bluuebunny/crossref_metadata_2025 huggingface dataset:
Specific features of the establishment of puberty in girls with type 1 diabetes mellitus and related disturbances of menstrualand ovarian functions
Authors: Grigoryan Olga Rafael'evna , Okhotnikova Anna Alexandrovna , Andreeva Elena Nikolaevna
Published: November 2013

Type 1 diabetes mellitus (DM1) exerts negative impact on the formation and functioning of the reproductive system in young girls. The time of onset(especially in the prepubertal period) and duration of DM1 as well as the lack of metabolic control may cause delay of puberty, affect the age of menarche,and increase the frequency of menstrual disturbances (largely in the form oligo- and amenorrhoea). Despite extensive research devoted to thisproblem, the main cause of reproductive dysfunction in such patients remains unclear even though DM1 is known to negatively affect performanceof the hypothalamo-pituitary axis. Pathogenetic mechanisms behind reproductive disturbances include suppression of GnRH pulses due to enhancedcentral dopamine and opiate activity, decreased expression of insulin receptors on neural cells, and altered plasma leptin level. Pituitary may be affectedboth by hypothalamic activity and by lipid free radical oxidation products decreasing production of tropic hormones (LH and FSH).
Carbohydrate metabolism in menopausal women
Authors: Grigoryan Olga Rafael'evna , Andreeva Elena Nikolaevna
Published: November 2013

Data on the worldwide prevalence of carbohydrate metabolism disturbances are reviewed. Pathogenesis of metabolic syndrome in menopausal women(menopausal metabolic syndrome) is considered, its clinical and laboratory characteristics are presented. Main therapeutic modalities (medicamenousand non-medicamentous) are discussed. Properties of the hypoglycemic drug metformin and indications to its use are described along with indicationsand contraindications to substitution hormonal therapy in women with metabolic disturbances
The role of compensation of carbohydrate metabolism in pregnant women with type 1 diabetes mellitus in the development of perinatal complications
Authors: Esayan Roza Mikhailovna , Grigoryan Olga Rafael'evna , Pekareva Elena Vladimirovna
Published: November 2013

With DM1 morbidity reaching epidemic growth in young people including women of childbearing age, planning and managing pregnancy in patientswith disturbances of carbohydrate metabolism acquires increasingly greater significance. Of primary importance are evening mutual influence of DM1and pregnancy (a high-risk condition) and prevention of perinatal complications resulting from poor compensation of carbohydrate metabolism.
Specific features of pregnancy in patients with type 1 diabetes in the prepubertal period. Results of a 15-year long clinical observation
Authors: Bolotskaya Lyubov' Leonidovna , Efremova Natalya Vladimirovna , Suntsov Yury Ivanovich
Published: November 2013

Aim. To evaluate effect of different factors on pregnancy course in patients with type 1 diabetes mellitus developing in the prepubertal period. Materials and methods. The study based at Endocrinological Research Centre included 77 women with prepubertal diabetes 18 of whom developedpregnancy that ended in delivery. Results. As per 2009, the age of the patients is 26,6?4,6 years. They became pregnant at 23,2?3,3 years and had had diabetes since the age of9,6?4,8 years. Their HbA1c level before and after pregnancy was 8,6?1,4 and 6,8?1,6% respectively, the difference being insignificant (p=0,3).Significant difference was documented between these HbA1c levels and that during pregnancy (p=0,0004 and 0.003 respectively). Nine (56,2%) patientsused ultrashort-acting insulin analogs and the remaining 7 (43,7%) recombinant human insulins. The mean insulin dose was 43,7?11 U/din the 1st trimester, 51,8?13,7 U/d in the 2bd trimester, and 45,3?10,8 U/d after delivery. 16 (88%) of the patients reported frequent hypoglycemia,five (27,8%) of them had episodes of severe daytime and nocturnal hypoglycemia. 11 (61%) developed microvascular diabetic complications beforepregnancy, with 9 (50%) having DR and 4 (22,2%) DN (microalbuminuria). The delivery occurred on weeks 36-37 in 7 (38,9%) women. Naturaland cesarean section deliveries took place in one and 17 (94,4%) patients respectively. Conclusion. Long-term follow-up of patients wit DM1 in accordance with algorithms of specialized medical aid to DM1 patients in Russia at a multidisciplinaryendocrinological centre decreases the risk of pregnancy and delivery complications and that of microvascular diabetic complications
Control of type 2 diabetes mellitus: problems and prospects for their solution
Authors: Romantsova Tatiana Ivanovna , Glinkina Irina Vladimirovna
Published: November 2013

Important medico-social and economic implications of type 2 diabetes mellitus (DM2) are determined by its continuously growing prevalence, frequencyand severity of complications related to inadequate glycemic control. Large-scale studies (UKPDS, VADT, ACCORD, ADVANCE) havedemonstrated controversial effect of intensive glycemic control (estimated from HbA1c dynamics) on diabetic macrovascular complication. At thesame time, epidemiological, experimental, and observational studies yielded conclusive evidence of postprandial glycemia (PPG) contribution tooverall glycemic control and its role in the development of macrovascular complications. For this reason, PPG control is currently given as much attentionas traditional parameters (HbA1c and fasting glycemia). Dipeptidyl peptidase-IV (DPP-IV) inhibitors are a new class of hypoglycemic agentsthat raise levels of incretins, glucagons-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) in blood by suppressing DPPIVactivity. The resulting recovery of physiological insulin secretion promotes reduction of fasting and postprandial glycemia and HbA1c level.
Diagnosis of diabetic autonomous cardioneuropathy in patients with type 1 diabetes mellitus
Authors: Valeeva Farida Vadutovna , Shaydullina Maria Rustemovna
Published: November 2013

