Metformin in prediabetes: key mechanisms for the prevention of diabetes and cardiometabolic risks

Today, prediabetes is regarded by the world medical community as early diabetes mellitus. The accumulated research evidence shows that prediabetes is characterized by a spectrum of complications that are similar to those of diabetes mellitus, which means that the deterioration of cardiovascular prognosis starts already at the stage of prediabetes. In the current timeframe, metformin is actually the only drug that is widely prescribed for the treatment of prediabetes to prevent type 2 diabetes mellitus and cardiovascular diseases associated with insulin resistance and hyperinsulinemia. Meanwhile, metabolically unhealthy obesity characterized by hyperinsulinemia and insulin resistance is associated with a significantly unfavourable course of prediabetes, as well as the highest risk of developing both type 2 diabetes mellitus and cardiovascular diseases, development/ progression of chronic kidney disease. The theme of this review is the priority of metformin for the management of the most prognostically unfavourable phenotypes of prediabetes. The review is also devoted to the description of the most significant mechanisms that provide effects of metformin underlying the management of key disorders that determine the unfavourable prognosis of prediabetes. In particular, it sets forth the role of unhealthy nutrition, its effects on the development of imbalance of the composition of gut microbiota, which, in turn, entails a cascade of metabolic disorders underlying the development of metabolic ill health. The review sets forth the key role of metformin as a drug that protects against the development of these disorders. The information presented in this review will be useful to personalize the choice of both the scope and nature of interventions in patients with different phenotypic characteristics

Efficacy of sibutramine in different types of eating behavior in obese patients

Introduction. One of the key factors contributing to the development and progression of obesity is impairment eating behavior (EB). Therefore, drug therapy for obesity should not only reduce hunger, contributing to weight loss, but also reducing the severity of EB disorders.Aim. Assess the representation of different types of EB in obese patients, the effect of sibutramine therapy on dynamics EB by The Dutch Eating Behavior Questionnaire (DEBQ) and for hunger/satiety on a visual analog scale (VAS). Quality life of patients, adherence to treatment of obese patients and their weight dynamics in different types of EB during therapy with sibutramine was also assessed.Materials and methods. The study included 36 obese patients (30 women and 6 men), mean age 38.7 ± 10.8 years, mean body weight 102.8 ± 16.4 kg, body mass index (BMI) 36.8 ± 4.6 kg/m2, receiving therapy with sibutramine at a dose of 10 mg per day once in the morning before meals in combination with hypocaloric nutrition.Results and discussion. The study showed the prevalence of the emotiogenic type of eating disorders in patients. However, it was pointed out that sibutramine therapy combined with hypocaloric nutrition proved its efficacy in any type of eating disorders. Positive dynamics anxiety/depression in subclinical conditions during treatment with sibutramine was also revealed.Conclusion. Sibutramine treatment may be recommended for the development of a new EB model in obese patients because it is effective in reducing weight in any type of EB disorder

Problems of blood glucose self-monitoring in patients with diabetes mellitus

Glycemic self-monitoring is essential in  the  treatment of  diabetes mellitus. Compliance with the  recommendations for  selfmonitoring of glycemia is an important condition for the prevention of diabetes complications. The article provides a review of the problems associated with blood glucose self-monitoring faced by diabetic patients and doctors. These include low frequency of blood glucose self-monitoring, technical errors in glucose measurements, errors in keeping a diary and errors in using measurement data to diabetes control. The blood glucose monitoring system, which includes the glucometer, test strips, application, сloud for data storage can be used for blood glucose self-monitoring in patients with diabetes mellitus. The article discusses the features and advantages of the blood glucose monitoring system. The advantages of the glucometer are the no сoding technology and the following options: аpplication of additional amount of blood to the test strip; adding meal marks, testing as the measurement results compare with targets and informing about it; storage a large number of measurement results. In addition to the standard blood glucose measurement, the glucose meter and the application offer many features to improve blood glucose self-monitoring that can help to improve diabetes management: automatic transferring measurement results to smartphone or tablet; saving notes in logbook; display of glucose trends and testing as they compare with targets; offering quick and valuable tips for critical high/low glucose values

О нормах разностных операторов Бомана — Шапиро

For given k ∈ N and h > 0, an exact inequality kW2k(f, h)kC ≤ Ck kfkC is considered on the space C = C(R) of continuous functions bounded on the real axis R = (−∞, ∞) for the Boman–Shapiro difference operator W2k(f, h)(x):= (−h1)k Z−hh (2kk)−1 ∆b 2tkf(x) ( 1 − |ht| ) dt, where ∆b 2tkf(x):= P (−1)j(2jk)f(x + jt − kt) is the 2k j=0 central finite difference of a function f of order 2k with step t. For each fixed k ∈ N, the exact constant Ck in the above inequality is the norm of the operator W2k(·, h) from C to C. It is proved that Ck is independent of h and increases in k. A simple method is proposed for the calculation of the constant C∗ = limk→∞ Ck = 2.6699263 . . . with accuracy 10−7. We also consider the problem of extending a continuous function f from the interval [−1, 1] to the axis R. For extensions gf := gf,k,h, k ∈ N, 0 < h < 1/(2k), of functions f ∈ C[−1, 1], we obtain new two-sided estimates for the exact constant Ck∗ in the inequality kW2k(gf, h)kC(R) ≤ Ck∗ ω2k(f, h), where ω2k(f, h) is the modulus of continuity of f of order 2k. Specifically, for any natural k ≥ 6 and any h ∈ (0, 1/(2k)), we prove the double inequality 5/12 ≤ Ck∗ < (2 + e−2) C∗. © 2020 Krasovskii Institute of Mathematics and Mechanics. All rights reserved.This work was supported by the Russian Foundation for Basic Research (project no. 18-01-00336) and by the Russian Academic Excellence Project (agreement no. 02.A03.21.0006 of August 27, 2013, between the Ministry of Education and Science of the Russian Federation and Ural Federal University), and as part of research conducted in the Ural Mathematical Center

