Klinički pristup ginekomastiji [Clinical evaluation of gynecomastia]

Gynecomastia is characterized by the ennlargement of the male breast caused by glandular proliferation. Gynecomastia occurs when the estrogen-to-androgen ratio is disrupted, in plasma or locally in the breast tissue. The etiology is usually benign. Physiologic gynecomastia is common in newborns, adolescents, and older men. Nonphysiologic gynecomastia may be caused by chronic conditions (e.g. hypogonadism, liver cirrhosis, renal insufficiency), use of certain medications or substances, and, rarely tumors. The diagnostic evaluation starts with careful history taking and physical examination which may be followed by extensive work-up that includes selective imaging and laboratory testing. Discontinuing the use of contributing medications and treating the underlying disease are the mainstay of treatment

CLINICAL EVALUATION OF GYNECOMASTIA

Ginekomastijom nazivamo povećanje dojke u muškaraca uzrokovano proliferacijom žljezdanog tkiva. Posljedica je poremećenog omjera estrogena i androgena u plazmi ili lokalno u žljezdanom tkivu dojke. Uzroci ginekomastije uglavnom su benigni. Fiziološka ginekomastija česta je pojava i nalazimo ju u novorođenčadi, u pubertetu i u starijoj dobi. Nefiziološka ginekomastija može nastati kao posljedica raznih kroničnih bolesti (npr. hipogonadizam, ciroza jetre, zatajenje bubrega), upotrebe lijekova ili drugih tvari i, rijetko, tumora. Obradu započinjemo pažljivim uzimanjem anamneze i fizikalnim pregledom, nakon čega, prema potrebi, obradu proširujemo ciljanim radiološkim i laboratorijskim pretragama. Terapija ginekomastije temelji se na liječenju bolesti koja ju je uzrokovala, odnosno prekidu primjene lijekova/tvari koji su je potencijalno izazvali.Gynecomastia is characterized by the ennlargement of the male breast caused by glandular proliferation. Gynecomastia occurs when the estrogen-to-androgen ratio is disrupted, in plasma or locally in the breast tissue. The etiology is usually benign. Physiologic gynecomastia is common in newborns, adolescents, and older men. Nonphysiologic gynecomastia may be caused by chronic conditions (e.g. hypogonadism, liver cirrhosis, renal insufficiency), use of certain medications or substances, and, rarely tumors. The diagnostic evaluation starts with careful history taking and physical examination which may be followed by extensive work-up that includes selective imaging and laboratory testing. Discontinuing the use of contributing medications and treating the underlying disease are the mainstay of treatment