Autonomous cardiac neuropathy is a diabetic complication characterized by early disseminated sympathetic and parasympathetic small-fiber neuronaldegeneration. Prevalence, pathogenesis, risk factors, clinical manifestations, and early diagnosis of pathology are discussed.
Factors of tubulointerstitial lesions in diabetic kidneys
Authors: Shamkhalova Minara Shamkhalovna , Kurumova Kseniya Olegovna , Shestakova Marina Vladimirovna
Published: November 2013

As the number of cases with classical manifestations of diabetic nephropathy (DN), i.e. nodular or diffuse glomerulosclerosis, grows, an increasinglylarger number of DM patients especially those with DM2 present with renal pathology largely affecting interstitium and tubules (ischemic nephropathy,urinary infection, interstitial nephritis, etc.). The rate of renal filtration impairment in glomerular diseases (DN, glomerulonephritis) is also relatedto the severity of tubulointerstitial fibrosis (TIF). Intricate intercellular interactions activated by immune and non-immune factors have been shownto play an important role in the development of tubulointerstitial lesions. Studies of the most important factors contributing to remodeling tubulointerstitiumin DM patients may provide a deeper insight into the mechanisms of nephrosclerosis and extend possibilities for prognostication of renalfunction.
IMPROVE observational program: safety and effectiveness of biphasic insulin aspart 30 in routine clinical practice. Overview of starting characteristics of the Russian patient cohort
Authors: Shestakova Marina Vladimirovna , Ballan Akill
Published: November 2013

AIM: To analyse starting characteristics of the Russian patient cohort included in the IMPROVE observational program with reference to its demographiccomposition and clinical features of the disease in patients allocated to different groups depending on previous treatment, reason for prescribing DiAsp 30 (NovoMix 30) therapy, and its initial dosage regime.

METHODS:The analysis covered the cohort of Russian patients included in the IMPROVE global program, an open non-randomizedobservational multicentre study of safety and effectiveness of insulin DiAsp for patients with DM2 during 26 weeks of routine clinical practice. In thepreceding period, the patients (n=4869) received either oral hypoglycemic agents (OHAs) (n=2430) or insulin +/- OHAs (n=2343); the controlgroup was comprised of 95 patients given no previous antidiabetic treatment.

RESULTS: Most patients had inadequate glycemic control prior to DiAsp therapy with the mean HbA1c level of 9,2%. Those given no previous antidiabetictreatment showed the highest HbA1c level (9,9%) and higher frequency of microvascular vs macrovascular complications (91 and 51% respectively).Patients that used the largest amount of antidiabetic agents developed the highest number of complications; this situation reflects therelationship between poor glycemic control and the risk of complications.

CONCLUSIONS: The Russian patient cohort is one of the three largest ones in the IMPROVE? global program. They reside in different geographic regions,have different history of antidiabetic treatment and far-from-normal HbA1c levels as a result of altogether poor glycemic control in Russian patientswith DM2. The cohort at large exhibits a suboptimal HbA1c level even though the majority of the patient have an access to antidiabetic therapy. Mostphysicians participating in the study refer to improved glycemic control in their DM2 patients (lowered HbA1c, fasting and postprandial glucose levels)as the main reason for the initiation of therapy with DiAsp 30 (NovoMix 30).
Russian Association of Endocrinologists expert consensus document on initiation and intensification of antyhyperglycaemic therapyin type 2 diabetes mellitus
Authors: Dedov Ivan Ivanovich , Shestakova Marina Vladimirovna , Ametov Alexander Sergeevich , Antsiferov Mikhail Borisovich , Galstyan Gagik Radikovich , Mayorov Alexander Yur'evich , Mkrtumyan Ashot Musaelovich , Petunina Nina Alexandrovna , Sukhareva Olga Yur'evna
Published: November 2013

Current consensus proposes a differentiated algorithm of initiation and intensification of antihyperglycaemic therapy in treatment patients withtype 2 diabetes mellitus. Patient-centered approach is considered a priority at any stage of diabetes care, as it ensures efficiency and safety of treatment.This document formulates guidelines for setting adequate therapeutic goals depending on vascular complications, age, life expectancy and riskof hypoglycemic events. Therapeutic options are stratified with regard to initial HbA1c level. This Algorithm considers all classes of antidiabetic medicationsregistered in Russian Federation, rational and irrational combinations of drugs as well as contraindications.
Role of plasminogen activator inhibitor and free fatty acids in diagnosis of insulin resistance in patients with myocardial infarction
Authors: Gruzdeva Olga Viktorovna , Barbarash Olga Leonidovna , Akbasheva Olga Evgen'evna , Fedorova Tatiana Sergeevna , Palicheva Elena Ivanovna , Kashtalap Vasiliy Vasil'evich , Dyleva Yulia Alexandrovna , Silonova Anna Alexandrovna , Sionina Ekaterina Vladimirovna , Uchasova Evgenia Gennad'evna
Published: November 2013

