Kidneys cytomembranes stability in pregnant women with type 1 diabetes and pregnancy outcomes depending on the method of insulin delivery

Objective. To evaluate of kidney cytomembranes stability during pregnancy and its outcomes in patients with diabetes mellitus type on type 1 with different stages of diabetic nephropathy (DN) according to the route of insulin administration. Materials and Methods. We study 100 pregnant women with type 1 diabetes with the introduction of insulin in the mode of multiple subcutaneous injections (MSII) and with portable dispenser with a continuous subcutaneous insulin infusion (CSII). DN stage determined by the level of albumin in the daily urine. Cytomembranes stability assessment conducted on daily excretion of ethanolamine and phospholipids with urine in each trimester. Pregnancy outcomes were analyzed in 52 patients with type 1 diabetes. In the group of pregnant women with delivery at term 38-40 weeks we also analyzed the status of newborns. Results. Indicators of cytomembranes stability of kidneys in pregnant women on CSII consistent with those in healthy pregnant women (p>0.05) the whole pregnancy, regardless of the level of daily urinary albumin excretion. There were no differences in cytomembrana stability of kidneys between the group of patients on MSII with normal albumin excretion (NAU) and the control group regardless to the gestational age (p>0.05). With the introduction of insulin in the mode of MSII on the stage of microalbuminuria (MAU) in the 3rd trimester we found the increase of ethanolamine excretion as compared to control groupy (U=8,00, p=0.012) and the group on CSII with a similar stage of nephropathy (U=2.00, p=0.033). In patients with proteinuria (PU) in the group on the MSII in the third trimester phospholipids excretion is increased with a daily urine (U=27,5, p=0.03 and U=22,00, p=0.07 for patients MSII and CSII, respectively). The use of an insulin pump allowed to prolong gestational period, even in severe proteinuric stage of nephropathy. Manifestations of diabetic fetopathy as macrosomia, hypoglycemia in the fetus at birth time mothers using CSII mode were less common than with MSII (p=0.01 and p=0.04, respectively). In the CSII group no resuscitation was needed, as opposed to 20% of children whose mothers used the MSII. Conclusion. The administration of insulin using portable dispenser the of mode CSII during pregnancy in patients with type 1 diabetes, even at the initial stage of the DN the cytomembranes stability is saved, pregnancy outcomes are improved

Excretion of amine nitrogen and ammonia in urine of pregnant women with type 1 diabetes mellitus

Aim. To study excretion of amine nitrogen and ammonia in urine of pregnant women with type 1 diabetes mellitus depending on gestational ageand albuminuria level. Materials and methods. A total of 60 pregnant women with type 1 diabetes mellitus were examined. Proximal and distal tubular function was estimatedfrom daily excretion of amine nitrogen and ammonia respectively. Results. Daily excretion of amine nitrogen and ammonia in urine of pregnant women with type 1 diabetes mellitus was lower than in healthycontrols in the 2nd trimester regardless of albuminuria and in the 3rd trimester in patients with microalbuminuria (MAU) and proteinuria (PU).Ammonia excretion was twice lower than normal in the 2nd trimester in women with MAU and PU, and in the 3rd trimester in patients with PU.Healthy pregnant women showed significant correlation between ammonia and amine nitrogen excretion throughout pregnancy (r?0.833,

History of the development of endocrinology in the Republic of Tatarstan

May 14, 2014 marks 200 years since the establishment of the Medical Department of the Imperial Kazan University (now Kazan State Medical University, KSMU). Since the XIX century, scientists of the Kazan Medical School studied physiology and pathology of the endocrine system. The first researchers were interested in the problems of endemic goitre, diabetes mellitus, and function of the adrenal glands. In 1976, the Endocrinology Department was organised in the Kazan State Medical Institute, the first among universities of the RSFSR. The head of the Department, V.V. Talantov, became the chief non-staff endocrinologist of the Ministry of Health of the Republic of Tatarstan (RT) and organiser of the Association of Endocrinologists in the RT. Moreover, he contributed to the organisation of the endocrine service in the republic and endocrinology began to be taught as an independent discipline. V.V. Talantov was a member of the Scientific Council of Endocrinology of the Russian Academy of Medical Sciences, Deputy Chairman of the Committee of Endocrinology Problems of the Ministry of Health, and a member of the editorial boards of four medical journals. The research in the field of endocrinology is now actively continued on the endocrinology course at KSMU. In-depth study of various aspects of the pathogenesis of diabetes and its complications was selected as the first-priority