EARLY CHRISTIAN COMPLEX IN MIRINE IN THE SAPAN BAY NEAR OMIŠALJ ON THE ISLAND OF KRK

U uvodnom dijelu autori se b~ve pit~njima vezanim za osnutak Fulfinuma (Omišlja), odnosom novonastalog grada i omišaljske gr~dine, te odnosom Fulfinuma i Curicuma (Krka) nastojeći protumačiti zbivanja koja su prethodil~ utemeljenju i gradnji sakralnog kompleksa na Mirinama. Potom iznose rezultate arheoloških istraživanja, koja su 1993. godine provedena u unutrašnjosti crkve, te po,ebno apostrofiraju integralni aspekt spomc:ničke zaštite crkve na Mirinama i njenog kulturno-povijesnoga okoliša.The scholarly world was introduced to the early Christian church in Mirine in the Sapan Bay near Omišalj in early 20th century through the works of A. Gnirs and G. Szabo. In midcentury, trial trenches were dug by the Institute for Protection of Monuments, Rijeka. It was sporadically surveyed by archaeologists working in ancient Fulfinum. The church, which occupies thc central position in the complex, belongs to the early type of Christian church which had a cross-shaped ground plan, with a flat back wall, a subselium inscribed in its eastern arm, pastophories, transept, nartex, a tower by its facade and a portico to the south. In spite of all of these particulars there are still many problems concerning this complex: general and particular geographical location; original architectural articulation; its relation to the historical landscape in which it originated, lasted, and underwent many changes; and eventually, its chronology and datation. In an attempt to solve these problems the author used three parallel approaches whose aims were to survey and protect the entire complex. The first approach offers a global historical genesis of those settlements which show continuity of life in the north-western part of the Island of Krk on which the early Christian complex in Mirine originated and endllred. These are Omišalj -whose chronology ranges from prehistoric hillfort, over an ancient satellite settlemcnt to a mediaeval town, anci Fulfinum -a classical ancient town and mllnicipium, a newly designed town in the Sapan Bay. To date, a poorly known ancient and early mediaeval component of the historical continuity of thc Omišalj hillfort has been stressecI as well as the rival parallelism of ancient municipiums on the Island of Krk: that of Curicllm and Fulfinum which might have been reflected in the process of the formation of their early Christian communes. Protective research works carried out by RRI in 1993 included relevant parts of the nave and portico facing the Sapan Bay. At the same time, church walls and the area of nearby ancient Fulfinum were surveyed. Special attention was paid to the interior behind the facade wall where graves and a part of a lime-kiln from the beginning of ancient Fulfinum were discovered. At this time trenches which were made 50 years prior were revised to define articulation of thc church interior. Foundations which were discovered opposite the groove on the northern wall (the base of a pilar) show that the church had cl nave and two aisles. On the basis of those grooves left by the arcades the author concludcd that the original church interior was in a later phase divided by arcades in three parts. This adaptation, however, may be considered as a completely indepcndent phase when the entire complex was fortified. The impression is strcngthened by meticulously built-in openings for windows along the longitudinal walls of the church atrium. Research on the eastern arm of the church have only just started on the groundplan projection of the triumphal arch. The wall foundations, which were found, suggest that any solution might bc possible for the triumphal arch including a "classical" one. This impressive arch, with a 9 m span, rests on a pilar and a massive column wbich were statically reinforced by a console. The central part of the transept might have been separated from the eastern arm of the church by a wall into which a triumphal arch of modest dimensions with a door leading behind subselium was made. Although there were alsu separate pastoforias, subselium may have preserved its function. The portico and the building whose ground floor was connected tu the nartex and to the south with the area outside the church (which can be defined as a bell tower, and in one phase even a "mausoleum"), have been researched. Although the soil was rather eroded it was possible to reconstruct the rhythm of the arcades, the architecture and the appearance of the entire portico owing to vague traces of foundation architecture on the bed rock, and marks of the roof construction on the southern perimetral wall. Multidisciplinary research of the church complex -a one time center of spiritual life and ancient civilization -started in 1993. The aim of the research is to establish its future which hopefulJy is a multi-purpose ambience of cultural (material and spiritual) activity, which would counterbalance the destruction and the attempt to sacrify it to "gods of energy" surrounding it. This is the reason for the necessity to continuously conserve and preselve the activity of this monument and why it is so strongly stressed. So a large number of suggestions, ideal reconstructions of architectonic elements, segments and wholcs should be taken as "working material" which will be completed by further research, and when fully defined, become a nucleus of the final project. Together with the first phase of field work, this paper presents some introductory observations concerning the typology of church es with inscribed crosses to which the Mirine church belongs and their acceptance, indirectly, from the East through Ambrosiano-Milanese as terminus post quem Ravenatian and Aquileian-Istrian building practices, that is, historical, political and religious influences. The possible existence of early Christian monastic enclaves in this area has also been researched

Adropin - potencijalni čimbenik kardiovaskularne sigurnosti u muškaraca oboljelih od šećerne bolesti tip 2 liječenih liraglutidom