Aim. Evaluation of the dynamics of the markers of insulin resistance in patients with myocardial infarction with ST-segment elevation with andwithout type 2 diabetes mellitus in the acute and early recovery period of the disease. Materials and methods. The study included 95 patients with myocardial infarction and 60 patients with myocardial infarction and type 2 diabetes.The control group consisted of 30 persons. We all studied at 1 st and 12 th day of myocardial infarction was determined by the content of free fattyacids, glucose, C-peptide, insulin in serum and plasminogen activator inhibitor in blood plasma. In addition, the 12 th day was determined postprandialglycemic, insulin and C-peptide 2h after a standard carbohydrate breakfast. Results. It is established that during myocardial infarction accompanied by the development of insulin resistance, characterized by postprandialglycemia and insulinemia, as well as the presence of elevated levels of free fatty acids, plasminogen activator inhibitor. Conclusion. The definition of metabolic markers of insulin resistance may be of great predictive capacity for assessing the risk of both acute coronaryevents and select tactics to further treatment
Experience with the treatment of diabetic foot syndrome in Barnaul
Authors: Zaplavnova Oksana Dmitrievna , Shaydurova Olga Semenovna , Pantyukov Dmitriy Anatol'evich , Chernenko Vladimir Viktorovich , Litvinov Ergey Vladimirovich
Published: November 2013

The interdisciplinary service organized in the city of Barnaul provides care for patients with diabetic foot syndrome (DFS) including regular medicalexamination, diagnostics, treatment, and prophylactic measures to prevent new lesions and amputations. The service is based on the DiabeticFoot Cabinet of City Hospital No 5, Department of Wound Infections of City Hospital No 3, and Barnaul Prosthetics and Orthopedics Company,a manufacturer of prostheses and orthopedic devices for patients with DFS. These organizations have just begun cooperation with the Departmentsof Vascular Surgery of City Hospital No 5 and Regional Clinical Hospital aimed to perform vascular reconstructive surgery. The joint efforts areexpected to ensure long-term observation of the patients, their education in podiatric self-care, and introduction of the total contact cast method foroff-loading the foot at the stage of ulcer formation with the ultimate purpose of reducing it by 45-75%. Almost 3000 patients (10,000 visits) have beenexamined by specialist of Diabetic Foot Cabinet since 2005; most of them were referred to the group of high and very high risk of foot ulceration. Thenumber of patients with DFS hospitalized for the treatment of wound infections decreased from 263 in 2005 to 122 in 2010 despite a rise in overalldiabetes morbidity among the population of Barnaul. During the same period, the total number of amputations decreased from 269 to 64 and thenumber of high-level amputations from 119 to 3. The number of amputations in the patients regularly visiting the Cabinet is much lower than in thegeneral population and continues to decrease (4.7% in 2008 and 1.6% in 2010). 23% of the patients with DFS referred to the Cabinet underwentamputation in 2008 compared with 11% in 2010. In 2010, savings to the Altai region budget in direct medical expenditures for the patients with DFSamounted to 41,000,000 rubles (exclusive of management and drug costs and social benefits). The total savings to the budget in direct expendituresfor the hospital-based treatment of such patients during the last 3 years are estimated at more than 108,000,000 rubles.
Urinary excretion of type IV collagen as an early marker of renal fibrosis in patients with diabetes mellitus
Authors: Bondar' Irina Arkad'evna , Klimontov Vadim Valer'evich , Parfent'eva Ekaterina Mikhailovna , Romanov Vyacheslav Vital'evich , Nadeev Alexander Petrovich
Published: November 2013

Aim. To determine the diagnostic value of urinary excretion of type IV collagen in patients with type 1 diabetes with different stages of nephropathy.Methods. Urinary type IV collagen was determined in 60 patients with type 1 diabetes (23 with normal albuminuria, 28 with microalbuminuriaand 9 with macroalbuminuria) by an enzyme immunoassay. 10 healthy individuals were acted as the control group. Renal biopsy was performedin 22 patients. Deposits of type IV collagen were revealed by 11 individuals by immunohistochemistry. Results. The urinary excretion of type IV collagen increased with severety of diabetic nephropathy, correlating with the urinary albumin/creatinineratio, serum creatinine and parameters of daytime and nighttime systolic and diastolic blood pressure. Patients with excessive accumulation of typeIV collagen in the glomeruli had significantly higher level of type IV collagen in the urine. Conclusion. The determination of urinary type IV collagen can be used for early detection of renal fibrosis in patients with type 1 diabetes.
First GLP-1 analog liraglutide: the result of clinical trails on efficacy
Authors: Ametov Alexander Sergeevich , Kamynina Lyudmila Leonidovna
Published: November 2013

This review analytically considers the results of clinical trials on efficacy and safety and clinical perspectives of GLP-1 analog liraglutide
Pancreatogenic diabetes mellitus: incidence and detection rate analysis
Authors: Kunitsyna Marina Alekseevna , Kashkina Elena Igorevna
Published: November 2013

Aims. The article addresses incidence and causes of belated diagnostics of pancreatogenic diabetes mellitus (DM). Materials and methods. In 367 patients with chronic biliary or alcoholic pancreatitis (CP) glycemia and glycated hemoglobin HbA1c levels were testedin order to detect a metabolic disorder (DM or impaired glucose tolerance). Results. We observed positive correlation between duration of CP (1 to 10 years) and incidence of DM, with the latter being 3 to 5 times greater inpatients with 10 years of CP experience. During remission period 44,8% of patients were not aware of development of DM. In more than 80% ofpatients CP was diagnosed during admission for exacerbation of DM. Conclusion. Low detection rates of pancreatogenic DM is largely due to insufficient risk awareness of patients as well as inadequate attention of medicalpractitioners to the problem of CP and DM comorbidity.
Priority areas in management of diabetes mellitus type 1 & 2 (following 47th EASD Annual Meeting)
Authors: Yarek-Martynova Ivona Renata , Bolotskaya Lyubov' Leonidovna
Published: November 2013

