencing the individuals lifestyle. There is a need to investigate the fact that married people have higher levels of IR.
Epidemiological aspects of type 2 diabetes in the young
Authors: Suplotova Lyudmila Alexandrovna , Bel'chikova Larisa Nikolaevna , Rozhnova Nadezhda Alexandrovna
Published: November 2013

Aim. To study prevalence and incidence of type 2 diabetes in the young population of Tyumen region. Materials and methods. The study included 201 adult patient with type 2 diabetes mellitus (DM). The first group included 99 patients with disease onset before 35 years, while the second group included 102 patients with disease onset after 40 years. We have used a Tyumen regional diabetes register data, covering last 10 years period. We assessed the prevalence and incidence of type 2 DM and its vascular complications. Results. The prevalence of type 2 DM in patients with disease manifest before 35 years increased by 2,7 times and the incidence ? by 2,1 times during last 10 years. We noted predominance of retinopathy and nephroopthy in the structure of vascular complications in this group. Conclusion. Patients with type 2 DM onset before 35 years are characterized by increasing prevalence and incidence during last 10 years, as well as rapid development of late diabetic complications with a predominance of microangiopathy.
Arrhythmogenic effects of hypoglycemia
Authors: Laptev Dmitriy Nikitich , Shmushkovich Irina Anatol'evna
Published: November 2013

Hypoglycemia is a frequent event in patients on insulin therapy. Current clinical and experimental evidence shows hypoglycemia tobe a cause of arrhythmia and, possibly, a link to increased mortality risk in patients with diabetes mellitus. This review addressesprobable mechanisms and pathogenic factors of arrhythmia development due to hypoglycemic events. We adduce data accumulatedon rates of hypoglycemia, as well as their correlation with cardiovascular and general mortality according to ACCORD, ADVANCEand VADT trials.
Insulin pump therapy in type 1 diabetes mellitus: education effectiveness and quality of life
Authors: Ibragimova Lyudmila Ibragimovna , Filippov Yury Ivanovich , Mayorov Alexander Yur'evich
Published: November 2013

Aim. To compare efficacy of special structured program for type 1 diabetes mellitus (DM) group education between users of an integratedreal-time (RT) continuous glucose monitoring (CGM)/continuous subcutaneous insulin infusion (CSII) systems and patientson CSII and self-monitoring of blood glucose (SMBG).Methods. This 4 months trial included 39 adults (18 male, age 27 [24,0;35,0] years) with type 1 DM (duration of diabetes 12[8,0;18,0] years). All subjects were randomized to study groups: 20 in the CSII/SMBG arm and 19 in the RT-CGM/CSII arm. Allparticipants were provided with special structured program for group education of diabetes patients on insulin pump therapy. Qualityof life (QoL) was assessed with questionnaire SF-36. Results. Both groups were not significantly different in HbA1c, BMI and QoL at baseline. After 4 months HbA1c was significantly lowerin both study groups without increase in rate of hypoglycemia. Improvements in QoL were observed in psychic health score in the CSII/SMBG arm and in physical health and psychic health scores in the RT-CGM/CSII arm. There was no significant difference in HbA1c,BMI and QoL between groups. Conclusion. Transfer to CSII during group training under special structured program for patients with type 1 DM significantly improvesglycemic control regardless of glucose monitoring method. Both RT-CGM+CSII and SMBG+CSII amend several aspects of QoL.Finally, transfer to CSII during group training considerably reduces total consumption of trainers time without loss of training quality.
Age-related hypogonadism in men with metabolic syndrome
Authors: Tishova Yulia Alexandrovna , Mskhalaya Georgy Zhiulievich , Kalinchenko Svetlana Yur'evna
Published: November 2013

Aim. To elucidate the relationship between testosterone and SSBG levels in men with age-related hypogonadism and metabolic syndrome. Materials and methods. The study included 125 men aged 30-80 years with a diagnosis of age-related hypogonadism. In all the cases, testosterone(T) and SSBG levels were determined, free T fraction calculated, and waist circumference measured. Almost half of the patients (n=56) presentedwith metabolic syndrome (MS) and underwent measurement of basal immunoreactive insulin (IRI). Results. Mean age of the patients (n=125) was 54 [46; 65] years, waist circumference 108 [102; 115] cm, total T 8.3 [5.9; 11] nmol/l (norm 12 -33.5), free T 140 [99.6; 184] pmol/l (norm