The aim of this study was to determine plasma adropin concentration and parameters of insulin resistance in obese male type 2 diabetes mellitus (T2DM) patients before and after 3-month liraglutide treatment. In this interventional study, we enrolled 15 obese male T2DM patients with body mass index (BMI) >35 kg/m2, uncontrolled disease and HbA1c >7.5%, having previously taken taking two oral antidiabetic drugs. We modified their therapy to metformin and liraglutide for the next three months. After three months of liraglutide treatment, we observed significant decrease in body weight (from 111.5±18.7 kg to 109.2±17.5 kg, p=0.016) and BMI (from 40.9±7.3 to 40.1±7.0 kg/m2, p=0.021). Plasma adropin concentration increased significantly (p=0.003) compared with baseline. Fasting plasma insulin level decreased from 17.79±6.53 to 13.38±3.51 mU/L (p=0.002), fasting plasma glucose level decreased from 8.66±3.07 to 7.41±2.21 mmol/L (p=0.004) and HbA1c decreased from 7.98±0.70% to 7.26±0.36% (p=0.003). Insulin resistance presented as HOMA-IR decreased significantly from 7.30±5.19 to 4.52±2.61 (p=0.002). Systolic blood pressure, lipid status, liver and kidney function improved, but not reaching statistical significance. Treating obese male T2DM patients with liraglutide resulted in a significantly higher plasma adropin concentration, significant weight loss and improved parameters of insulin resistance, i.e. decreased fasting plasma insulin, plasma glucose levels and HOMA-IR.Cilj je bio usporediti plazmatske vrijednosti adropina i parametre inzulinske rezistencije kod pretilih muškaraca koji boluju od šećerne bolesti tip 2 (ŠBT2) prije i nakon 3 mjeseca primjene liraglutida. U ovoj intervencijskoj studiji sudjelovalo je 15 pretilih muškaraca koji boluju od ŠBT2 s indeksom tjelesne mase (ITM) >35 kg/m2, loše reguliranom bolešću i HbA1c >7,5%. Ispitanici su prethodno u terapiji imali dva peroralna antidijabetična lijeka. Nakon uključenja u studiju terapija im je modificirana na metformin i liraglutid tijekom tri mjeseca. Nakon primjene liraglutida kod ispitanika je zamijećeno smanjenje tjelesne mase (sa 111,5±18,7 na 109,2±17,5 kg, p=0,016) i ITM (s 40,9±7,3 na 40,1±7,0 kg/m2, p=0,021), dok su plazmatske vrijednosti adropina bile značajno povišene (p=0,003). Zamijećeno je sniženje vrijednosti inzulina natašte (sa 17,79±6,53 na 13,38±3,51 mU/L, p=0,002), glukoze natašte (s 8,66±3,07 na 7,41±2,21 mmol/L, p=0,004) te HbA1c (sa 7,98±0,70% na 7,26±0,36%, p=0,003). HOMA-IR se značajno smanjio (sa 7,30±5,19 na 4,52±2,61, p=0,002). Također su zabilježene niže vrijednosti sistoličkog arterijskog tlaka, bolji lipidni profil te poboljšanje jetrene i bubrežne funkcije, iako ne statistički značajno. Primjena liraglutida u pretilih muškaraca koji boluju od ŠBT2 rezultira statistički značajno višim razinama plazmatskog adropina, značajnim smanjenjem tjelesne težine i poboljšanjem svih parametara inzulinske rezistencije, tj. sniženjem plazmatskog inzulina i glukoze natašte te nižim HOMA-IR

NEW INSIGHTS IN STEROID DIABETES

Glukokortikoidi su učinkoviti u liječenju širokog spektra kroničnih autoimunih i upalnih bolesti. Liječenje glukokortikoidima povezano je sa značajnim metaboličkim nuspojavama uključujući inzulinsku rezistenciju i šećernu bolest. Predisponirajući čimbenici za pojavu steroidnog dijabetesa su starija dob, povećana tjelesna masa, obiteljska anamneza šećerne bolesti i gestacijski dijabetes. Nekoliko mehanizama pridonose pojavi steroidnog dijabetesa, uključujući smanjenje periferne inzulinske osjetljivosti, povećanje proizvodnje glukoze u jetri i ometanje proizvodnje i lučenja inzulina iz gušterače. Liječnici koji liječe bolesnike glukokortikoidima trebali bi biti upućeni u metaboličke poremećaje koje oni uzrokuju. U liječenju steroidnog dijabetesa mogu se koristiti sve skupine antidijabetika, ali inzulinska terapija bio bi najbolji izbor u liječenju većine bolesnika sa steroidnim dijabetesom.Glucocorticoids (GC) are the cornerstone in the treatment of numerous chronic autoimmune and inflammatory diseases. GC treatment is accompanied by significant metabolic adverse effects, including insulin resistance, glucose intolerance and diabetes, visceral adiposity, dyslipidemia and skeletal muscle atrophy. GCs are the most common cause of drug-induced diabetes mellitus. However, not everyone treated with glucocorticoids develops diabetes. Predictors of development of diabetes are age, weight, family history of diabetes mellitus, or personal history of gestational diabetes. There is evidence that patients with decreased insulin secretory reserve are much more likely to develop diabetes. Diabetes from topical steroid use is uncommon, but high-dose steroids have been associated with significant hyperglycemia, including development of hyperglycemic hyperosmolar syndrome and even diabetic ketoacidosis in patients with type 1 diabetes mellitus. Several mechanisms contribute to the development of hyperglycemia and steroid-induced diabetes, including decreased peripheral insulin sensitivity, increased hepatic glucose production, and inhibition of pancreatic insulin production and secretion. Physicians treating patients with GCs should be aware of the induction of metabolic disturbances and should not solely rely on fasting measurements. In addition, our review indicates that insulin therapy could be considered when treating patients on GC therapy