Individualization of treatment goals is a modern trend in diabetology. During 47th Annual Meeting of European Association for the Study of Diabetesthis very problem was addressed repeatedly. The Sanofi Satellite Symposium under the name A step towards individualizing care to achieve earlyand sustained glycemic control presented lectures of worlds leading experts, giving priority to the problem of early diagnosis and early interventionfor individuals with T2DM, as well as potential benefits of early insulinisation, significance of adequate self-monitoring and pharmacoeconomicaspects of diabetes care.
Tauopathy and cognitive impairment in experimental diabetes mellitus
Authors: Matveeva Mariia V. , SamoiIova Yulia G. , Zhukova Natalia G. , Oleynik Oksana A. , Rotkank Maria A.
Published: November 2013

Currently, diabetes mellitus (DM) is the most common metabolic disorder, which is manifested by hyperglycemia and leads to vascular and cognitive impairment. Mechanisms of cognitive dysfunction in patients with DM remain highly unclear, thus complicating the search for effective strategies for the prevention and treatment of dementia. Recently, scientists have discussed the issues regarding the relationship between DM and Alzheimers disease (AD), such as risk factors that trigger the cascade of pathological reactions. Patients with DM show an increased risk of developing AD. Similarly, patients with AD have been shown to have impaired insulin and glucose metabolism. Both these diseases have common nosology, pathology and biochemical basics, including oxidative stress, formation of advanced glycation end products, dysregulation of glucose metabolism and altered insulin signaling pathways. The microtubule-associated tau protein is involved in one of the causative mechanisms underlying the development of AD. We provide an overview of the major domestic and foreign data analyses regarding tau protein and the development of cognitive disorders in experimental DM.
Stratification of patients with type 2 diabetes mellitus for painless ischemic heart disease
Authors: Volkova Natalya Ivanovna , Kharakhashyan Andrey Vladimirovich , Sorokina Yulia Alekseevna , Davidenko Il'ya Yur'evich
Published: November 2013

Aims. Development of assessment model for type 2 diabetes mellitus (DM) patient stratification for painless ischemic heart disease(IHD). Materials and methods. 258 patients with DM type 2 participated in this study (109 male and 149 female) of mean age 58.4?8.5 withDM experience of 7.9?6.1 years. All participants were subdivided into three groups: first - DM type 2 without history of painless IHD(138 individuals); second - DM type 2 with diagnosed painless IHD (50 individuals); third - DM type 2 with painful myocardialischemia. We assessed "classic" risk factors for IHD, immediately connected with DM comorbidity, as well as "additional" risk factors,potentially capable of provoking both painless and painful IHD. In addition, we screened our patients for structural abnormalitiesof heart by means of echocardiography. Painless IHD was diagnosed by treadmill-tests or Holter monitoring with submaximal exercise.Accumulated data was statistically processed with the use of Spearman's rank correlation, as well as binary logistic regression method.Results were deemed statistically significant at р
Endothelial dysfunction in development of cerebrovascular disorders in patients with diabetes mellitus
Authors: Kosobyan Evgenia Pavlovna , Yarek-Martynova Ivona Renata , Martynov Mikhail Yur'evich , Yasamanova Alla Nikolaevna , Kolesnikova Tatiana Ivanovna
Published: November 2013

Endothelial dysfunction and aberrations of haemostasis play an important part in development of cerebrovascular disorders in patientswith diabetes mellitus. Such factors as hyper- and hypoglycemia, hyperinsulinism, insulin resistance and excessive weight affect progressionof microcirculation deficiency and cerebral ischemia. Transcranial Doppler ultrasound examination is useful as a noninvasivemethod of hemodynamic assessment.
Prevalence of combined atherosclerotic vascular lesions in patients with diabetes mellitus
Authors: Gracheva Svetlana Alexandrovna , Klefortova Inna Igorevna , Shamkhalova Minara Shamkhalovna
Published: November 2013

During latest decade, as threat of acute complications of diabetes mellitus was surmounted, cardiovascular complications became leadingcause of death. Clinical manifestation of coronary, brachiocephalic and renal atherosclerosis is quite dramatic in diabetes mellitus,which determines extent of dissemination and intensity of lesions. Combination of these mutually confounding conditions is a characteristicproblem of patients with diabetes mellitus. Presence of 2+ risk factors (one of which is diabetes mellitus in itself) requiresactive examination in order to rule out coronary, brachiocephalic, peripheral and renal artery lesions. Aggressive care is necessaryin order to control progression of disease and administer adequate conservative and endovascular treatment with account of high riskof combination of lesions.
Therapeutic training: past, present and future
Authors: Ametov Alexander Sergeevich , Valitov Bulat Iskandarovich , Chernikova Natalya Al'bertovna
Published: November 2013

Diabetes mellitus is a serious medical and social problem in many countries. Nowadays it is well known that most of therapeutic goalscan hardly be reached without patients willingness to take active part in the process of treatment. Thus therapeutic training in diabetesself-management is a necessity. Today different new options in the field of therapeutic education are developing rapidly. Amongthem are training via internet and other telecommunication systems, electronic diaries, various dose calculators, wizards and?simulators?. Many of such approaches show their clinical and economic effectiveness, thus indicating need for further developmentof this sphere.
Prevalence of type 2 diabetes mellitus and other abnormalities of carbohydrate metabolism depending on diagnostic criteria
Authors: Dreval' Alexander Vasil'evich , Misnikova Inna Vladimirovna , Barsukov Il'ya Alexeevich , Ponchakova Galina Vladimirovna , Kuznetsov Anatoliy Vasil'evich
Published: November 2013

