Insulin-induced lipohypertrophy: clinical and ultrasound characteristics

Background: Lipohypertrophy is primary dermal complication of insulin therapy. The data on the prevalence of lipohypertrophy in diabetic subjects are inconsistent, that may be due to the lack of sensitivity and subjectivity of palpation as diagnostic technique. Meanwhile, the reliability of lipohypertrophy detection can be increased by ultrasound. Aims: to compare clinical and ultrasound characteristics and to determine the risk factors of insulin-induced lipohypertrophy in diabetic subjects. Materials and methods: We observed 82 patients, including 26 individuals with type 1 diabetes and 56 subjects with type 2 diabetes. Duration of insulin therapy varied from 3 months to 37 years (median 14 years). The sites of insulin injections were assessed by palpation and ultrasound. Visualization protocol included gray-scale densitometry, strain elastography, and 3D Doppler power ultrasound. Scaled evaluation of ultrasound sings was applied. Insulin injection technique was assessed by questionnaire. Serum levels of insulin antibodies were determined by ELISA. Results: Lipohypertrophy was revealed by palpation and ultrasound in 57 and 80 patients (70% and 98%) respectively. Total lipohypertrophy area, acoustic density and total ultrasound score showed weak positive correlations with daily insulin dose (r=0.3, r=0.3 and r=0.35, respectively, all p0.006). Patients receiving insulin analogues had smaller area of abdominal lipohypertrophy than those on human insulin (p=0.03). A positive correlation was found between abdominal lipohypertrophy area and mean postprandial glucose (r=0.35, p=0.001). A rare needle change and injections in lipohypertrophy sites were the most common deviations in insulin injection technique (70 and 47 subjects, 85% and 53% respectively). The levels of insulin antibodies showed no association with lipohypertrophy parameters. Conclusions: Patients with type 1 and type 2 diabetes demonstrate high prevalence of lipohypertrophy in insulin injection sites. Ultrasonography is more sensitive method of diagnostics of lipohypertrophy compared with palpation. Insulin-induced lipohypertrophy is associated with errors in injection technique and higher insulin doses

Состояние и перспективы развития системы мониторинга гидрологических условий акватории Северного Ледовитого океана

The article briefly substantiates the need for regular monitoring of the state of the waters of the Russian Arctic Seas and the Arctic Basin of the Arctic Ocean. The goals and objectives of monitoring hydrological conditions are formulated. General ideas about the development and construction of a system for monitoring hydrological conditions in the Arctic are expressed, taking into account the use of modern instruments and methods of oceanographic observations. It is shown that the most promising is the use of autonomous measuring complexes in the monitoring system, including moorings and drifting profiler buoys. The special value of satellite oceanographic data is emphasized. No less important are coastal observations carried out over the network of Roshydromet stations, as well as at research centers united into the Arctic Space-Distributed Observatory. The inclusion into this Observatory of the ice self-propelled platform “North Pole”, which will replace the drifting stations, will allow not only observing and measuring the main characteristics of the water masses, but also conducting controlled field experiments that will provide a deeper understanding of different-scale physical processes occurring in the waters of the Arctic Ocean. An important element of the monitoring system is data assimilation based on the use of numerical models that allow for the effect of the ice cover in the atmosphere-sea ice-ocean interaction system.В статье сформулированы цели и задачи мониторинга гидрологических условий, излагаются общие соображения о развитии и построении системы мониторинга гидрологических условий в Арктике с учетом использования современных средств и методов океанографических наблюдений и исследований. Показано, что наиболее перспективным представляется использование в системе мониторинга автоматических измерительных комплексов, включающих в себя заякоренные буйковые станции, дрейфующие буи-профилографы. Отмечена особая ценность данных спутниковой океанографии. Вместе с тем сохраняется ценность прибрежных наблюдений, выполняемых на сети станций Росгидромета, а также на базе научных центров, объединенных в Арктическую пространственно-распределенную обсерваторию. Включение в состав этой обсерватории ледостойкой самодвижущейся платформы «Северный полюс», идущей на смену дрейфующим станциям, даст возможность не только наблюдать и измерять основные характеристики водных масс, но и проводить управляемые натурные эксперименты, позволяющие глубже понять разномасштабные физические процессы, протекающие в водах Северного Ледовитого океана. Важным элементом системы мониторинга является усвоение данных, основанное на использовании численных моделей, учитывающих влияние ледяного покрова в системе взаимодействия атмосфера — морской лед — океан

Interannual variability of Pacific summer waters in the Arctic Ocean

his work is devoted to study of interannual variability of characteristics of Pacific summer waters (PSWs) supplied into the AO in summer. The distribution area, volume, and heat content of PSWs have been calculated for the first time for the entire Arctic Basin in the periods of 1950–1989 and 2008–2009 demonstrating the presence of substantial interannual variability. From 1953 until 1983 a negative trend and since 1984 a positive trend have been observed; the latter lasted until 2009, when the heat content, volume, and distribution area of PSWs reached their maximal values for the entire period considered. It has been shown that PSW quantity in the Arctic Basin, identified by temperature, rather depends on the intensity of heat flux through the Bering Strait, and the calculated value for PSW life in the Arctic Basin is seven years