PRECIPITATING FACTORS AND CLINICAL FEATURES OF DIABETIC KETOACIDOSIS

vod: Dijabetička ketoacidoza (DKA) jedna je od najozbiljnijih akutnih komplikacija šećerne bolesti (ŠB). Pojedina istraživanja su pokazala da su infekcije precipitirajući čimbenik u polovice ispitanika. Nekoliko novijih istraživanja naglašava da je loše pridržavanje liječenja također česti uzrok DKA. Cilj: Identifi cirati najčešće precipitirajuće čimbenike za DKA u Republici Hrvatskoj. Ispitanici i postupci: Ovo retrospektivno multicentrično istraživanje uključivalo je bolesnike sa ŠB-om tipa 1 ili tipa 2 s dijagnozom DKA između 1. siječnja 2014. i 31. prosinca 2018. i liječenih u 5 različitih središta za liječenje ŠB-a: Dubrovnik, Našice, Split, Zagreb i Osijek. U analizu je uključena samo prve epizoda DKA. Pacijenti koji boluju od steroidnog ŠB-a i ŠB-a zbog endokrinih poremećaja kao što su akromegalija i Cushingov sindrom bili su isključeni. Rezultati: Istraživanjem je obuhvaćeno 160 bolesnika (55 % muškaraca), od kojih je 68% imalo ŠB tip 1. Srednja dob ispitanika bila je 42 godine (od 18 do 89). Najčešći uzrok DKA bila je infekcija (57 %), zatim slabo kontrolirani ŠB (37 %) i prva prezentacija ŠB-a (9 %), dok je u 7% bolesnika DKA bila uzrokovana ostalim uzrocima kao što su kvar inzulinske pumpe, moždani ili srčani udar. U skupini bolesnika s infekcijama najčešće su bile infekcije mokraćnog sustava (30 %), probavne infekcije (30 %) i infekcije respiratornog trakta (19 %), dok je 21 % bolesnika imalo druge izvore infekcije. U 36 ovih bolesnika uz infekciju je bio prisutan i prethodno loše kontroliran ŠB, a u 12 % DKA uzrokovana infekcijom bila je prvo očitovanje bolesti. U bolesnika sa ŠB-om tipa 2 infekcije su češće bile uzrok DKA nego u bolesnika sa ŠB-om tipa 1 (P < 0,05). U bolesnika sa ŠB-om tipa 1, slabo regulirana glikemija je češće uzrok DKA (31%) nego u bolesnika sa ŠB-om tipa 2 (18 %). Zaključak: Najčešći precipitirajući čimbenici za razvoj DKA su infekcije i loša regulacija ŠB-a. Potrebna je bolja edukacija bolesnika o važnosti redovite primjene inzulina i korekcije terapije tijekom akutne bolesti.Introduction: Diabetic ketoacidosis (DKA) is one of the most serious acute complications of diabetes mellitus (DM). In some studies, infections have been found to be a precipitating factor in more than half of the subjects. On the other hand, several recent studies emphasize that poor treatment adherence is also a common cause of DKA. Objective: To identify the most common precipitating factors for DKA in Croatia. Patients and Methods: This retrospective, multicenter study included DM type 1 or DM type 2 patients diagnosed with DKA between January 1, 2014 and December 31, 2018, and treated in 5 different DM treatment centers, i.e., Dubrovnik, Našice, Split, Zagreb and Osijek. Only the fi rst episode of DKA was included in the analysis. Patients receiving steroids and DM due to endocrine disorders such as acromegaly and Cushing\u27s syndrome were excluded. Results: The study included 160 patients (55% of men), of whom 68% had DM type 1. The mean age of the respondents was 42 (18-89) years. The most common cause of DKA was infection (57%), followed by poorly controlled DM (37%) and fi rst presentation of DM (9%), while in 7% of patients DKA was due to other causes such as insulin pump failure, stroke or myocardial infarction. In the group of patients with infections, urinary tract infections (30%), gastrointestinal infections (30%) and respiratory tract infections (19%) were most common, whereas 21% of patients had other sources of infection. In 36% of these patients, the infection was associated with previously poorly controlled diabetes, and in 12% of them, DKA caused by the infection was the fi rst manifestation of the disease. In patients with type 2DM, infections were more often the cause of DKA than in patients with type 1DM (p<0.05).Poorly controlled glycemia appeared to be a more frequent cause of DKA in patients with type 1 DM (31%) than in patients with type 2 DM (18%). Conclusion: The most common precipitating factors for the development of DKA were infections and poor diabetes management. Better education of patients about the importance of regular insulin administration and correction of therapy in acute illness could reduce the risk of DKA