Aim. To assess current criteria for type 2 diabetes mellitus. Materials and methods. This screening study involving 2,368 residents of two municipal districts of the Moscow region was designed to elucidate differencesin the prevalence of abnormalities of carbohydrate metabolism depending on diagnostic criteria (WHO and ADA). Results. The prevalence of early disorders of carbohydrate metabolism and DM2 among the adult population of Moscow region is 17,1 and 7,2 respectivelyusing WHO criteria and 40,0 and 5,9% by ADA criteria. Conclusion. Refusal to undergo OGTT during screening decreases detectability of early metabolic disorders by 28,8 and 6,1% using WHO and ADAcriteria respectively. When screening is aimed to diagnose DM2 alone, OGTT can be omitted in subjects with fasting plasma glucose level below4,7 mmol/l. If it is aimed to diagnose both DM2 and impaired glucose tolerance, OGTT is not needed in subjects with fasting plasma glucose levelbelow 4,2 mmol/l. The use of ?combined? diagnostic criteria (i.e. OGTT according to ADA, but not WHO) significantly increases the prevalence ofmetabolic disorders from 24,9 to 48,8%.
Onset of type 1 diabetes mellitus in a patient with infectious mononucleosis
Authors: Kharlashina Elena Alexandrovna , Shapoval'yants Olga Sergeevna , Pekareva Elena Vladimirovna , Nikonova Tatiana Vasil'evna
Published: November 2013

Diabetes mellitus (DM) is a polygenous multifactor disease that may be triggered by a viral infection that causes death of beta-cells by at least two mechanisms,virus-mediated autoimmunity and direct cell injury. A case of DM1 following infectious mononucleosis is described to illustrate the necessityof a combined approach to the examination of patients and prescription of treatment.
Myocardial revascularization in diabetic patients
Authors: Dedov Ivan Ivanovich , Terekhin Sergey Anatol'evich
Published: November 2013

Patients with diabetes mellitus (DM) are predisposed to diffuse and rapidly progressing forms of atherosclerosis which significantly increasesthe probabilityof surgical revascularization of myocardium. However, unique pathophysiological features of atherosclerosis in DM patients are responsiblefortheirunusual reaction to an arterial injury associated with percutaneous coronary intervention (PCI).Numerousstudies showed that DM is an independentrisk factor of restenosis following successful balloon angioplasty or stenting of coronary arteries and significantly increases the need forsecondary myocardial revascularization that compromises the outcome of the treatment.Preliminary data indicate that the use of drug-releasing stentsdecreases the need for repeat interventions in both diabetic and non-diabetic patients without negative effect on certain clinical end-points, such asmyocardial infarction and mortality. Any surgical intervention causes less pronouncedimprovement of the clinical picture or prognosis in patients withfunctional class I or II angina of effort compared with optimal medicamental therapy. Surgical revascularization, PCI and aortocoronary bypasssurgery (ACB) is indicated to patients that remain symptomatic despite adequate conservative therapy. The choice of an optimal revascularizationstrategy is of primary importance for DM patients with multiple lesions in the coronary system. Randomized studies comparing multivascularPCI withballoon angioplasty and holometallic stents demonstrated the advantage of ACB for DM patients who showed a higher survival rate, lower frequencyof infarctions and secondary revascularization. Certain authors demonstrated that ACB surpasses PCI even when drug-releasing stents are used.It may be hoped that the ongoing randomized studies comparing the two modalities will help to develop the optimal strategy for myocardial revascularizationindiabetic patients.
International guidelines on the study of glycated hemoglobin HbA1c level as a diagnostic criterion for diabetes mellitus and otherdisorders of carbohydrate metabolism
Authors: Galstyan Gagik Radikovich
Published: November 2013

Type 2 diabetes mellitus is rising at an epidemic scale throughout the world. Up to a certain moment, DM2 develops as a latent pathology which accounts for its late diagnosis and onset of therapy. Hence, the high frequency of vascular complications, early disablement and mortality. Therefore, the improvement of screening studies is of primary importance for the detection of metabolic disorders. At present, HbA1c determination is the most informative and cost-effective tool for the purpose. The choice of the method for measuring HbA1c is a paramount consideration. It must be standardized against a reference technique (high performance liquid chromatography) in conformity with the results of DCCT and UKPDS studies
The experience with the use of insulin pump therapy in children and adolescents with type 1 diabetes mellitus
Authors: Bolotova Nina Viktorovna , Kompaniets Olga Viktorovna , Filina Natalya Yur'evna , Polyakov Vadim Konstantinovich
Published: November 2013

Aim. To evaluate the importance of insulin pump therapy for the achievement of DM1 compensation in children of different age. Materials and methods. The study included 36 patients aged 5-18 years with DM1. Efficiency of insulin pump therapy was assessed from the resultsof clinical and metabolic monitoring; the data obtained were treated with the use of the Statistica 6.0 program. Results. The use of insulin pump therapy permits to achieve compensation of carbohydrate metabolism in children and adolescents with type 1 diabetesby modeling therapeutic schemes for individual patients. The basal regime of insulin administration at a minimal rate is indicated to young childrentaking into account their generally low background requirement for insulin. Adolescents need a stepwise regime of insulin delivery with an increasedrate of administration inearly morning and evening hours. Conclusion. The continuous regime of subcutaneous insulinadministration ensures the freedom of choice of the character of physical activity and simplifiescontrol of diabetes in children and adolescents engaged in sports activities.
Allele variants of HLA II genes DRB1 and DQB1 regarding risk for type 1 diabetes mellitus in population of Bashkortostan
Authors: Avzaletdinova Diana Shamilevna , Morugova Tatiana Vyacheslavovna , Mustafina Olga Evgen'evna
Published: November 2013