Reflection of hydrogen and deuterium atoms from the beryllium, carbon, tungsten surfaces

Particle reflection coefficients for scattering of hydrogen and deuterium atoms from amorphous beryllium, carbon and tungsten were obtained, which are of interest for thermonuclear reactor physics. For the case of deuterium scattering from tungsten the data were also calculated for polycrystalline and crystalline target. The calculations were carried out by two methods: by modeling the trajectories of the incident particles and by using the binary collision approximation. Interaction potentials between hydrogen and helium atoms and the selected materials were calculated in the scope of the density function theory using program DMol for choosing wave functions. The dependence of the reflection coefficient RN on the potential well depth was found. The results demonstrate a good agreement with the available experimental values.Peer reviewe

Маркеры фиброза и эхокардиографические параметры у пациентов с сахарным диабетом 2-го типа в зависимости от уровня альбуминурии

Background. Diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM) is associated with a risk of developing chronic heart failure (CHF). The degree of albuminuria is a marker of DN and is associated with an increased risk of chronic heart failure (CHF).Aim. To evaluate fibrosis biomarkers and echocardiographic parameters in patients with T2DM without CHF, depending on urinary albumin excretion.Materials and methods. The study included 42 patients with T2DM without verified CHF. The patients were divided into two groups: 1) a group with normoalbuminuria and 2) a group with a moderate increase in albuminuria (albumin / creatinine ratio of 30–300 mg / g). Echocardiography was performed and galectin-3, ST-2, PIСP, MMP-9, and TIMP-1 concentrations were measured.Results. The groups did not differ by age, sex, body mass index (BMI), glycated hemoglobin (HbA1c), and glomerular filtration rate (GFR). Galectin-3 concentrations were significantly higher in the group with a moderate increase in albuminuria than in the group of patients without albuminuria – 13.6 (11.2; 15.1) ng / ml and 7.4 (6.7; 7.9) ng / ml, respectively, p = 0.002. The groups also did not differ in the values of biomarkers, such as P1CP, TIMP-1, and MMP-9. Besides, the group with normoalbuminuria had lower E/e’ values than the group with a moderate increase in albuminuria – 8 (7; 9) and 10 (9; 12.5), p = 0.02.Conclusion. The patients with type 2 diabetes and a moderate increase in albuminuria have higher values of galectin-3 and a more pronounced diastolic dysfunction. The identified changes may reflect a higher risk of chronic heart failure in this group of patients.Введение. Наличие диабетической нефропатии (ДН) у пациентов с сахарным диабетом 2-го типа (СД2) ассоциировано с риском развития хронической сердечной недостаточности (ХСН). Степень альбуминурии является маркером прогрессирования ДН и связана с повышенным риском ХСН.Цель. Оценка биомаркеров фиброза и эхокардиографических параметров у пациентов с СД2 без ХСН в зависимости от экскреции альбумина с мочой.Материалы и методы. В исследование были включены 42 пациентов с СД2 без установленного диагноза ХСН. Пациенты были разделены на группы: с нормальной альбуминурией и с умеренным повышением альбуминурии (альбумин/креатининовое соотношение 30–300 мг/г). Пациентам была выполнена эхокардиография, определялась концентрация галектина-3, ST-2, PIСP, ММР-9 и TIMP-1.Результаты. Группы не различались между собой по возрасту, полу, индексу массы тела (ИМТ), значениям гликированного гемоглобина (HbA1c), cкорости клубочковой фильтрации (СКФ). Концентрации галектина-3 были значимо выше в группе с умеренным повышением альбуминурии – 13,6 (11,2; 15,1) нг/мл и 7,4 (6,7; 7,9) нг/мл соответственно, р = 0,002. Группы также не различались между собой по значениям таких биомаркеров, как P1CP, TIMP-1 и MMP-9. Кроме того, группа с нормоальбуминурией имела меньшие значения E/e’, чем группа с умеренным повышением альбуминурии – 8 (7; 9) и 10 (9; 12,5), р = 0,02.Заключение. Пациенты с СД2 и умеренным повышением альбуминурии имеют большие значения галектина-3 и более выраженное нарушение диастолической функции сердца, чем пациенты с нормоальбумин урией. Выявленные изменения могут отражать более высокий риск развития хронической сердечной недостаточности в данной группе пациентов