PRECIPITATING FACTORS AND CLINICAL FEATURES OF DIABETIC KETOACIDOSIS

vod: Dijabetička ketoacidoza (DKA) jedna je od najozbiljnijih akutnih komplikacija šećerne bolesti (ŠB). Pojedina istraživanja su pokazala da su infekcije precipitirajući čimbenik u polovice ispitanika. Nekoliko novijih istraživanja naglašava da je loše pridržavanje liječenja također česti uzrok DKA. Cilj: Identifi cirati najčešće precipitirajuće čimbenike za DKA u Republici Hrvatskoj. Ispitanici i postupci: Ovo retrospektivno multicentrično istraživanje uključivalo je bolesnike sa ŠB-om tipa 1 ili tipa 2 s dijagnozom DKA između 1. siječnja 2014. i 31. prosinca 2018. i liječenih u 5 različitih središta za liječenje ŠB-a: Dubrovnik, Našice, Split, Zagreb i Osijek. U analizu je uključena samo prve epizoda DKA. Pacijenti koji boluju od steroidnog ŠB-a i ŠB-a zbog endokrinih poremećaja kao što su akromegalija i Cushingov sindrom bili su isključeni. Rezultati: Istraživanjem je obuhvaćeno 160 bolesnika (55 % muškaraca), od kojih je 68% imalo ŠB tip 1. Srednja dob ispitanika bila je 42 godine (od 18 do 89). Najčešći uzrok DKA bila je infekcija (57 %), zatim slabo kontrolirani ŠB (37 %) i prva prezentacija ŠB-a (9 %), dok je u 7% bolesnika DKA bila uzrokovana ostalim uzrocima kao što su kvar inzulinske pumpe, moždani ili srčani udar. U skupini bolesnika s infekcijama najčešće su bile infekcije mokraćnog sustava (30 %), probavne infekcije (30 %) i infekcije respiratornog trakta (19 %), dok je 21 % bolesnika imalo druge izvore infekcije. U 36 ovih bolesnika uz infekciju je bio prisutan i prethodno loše kontroliran ŠB, a u 12 % DKA uzrokovana infekcijom bila je prvo očitovanje bolesti. U bolesnika sa ŠB-om tipa 2 infekcije su češće bile uzrok DKA nego u bolesnika sa ŠB-om tipa 1 (P < 0,05). U bolesnika sa ŠB-om tipa 1, slabo regulirana glikemija je češće uzrok DKA (31%) nego u bolesnika sa ŠB-om tipa 2 (18 %). Zaključak: Najčešći precipitirajući čimbenici za razvoj DKA su infekcije i loša regulacija ŠB-a. Potrebna je bolja edukacija bolesnika o važnosti redovite primjene inzulina i korekcije terapije tijekom akutne bolesti.Introduction: Diabetic ketoacidosis (DKA) is one of the most serious acute complications of diabetes mellitus (DM). In some studies, infections have been found to be a precipitating factor in more than half of the subjects. On the other hand, several recent studies emphasize that poor treatment adherence is also a common cause of DKA. Objective: To identify the most common precipitating factors for DKA in Croatia. Patients and Methods: This retrospective, multicenter study included DM type 1 or DM type 2 patients diagnosed with DKA between January 1, 2014 and December 31, 2018, and treated in 5 different DM treatment centers, i.e., Dubrovnik, Našice, Split, Zagreb and Osijek. Only the fi rst episode of DKA was included in the analysis. Patients receiving steroids and DM due to endocrine disorders such as acromegaly and Cushing\u27s syndrome were excluded. Results: The study included 160 patients (55% of men), of whom 68% had DM type 1. The mean age of the respondents was 42 (18-89) years. The most common cause of DKA was infection (57%), followed by poorly controlled DM (37%) and fi rst presentation of DM (9%), while in 7% of patients DKA was due to other causes such as insulin pump failure, stroke or myocardial infarction. In the group of patients with infections, urinary tract infections (30%), gastrointestinal infections (30%) and respiratory tract infections (19%) were most common, whereas 21% of patients had other sources of infection. In 36% of these patients, the infection was associated with previously poorly controlled diabetes, and in 12% of them, DKA caused by the infection was the fi rst manifestation of the disease. In patients with type 2DM, infections were more often the cause of DKA than in patients with type 1DM (p<0.05).Poorly controlled glycemia appeared to be a more frequent cause of DKA in patients with type 1 DM (31%) than in patients with type 2 DM (18%). Conclusion: The most common precipitating factors for the development of DKA were infections and poor diabetes management. Better education of patients about the importance of regular insulin administration and correction of therapy in acute illness could reduce the risk of DKA