Aims. To estimate significance of HLA II DRB1 and DRB2 allele variants for development of type 1 diabetes mellitus (T1DM) in Bashkortostanpopulation (ethnical Russians, Tatar, Bashkir). Materials and methods. We analyzed DNA of 323 patients with T1DM and 683 healthy controls. DNA was derived from venous bloodsamples by phenol-chloroform extraction. DRB1 and DQB1 gene typing was performed by PCR method. Amplification products wereidentified with electrophoresis on a 1% agarose gel. Statistica for Windows v6.0 and MS Excel 98 software were applied for statisticalprocessing of acquired data. Results. Common markers of high risk for T1DM were found to be DRB1*04, DRB1*17, genotype DRB1*04/*17. On the contrary,lower risk was associated with DRB1*15 allele. In ethnical Russians lower risk of T1DM is also determined by DRB1*11 allele andDRB1*01 in Tatars. Predisposition by DQB1-alleles in Russians and Bashkir realizes only within DRB1*04/*17 genotype. However,in Tatar subpopulation DQB1*0302 is an independent risk marker of T1DM development. Conclusion. Common low risk markers for all three ethnic groups are DQB1*0301, DQB1*0602-08 alleles. Their presence negates riskof disease in all studied subpopulations even within DRB1*04/*17-genotype.
Ischaemic heart disease in patients with diabetes mellitus and critical lower limb ischemia
Authors: Melkozerov Konstantin Vladimirovich , Kalashnikov Victor Yur'evich , Terekhin Sergey Anatol'evich , Bondarenko Olga Nikolaevna
Published: November 2013

Aims. To assess prevalence of ischemic heart disease (IHD) and clinical features of asymptomatic IHD in patients with diabetes mellitus(DM) and critical lower limb ischemia (LLI).Materials and Methods. We examined 118 patients with DM, who underwent hospitalization for critical LLI. Besides routinecardiologic examination, all patients were subject to color duplex ultrasonography of lower limbs and CT contrast angiography. Patientswith proper indications underwent coronary angiography. Statistical data was processed with SPSS v17.0.0. software package. Results. We have found 58.5% of patients with DM and critical LLI to suffer from IHD - and approximately 40% to have myocardialinfarction in their medical history. According to acquired coronary angiograms, 89% of asymptomatic cases were characterized byhemodynamically significant stenosis, while 68.7% of them had either three arteries affected or left main coronary artery lesions. Conclusion. Patients with DM and critical LLI require thorough examination, as subclinical IHD may be masked in them by lowerlimb angiopathy.
Influence of intensive glycemic control on development and progression of diabetic nephropathy in patients with type 2 diabetes mellitus (based on results from ADVANCE study)
Authors: Klefortova Inna Igorevna
Published: November 2013

Current article presents data on effects of intensive glycemic control with Diabeton MR on development and progression of diabeticnephropathy in patients with type 2 diabetes mellitus (T2DM), accumulated from ADVANCE (Action in Diabetes and Vascular Disease:Preterax and DiamicroN Modified Release Controlled Evaluation study). Influence of intensive therapy with Diabeton MR wasassessed in that study separately and in conjunction with active antihypertensive treatment with perindopril and indapamide.
Izuchenie vliyaniya sulodeksida na endoteliy-zavisimuyu vazodilatatsiyu mozgovykh sosudov u zhivotnykhso streptozototsin-indutsirovannym sakharnym diabetom
Authors: Tyurenkov Ivan Nikolaevich , Voronkov Andrey Vladislavovich , Slietsans Anna Al'bertovna , Petrova Evgenia Viktorovna , Snigur Grigoriy Leonidovich
Published: November 2013

Aim. To analyse effects of sulodexide on endothelium-dependent vasodilation (EDVD) of brain vessels in animals with experimental diabetes mellitus. Materials and methods. The study was performed on 45 Wistar male rats (180-219 g b.w.) allocated to 3 equal groups. Group 1 served as control, group 2 included rats with DM given physiological saline, group 3 was comprised of animals with DM given sulodexide (30 LRU for 4 weeks). The endothelial dysfunction (ED) was simulated by inducing DM (single v/v injection of 50 mg/kg streptozotocin). A month later, the endothelium-dependent and independent vasodilation was tested by registration of circulation in brain vessels in the projection of the middle cerebral artery, determination of Pourcelot?s and Gosling?s indices before and after administration of 0.001 mg/kg acetylcholine (Acros organics, USA), 300 mg/kg L-arginine (Acros organics, USA), 0.007 mg/kg nitroglycerin (MTKh, Moscow), 10 mg/kg nitro-L-arginine (Acros organics, USA). Samples for immunohistochemical analysis were prepared using antibodies against e-NOS and endothelin-1 (Novocastra TM) as recommended by the manufacturer. STATISTICA/w7.0 program for Windows (StatSoft Inc., USA) was used for basic statistical analysis of the results of all experiments. Results. Administration of acetylcholine to DM rats caused a much greater (2.58-fold) decrease of EDVD than in control animals whereas endothelium-independent vasodilation remained unaltered (following nitroglycerin administration); Pourcelot?s and Gosling?s indices significantly increased. DM rats given sulodexide showed lower Pourcelot?s and Gosling?s indices than untreated animals. Thus, impaired expression of antibodies against e-NOS and enhanced expression of anti-endothelin-1 antibodies (specific markers of endothelial disturbance) suggest development of ED in DM and endothelium protection by sulodexide that increases the eNOS level and decreases the endothelin-1 level thereby improving EDVD. Conclusion. Administration of sulodexide to DM rats increases the eNOS level and decreases the endothelin-1 level thereby improving EDVD.
New glance at pathogenesis of type 2 diabetes mellitus: incretin and antiincretin systems.
Authors: Shestakova Ekaterina Alekseevna
Published: November 2013

