14th International Endocrinological Congress, Kyoto, 26-30 April 2010

В городе Киото (Япония) с 26 по 30 апреля 2010 г. состоялся 14-й Международный эндокринологический конгресс. Международное эндокринологическое общество (International Society of Endocrinology) проводит эти форумы каждые 2 года. Программа конгресса включала около 200 секций в виде пленарных лекций, симпозиумов, встреч с профессорами, семинаров, постерных презентаций вразличных областях эндокринологии: нейроэндокринология, щитовидная и паращитовидные железы, надпочечники, сердце, костная система, ожирение, репродуктивная система

Insulin resistance in pathogenesis of type 2 diabetes mellitus

This review focuses on the mechanisms of impaired sensitivity to insulin associated withevolution of carbohydrate metabolism disorders from enhanced fasting glycemia (EFG) to impaired glucose tolerance (IGT) and type 2 diabetes.Disturbances of glucose utilization at the receptor and post-receptor levels are considered along with the role of glucose and lipotoxicity. Original dataon insulin resistance (IR) in patients with disorders of carbohydrate metabolism are presented. Insulin sensitivity in DM2, EFG and IGT is shownto be 50, 25 and 15% lower respectively than in normal subjects. M-index positively correlates with BMI and quality of metabolic control (HbA1cand triglyceride levels). The differences in clinical and biochemical characteristics of DM2 patients are analysed depending on the degree of IR.Adiponectin and resistin levels in DM2 are shown to be lower than in healthy subjects while TNF-a and proinsulin levels increase. Therapy withmetformin, pyoglitazone, and insulin improves insulin sensitivity even in patients with early disturbances of carbohydrate metabolism. It is concludedthat intensive hypoglycemic therapy should be initiated before marked deterioration of insulin sensitivity developed

Kommentarii k Rukovodstvu Mezhdunarodnoy Diabeticheskoy Federatsii po kontrolyu postprandial'noy glikemii

В 2007 г. Рабочей группой National Kidney FoundationKidney Disease Outcomes Quality Initiative (NKFKDOQITM) разработано первое уникальное руководство по ведению больных сахарным диабетом и хронической болезнью почек ? KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease, включающее практические клинические руководства (Clinical Practice Guidelines ? CPGs) и рекомендации (Clinical Practice Recommendations ? CPRs)

20th World Diabetological Congress of International Diabetes Federation, 18-22 October, 2009, Montreal

В Канадае, в г. Монреаль 19-22 октября 2009 г. состоялся 20-й конгресс Международной Диабетической Федерации ? International Diabetes Federation (IDF). В конгрессе приняло участие более 10 000 делегатов из 156 стран

The injection technique: results of a questionnaire study of diabetic patients in Russia. New international guidelines on the injectiontechnique

Aim. To consider technical aspects of antihyperglycemic injection therapy in patients with type 1 and type 2 diabetes mellitus.Methods. The analysis included 200 adult patients (60 men and 140 women) receiving injection therapy for at least 6 months. They filled a 40-iremquestionnaire designed to estimate socio-demographic parameters, the use of different devices for insulin injection, and the most frequent mistakesmade by the patients. Their mean age was 51.7?15.1 years, duration of DM 11.9?9.1 years, mean HbA1c level 8.4?1.5%. Results. 130 (65%) patients used semiautomated injection pens, 39 (19.5%) disposable syringes, 31 (15.5%) both devices. Most patients (122, 61%)used 8 mm needles, 32 (16%) used 12.7 mm needles, 31 (15.5%) 10 mm, 28 (14%) 12 mm, 19 (9.5%) 6 mm, 18 (9.0%) 5 mm. 64 (32%) patientsused needles of different length, 25 (12.5%) could not give a definitive information about the needle length they used. Location of injection sites variedconsiderably in individual patients. 87 (43.5%) made injections within a single anatomic regions (62 into the anterior abdominal wall, 19 into theanterolateral surface of the thigh, 5 into shoulders, and 1 into buttocks. 113 (56.5%) patients made injections into two or more regions. 83 (41.5%)developed lipodystrophy at injection sites, 42 (50.6%) continued to use them for injections (12 did it on a regular basis and 30 occasionally). HbA1clevels were 9.5 and 8.2% in patients who made injections into affected sites and who had no lipodystrophic changes respectively (p=0.02). Over halfof the interviewed patients (106 or 53%) were informed about correct subcutaneous injection technique by the attending endocrinologist, 60 (30%)were taught by the nursing staff while staying in a hospital or visiting an endocrinological dispensary, 28 (14.%) were educated at Diabetes schools,9 (4.5%) when seeing the local therapist, and 19 (9.5%) by non-professionals. Conclusion. Many patients make serious mistakes when self-administering insulin. Incompliance with the guidelines on insulin injections leading tothe impairment of carbohydrate metabolism, the technical aspects of injections must be in the focus of attention of any practitioner. New (2010) internationalguidelines on the injection technique are overviewed

72st Scientific Session of American Diabetes Association (ADA), June 8-12, 2012, Philadelphia

С 8 по 12 июня 2012 г. в г. Филадельфия (США) состоялся 72-й Ежегодный конгресс Американской диабетической ассоциации (ADA), который посетили тысячи участников-членов диабетических сообществ со всего мира. Программа конгресса была разработана 33 членами комитета по планированию научных сессий под руководством M-E Patti. Кроме того, около 400 ученых и профессионалов системы здравоохранения изучили более 3000 тезисов с последующей селекцией 2000 тезисов для устных и стендовых докладо

Clinical and psychological aspects of hypoglycemia in patients with diabetes mellitus

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

Insulin pump therapy in type 1 diabetes mellitus: education effectiveness and quality of life

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

Selected aspects of insulin pump therapy and continuous glucose monitoring in real time (in relation to the letter of E.D.Gorbachev)

This article is the answer to the letter sent by Gorbachev to the editor. It deals with problems and difficulties encountered by diabetic patients using insulin pumpsand systems for continuous glucose monitoring in real time are considered. Most of them are of purely technical character and may be reduced to a minimum bycompliance with medical advice. Nevertheless, it needs to be emphasized that insulin pump therapy implies a scope of immediate knowledge and imposes requirementson the users health self-care behaviour. Those patients who forget about diabetes relying on the effect of insulin pump therapy alone are unlikely to benefit fromit. This therapy provides a high-technology tool for the treatment of diabetes that may help the majority of patients to achieve almost ideal compensation of carbohydratemetabolism, but it requires specialized education. Many patients have very poor knowledge of insulin pump therapy and continuous glucose monitoring in real time