Expression of ganglioside GM3 and its sphingolipid precursors in muscle and kidney in rat models of type 1 and 2 diabetes

Cilj studije: Utvrditi izražaj gangliozida GM3 i njegovih glikosfingolipidnih preteča u bubregu i mišiću na štakorskim modelima šećerne bolesti tip 1 i tip 2. Metode: Model šećerne bolesti tip 1 (T1DM) induciran je intraperitonejskom injekcijom streptozotocina (STZ) u dozi od 55 mg/kg, a model šećerne bolesti tip 2 (T2DM) je induciran kombinacijom manje doze STZ-a (35 mg/kg) i masne hrane (udio masti 58%). Štakori su žrtvovani dva tjedna nakon induciranja šećerne bolesti, a zatim je analiziran izražaj gangliozida GM3 i njegovih sfingolipidnih preteča u tkivu bubrega i mišića metodama tankoslojne kromatografije visokog razlučivanja (HPTLC) i imunofluorescentnom mikroskopijom. PCR reakcijom u stvarnom vremenu određivan je izražaj gena za GM3 sintaze u tkivu bubrega skupine T1DM. Rezultati: U mišićima skupine T2DM statistički je značajno povećan sadržaj GM3 u u odnosu na kontrolnu skupinu. Sadržaj GM3 statistički je značajno povećan u tubulima bubrega štakora T1DM i T2DM u usporedbi s pripadajućim kontrolnim skupinama. Sadržaj GM3 je statistički povećan u glomerulima T1DM štakora. PCR metodom nađena je smanjena ekspresija gena za GM3 sintazu u bubrezima štakora T1DM. Zaključak: Povećani izražaj gangliozida GM3 u mišiću štakorskog modela šećerne bolesti tip 2 inducirane streptozotocinom i masnom prehranom potvrđuje dosadašnja istraživanja o posredovanju gangliozida GM3 u patogenezi šećerne bolesti tip 2. Povećani sadržaj GM3 u tubulima u oba modela šećerne bolesti može upućivati na ulogu gangliozida GM3 u patogenezi dijabetičke tubulopatije. Štakorski modeli šećerne bolesti tip 2 induciran streptozocinom i masnom hranom mogao bi se koristiti za istraživanja farmakoloških utjecaja na inzulinsku rezistenciju umjesto dosad korištenih modela.Aim of the study: was to determine the expression of the ganglioside GM3 and its sphingolipid precursors in kidneys and muscles in rat models of type 1 and 2 diabetes. Methods: the model of type 1 diabetes (T1DM) was induced with an intraperitoneal injection of streptozotocin (STZ) at a dose of 55 mg/kg, the model of type 2 diabetes (T2DM) was induced with a combination of a lower dose STZ (35 mg/kg) and a high-fat diet (58% fat). Rats were sacrificed two weeks after diabetes induction and then the expression of the ganglioside GM3 and its sphingolipid precursor in kidneys and muscles was analyzed by high performance thin layer chromatography (HPTLC) and immunofluorescence microscopy. The expression of the gene for GM3 synthase in kidney for the T1DM group was determined using real-time PCR. Results: In muscles of the T2DM group expression of GM3 was significantly increased compared to the control group. The expression of GM3 was significantly increased in tubules of T1DM and T2DM groups in comparison to their controls. The expression of GM3 was significantly increased in glomerules of T1DM rats. Using real time PCR method we found a decreased expression of GM3 synthase in kidneys of T1DM rats compared to controls. Conclusion: Increased expression of GM3 ganglioside in muscles of rat model for type 2 diabetes induced by streptozotocin and high-fat diet confirms recentlyobtained results showing that ganglioside GM3 plays one of key roles in pathogenesis of type 2 diabetes. Increased expression of GM3 in tubules of both diabetes models suggest that there is a significant role of ganglioside GM3 in pathogenesis of diabetic tubulopathy. The rat model for diabetes type 2 induced by streptozocine and a high-fat diet could be a new widely used model for researching pharmacological influences on insulin resistence instead of the models that are currently used