Type 2 diabetes mellitus (T2 DM) is often seen in patients with obesity. Bariatric surgery, aimed to decrease body weight, can often help those patientsto improve glycemic status. After some of bariatric operations patients reach normoglycemia in few days, the fact that cant be explained onlyby reduction in weight. Recent trials revealed that the reorganization of gastrointestinal tract provides hypoglycemic effect of such operations. Thisarticle explains the role of proximal and distal gut in pathophysiology of T2 DM.
Disturbances of skin microcirculation in lower extremities in diabetes mellitus:a pathophysiological phenomenon or an object for therapy?
Authors: Bregovsky Vadim Borisovich , Karpova I A , Alekseeva E S
Published: November 2013

Functional microcirculatory abnormalities in the foot have been given much attention in the recent years for their potential pathogenetic role in thedevelopment of diabetic neuropathy and diabetic foot syndrome. This paper reviews data on the disturbances of skin microcirculation in lower extremitieswith reference to the role of neuropathy and endothelial dysfunction in this pathology. Possible relationships between end-stage renal disease, highplantar pressure and compromised skin microcirculation are discussed. The influence of several drugs on foot skin microcirculation and prospects fortheir use for therapeutic purposes are considered.
Pharmalogical effects and results of clinical trials of the first incretinomimetic exenatide
Authors: Ametov Alexander Sergeevich , Kamynina Lyudmila Leonidovna
Published: November 2013

The review is devoted to the pharmacological effects, the results of clinical trials, safety and the research perspectives of the first incretinomimetic exenatide
Glibenclamide - profile of efficacy and safety
Authors: Nedosugova Lyudmila Viktorovna
Published: November 2013

Glibenclemide is the most effective drug among oral hypoglycemic ones. The efficacy of this drug is determined by its unique chemical structure thatcontains sulfonylurea, not only ring, but also benzamid group in the side chain. This provides the maximum affinity for SUR 1 on the betbeta-cell ATP-dependentK+ channels and ability to associate with SUR 2A cells in the peripheral tissues such as cardiomyocytes, smooth muscle cells of the vascular walland adipocytes. However, this feature can increase the risk of hypoglycemic states and have a negative effect on the cardiovascular system. We considerdata from clinical studies proving the efficacy and safety of the drug, which were based on evidence of long-term observations, and which demonstratedreduced risk of vascular complications of diabetes, compatibility with drugs of other groups, and possibility to use in elderand multimorbid patients. Glibenclamidewas evaluated by prestigious H.G. Creutzfeldt Drug Prize in 2010. It is the only SCI listed essential medicine of the World Health Organization.
Pharmacoeconomic aspects of the use of sulfonylurea drugs in type 2 diabetes mellitus
Authors: Rudakova Alla Vsevolodovna
Published: November 2013

In Russia, sulfonylurea drugs are extensively prescribed to patients with type 2 diabetes mellitus. This work was designed to study pharmacoeconomicaspects of application of 2nd generation sulfonylureas based on the results of the GUIDE study comparing effects of therapy with gliclazide modifiedrelease (diabeton MV) and glimepiride (amaryl). The two drugs are known to be equally effective, but gliclazide creates a much smaller risk ofhypoglycemia than glymepiride. Cost-effectiveness analysis showed that the use of gliclazide cuts the costs of therapy by 40%. It is concluded that thechoice of gliclazide modified release is economically more feasible than glimepiride.
Epidemiology of diabetes mellitus and prognosis of its prevalence in the Russian Federation
Authors: Suntsov Yury Ivanovich , Bolotskaya Lyubov' Leonidovna , Maslova Oksana Vladimirovna , Kazakov Igor Vladislavovich
Published: November 2013

The prevalence of diabetes mellitus (DM) in this country as well as throughout the globe has reached epidemic proportions. The register of DM patientsand relevant epidemiological studies are important sources of objective information about epidemiological situation with respect to DM morbidity thatmay be used to predict the prevalence of DM and its complications. The results of a 5-year project and subsequent prospective studies suggest a risein the number of diabetic patients in Russia (3,163,300 as of 01.01.2010). It is expected to increase up to 5.81 mln within the next two decades althoughsome of the patients will never be registered. The actual prevalence of DM complications also exceeds the registered one; they are not diagnosedin 40-55% of the patients. Prospective studies revealed an increased number of DM1 patients with the HbA1c level
Atrial fibrillation: a new facet of diabetes mellitus in the XXI century
Authors: Aleksandrov Andrey Alexeevich , Yadrikhinskaya M N , Kukharenko Svetlana Semenovna
Published: November 2013

Congestive heart failure, diabetes mellitus, and ciliary arrhythmia are three epidemic cardiovascular conditions threatening the mankind in the XXIcentury. Ciliary arrhythmia is the commonest disturbance of cardiac rhythm characterized by inability of the atrium to maintain coordinated contractions.The importance of ciliary rrhythmia as a problem facing public heath services is underlain by its role as a risk factor of disturbed cerebralcirculation and severe cardiac insufficiency, the two most serious and costly cardiovascular complications influencing life expectancy of the affectedsubjects.
Long-term outcomes of ophthalmosurgery in diabetic patients
Authors: Lipatov Dmitriy Valentinovich , Bessmertnaya Elena Grigor'evna , Kuzmin Anatoliy Gennad'evich , Smirnova Nataliya Borisovna , Tolkacheva Anna Anatol'evna , Chistyakov Timofey Alexandrovich
Published: November 2013

