Prediabetes. A new paradigm for early prevention of cardiovascular disease

This literature review focuses on the association of prediabetes with cardiovascular disease (CVD). Recently, much attention has been paid to the study of prediabetes due to its extremely high prevalence and strong association with a high risk of developing serious complications that worsen the quality of kife of patients. Prediabetes is not only a metabolic condition with a high risk of developing type 2 diabetes mellitus (T2DM), but also CVD and death from all causes. This association is true for both patients who do not yet have CVD and those with a history of CVD. Also during the COVID-19 pandemic, attention is drawn to the fact that people with prediabetes have a higher risk of a severe course of infection, complications and a worse prognosis of the disease. This is associated with hyperglycemia, the  presence of  chronic systemic inflammation of  a  low degree of  activity, impaired immune response mechanisms and a procoagulant state in patients with prediabetes, although these disorders are less developed than in patients with T2DM. Therefore, early screening of early disorders of normal metabolism. Since active early intervention at the stage of prediabetes helps to prevent the development of type 2 diabetes and CVD

Diabetes mellitus and osteoporosis: pathogenetic relationship and current principles of treatment

Diabetes mellitus (DM) is a well known risk factor for osteoporosis and an increased risk of fractures. A lot of data has been published about the relationship between diabetes and bone health. DM type 1 and DM type 2 have different effects on bone mineral density (BMD). The central link in pathogenesis of bone fragility in patients with DM type 1 is a violation of the activity and gifferentiation of osteoblasts. On the contrary, hyperinsulinemia in DM type 2 activates the division and gifferentiation of osteoblasts and contributes to an increase in BMD. However, Higher BMD values in patients with DM type 2 are combined with slowdown in bone metabolism. As the result, high-quality bone remodeling does not occur. And bone strength decreases despite the high BMD. Despite the differences, DM type 1 and DM type 2 have common pathogenic pathways, that lead to increased bone fragility. For example, non-enzymatic glycation of bone matrix collagen and increase in concentration of sclerostin, which blocks the Wnt signaling pathway. In this review, we will analyze current data about epidemiology and pathogenesis of osteoporosis in DM and discuss the practical issues of the clinic, diagnosis, stratification of fracture risk and treatment. Special attention will be paid to the effects of glucose-lowering and anti-osteoporotic drugs on bone tissue