ВЗАИМНЫЕ ЭФФЕКТЫ САХАРНОГО ДИАБЕТА, ОЖИРЕНИЯ И SARS-COV-2

С момента первой вспышки SARS-Cov-2 в Китае большое внимание медицинского сообщества было уделено людям с сахарным диабетом, так как хорошо известно, что сахарный диабет повышает риск развития ряда инфекционных заболеваний. Причина этого многофакторная: возраст, пол, этническая принадлежность, сопутствующие заболевания, такие как гипертония, сердечно-сосудистые заболевания, ожирение, а также провоспалительное и прокоагулянтное состояние – все это способствует более тяжелому течению SARS-Cov-2 у пациентов с сахарным диабетом. Более того, тяжелая инфекция SARS-Cov-2 сама по себе может представлять собой ухудшающий фактор для людей с сахарным диабетом, поскольку она может вызвать острые метаболические осложнения через прямое негативное воздействие на функцию β-клеток. Данный обзор призван обеспечить системную оценку потенциальных прогностических факторов и взаимных эффектов у пациентов с сахарным диабетом, ожирением и SARS-Cov-2

THE ROLE OF MAST CELLS DEGRANULATION REACTION IN THE ADJUSTMENT OF INSULIN IN DIABETES MELLITUS PATIENTS

Introduction: Strategy of treatment of patients with diabetes (DM) in Belarus is based on a basis of domestic and international conciliatory documents in the area of diabetes. Patients with DM apply domestic production insulin, and at development of individual intolerance or allergic reaction, there is a possibility to replace applied insulin other less antigenic preparation. Aim: To conduct a reaction clinics-experimental research based on mast cells degranulation corpulent cages (RDMC), arising on various kinds of the insulin applied in republic of Belarus. Material and methods: Estimation RDMC of animals on various kinds of insulin which received 31 patient with DM with presence in the anamnesis of various allergic reactions and necessity for correction insulin therapy or change of a preparation of insulin. Monitoring fasting and postprandial glycemia was carried out, degree of indemnification of a carbohydrate exchange was estimated. The applied technique consists in revealing RDMC of a rat at incubation with whey of the patient and investigated insulin. At presence in whey of the patient specific IgЕ to the given kind of insulin occurs degranulation corpulent cages. Results: More than 80 % of patients had sub- or decompensation of a diabetes. Sharply positive tests (RDMC more than 40 %) are absent. On 5 entered preparations of insulin positive reactions (3-13 %) are fixed. All preparations of insulin had weakly positive RDMC (29-55 %). Сonclusion: Carrying out RDMC on various kinds of insulin will help the clinical physician to pick up less immune medical product in case of presence at the patient of allergic reaction. All preparations of insulin investigated in given work can be applied to complex treatment DM

DIAGNOSIS AND TREATMENT OF ACTH-DEPENDENT AND ACTH-INDEPENDENT ENDOGENOUS HYPERCORTISOLISM

The study topicality of the differential diagnosis of various forms of endogenous hypercortisolism is due to the difficulty of topical diagnosis of neuroendocrine tumors of various localization, which produce ACTH, glucocorticoids, despite the significant improvement of existing methods of investigation that determines further treatment. Only a thorough search for the primary source of the tumor, which produces glucocorticoids or ACTH, enables to clearly identify the method of treatment and to significantly reduce subsequently the morbidity and mortality of patients with hypercortisolism

MODERN APPROACHES TO THE THERAPY OF ENDOCRINE OPHTHALMOPATHY

Background: The number of patients with thyroid disease is increasing due to people suffering from Graves' disease, which is often accompanied by endocrine autoimmune ophthalmopathy. This complication leads to impaired vision and a decrease in the quality of life of patients. Purpose: The analysis of domestic and foreign literature was conducted with the purpose of studying modern approaches to pathogenetic and symptomatic therapy of patients with endocrine ophthalmopathy. Material and methods: 55 literature sources were analyzed. Results: The comparative evaluation of the efficacy of various schemes and methods of treatment of endocrine ophthalmopathy was carried out. Conclusions: One of the priorities in fighting endocrine ophthalmopathy is the search for new methods of treatment, as well as the improvement of existing schemes and programs