Diabetes morbidity grows steadily despite recent progress in its diagnostics and treatment. Its most frequent complication is retinopathy although thereare increasingly more cases of diabetic cataract, secondary rubeous (neovascular) glaucoma, eyelid diseases, and transient impairment of vision.Aim To analyse late results of ophthalmosurgery in diabetic patients with vision problems.Materials and methods Over 24,000 patients were examined from January 2006 to November 2010 at the Department of Diabetic Retinopathyand Ophthalmosurgery, Endocrinological Research Centre. Results of more than 2660 seances of retinal laser coagulation and about 350 surgicalinterventions for diabetic cataract and secondary neovascular glaucoma were available for analysis.Conclusion Timely and correct application of retinal laser coagulation, modern facoemulsification of complicated cataract and drainage surgeryof uncompensated secondary rubeous glaucoma produces good functional results and permits to preserve or even improve visual acuity. The efficacyof surgical intervention is directly related to the quality of diabetes compensation and depends on the joint efforts of ophthalmologists, endocrinologists,and anesthesiologists.
Optical properties of unprotected and protected sputtered silver films: Surface morphology vs. UV/VIS reflectance
Authors: Jobst Paul Johannes , Stenzel Olaf , Schürmann Mark , Modsching Norbert , Yulin Sergiy , Wilbrandt Steffen , Gäbler Dieter , Kaiser Norbert , Tünnermann Andreas
Published: November 2013

The optical properties of opaque sputtered silver films are investigated and related to their surface morphology. As reference, an evaporated sample produced by thermal flash evaporation has been studied, too. Standard optical and electrical characterizations as well as scanning electron microscopy (SEM) and X-ray reflectometry have been carried out with unprotected silver films directly after deposition and reveal strong correlations between the corresponding characterization results. The aging behavior of the normal incidence reflectance has been studied over a time period of 36 weeks. Protected silver mirrors have been prepared by sputtering using silica and alumina as the protective coating. It is shown by model calculations that the main spectral features occurring in the reflectance spectra of as-deposited unprotected coatings, unprotected coatings after aging, and protected coatings can be reproduced assuming a rough silver surface covered by a corresponding ultrathin absorbing interface layer or overlayer.
The length metric on the set of orthogonal projections and
new estimates in the subspace perturbation problem
Authors: Makarov Konstantin A. , Seelmann Albrecht
Published: November 2013

We consider the problem of variation of spectral
subspaces for bounded linear self-adjoint operators in a Hilbert space. Using metric properties of the set of orthogonal
projections as a length space, we obtain a new estimate on the norm of the operator angle associated with two spectral subspaces for
isolated parts of the spectrum of the perturbed and unperturbed operators, respectively. In particular, recent results by
Kostrykin, Makarov and Motovilov from
[Proc. Amer. Math. Soc. 131, 3469–3476] and [Trans. Amer. Math. Soc. 359, 77–89] are strengthened.
Uniform bounds for bounded geodesic image theorems
Authors: Webb Richard C. H.
Published: November 2013

We give a universal bound for the bounded geodesic image theorem of Masur–Minsky. The proof uses elementary techniques.
We also give a universal bound for a stronger version of subsurface projection, this demonstrates good control over many standard subsurface projections simultaneously.
Ovariectomy lowers urine levels of unconjugated (+)-catechin, (–)-epicatechin, and their methylated metabolites in rats fed grape seed extract
Authors: Cutts John K. , Peavy Thomas R. , Moore Doyle R. , Prasain Jeevan , Barnes Stephen , Kim Helen
Published: November 2013

Steroid hormones modulate expression of enzymes that metabolize xenobiotics, including dietary supplements. Half of the human population undergoes menopause, yet the effect of this age-related loss of ovarian steroid hormones on the metabolism of dietary supplements has yet to be determined. Grape seed extract (GSE) is a dietary supplement comprised of monomeric and oligomeric catechins and has health benefits in models of age-related diseases. We hypothesized that surgically-induced loss of ovarian hormones would increase methylation, glucuronidation, and/or sulfation of the grape seed polyphenols (+)-catechin and (–)-epicatechin. Fourteen-week-old spontaneously hypertensive rats (SHRs) were ovariectomized (OVX) or sham-OVX. At 17 weeks of age, SHRs were gavaged with vehicle (water) or GSE (300 mg/kg body weight) once daily for 6 days. Urinary excretion of (+)-catechin, (–)-epicatechin, and their metabolites was analyzed by liquid chromatography-mass spectrometry. Although total urinary output of (+)-catechin, (–)-epicatechin, and their methylated metabolites was unaffected by OVX, the amounts of (+)-catechin, (–)-epicatechin and their methylated metabolites that were not conjugated with glucuronic acid or sulfate were lowered by OVX. Specifically, urine from OVX SHRs administered GSE contained 30% higher proportions (91.8% vs. 62.3%) of glucuronidated (+)-catechin and (–)-epicatechin and glucuronidated methyl (+)-catechin and methyl (–)-epicatechin than urine from sham-OVX SHRs. However, there were no differences in urinary levels of total methylated or sulfated catechins in OVX SHRs. This is the first quantitative characterization of metabolites of grape seed polyphenols in a model of menopause; it indicates that ovariectomy causes either an increase in expression and/or activity of select uridine 5′-diphospho-glucuronosyltransferase(s).