Vol 20, No 4 (2018)


Dulaglutide - an innovative medication for diabetes mellitus type 2 treatment that requires administration once in a weekInterview with M.V.Shestakova

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Интервью с академиком РАН, доктором медицинских наук, профессором, заместителем директора по научной работе ФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава России - директором Института диабета Мариной Владимировной Шестаковой. Дулаглутид - инновационный препарат для лечения сахарного диабета типа 2 с введением 1 раз в неделю
Consilium Medicum. 2018;20(4):8-11
pages 8-11 views

The change of glycemic disorders therapy paradigm Interview with A.S.Ametov

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Интервью с заслуженным деятелем науки Российской Федерации, доктором медицинских наук, профессором, заведующим кафедрой эндокринологии ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России Александром Сергеевичем Аметовым.
Consilium Medicum. 2018;20(4):12-15
pages 12-15 views

Antiplatelet therapy use in diabetes mellitus patients: modern approaches and ischemic heart disease prevention perspectives

Novikov V.I., Novikov K.Y.


Cardiovascular diseases are the leading cause of patients with diabetes mellitus mortality. Antiplatelet therapy is a crucial component of ischemic heart disease treatment and prevention, acetylsalicylic acid is the main drug of this group. The review presents modern approaches to primary and secondary prevention of unfavorable cardiovascular events in diabetes mellitus patients, meta-analyses results on effectiveness and safety of various doses and forms of acetylsalicylic acid and recent Russian and international clinical guidelines.
Consilium Medicum. 2018;20(4):16-23
pages 16-23 views

New technologies in diabetes mellitus management: from theory to practice

Barsukov I.A., Demina A.A.


At present time diabetes mellitus is one of the top-priority medical and social problems. The increased over the past 20 years diabetes mellitus incidence requires development not only of new treatment strategies but also of diagnostic methods. The number of endocrinologists' methods of glucose control constantly increases with new ones: new upgraded glucometers and continuous glucose monitoring systems. Considering that the measurement accuracy defines therapy choice and, therefore, degree of compensation of carbohydrate metabolism, it is quite important that patients' glucometers match the required standards. Insulin therapy with insulin pump is one of the most perspective treatment methods, its effectiveness has been repeatedly confirmed in clinical trials.
Consilium Medicum. 2018;20(4):24-28
pages 24-28 views

Pulmonary tuberculosis with multiple drug-resistant Mycobacterium tuberculosis in patients with diabetes mellitus

Komissarova O.G., Abdullaev R.Y., Aleshina S.V., Romanov V.V.


Aim. The aim of the study was to study the clinical manifestations and effectiveness of treatment of pulmonary tuberculosis with multidrug-resistant (MDR) Mycobacterium tuberculosis in patients with different types of diabetes mellitus (DM). Materials and methods. 66 patients with pulmonary tuberculosis combined with type 1 diabetes mellitus and 48 patients with pulmonary tuberculosis combined with type 2 diabetes were examined. Results and conclusions. It was found that in patients with type 1 DM, MDR tuberculosis was more often observed in men under 40 years of age, in the form of infiltrative pulmonary tuberculosis with the presence of destruction in lung tissue up to 2 cm in diameter with positive sputum and acute intoxication. In patients with type 2 DM, MDR tuberculosis was more often observed in men over the age of 40 in the form of fibrous-cavernous tuberculosis with the presence of destruction in lung tissue larger than 2 cm in diameter, with positive sputum and moderately severe intoxication. The effectiveness of treatment for negativation sputum in the compared groups did not differ significantly and amounted to 71.2% and 64.7% respectively. However, to close the caverns in the lung, the treatment was more effective in patients with type 1 diabetes, which is probably due to the peculiarities of the tuberculosis process in this category of patients.
Consilium Medicum. 2018;20(4):29-32
pages 29-32 views

Vitamin D supplementation in diabetes mellitus patients: commercialism or evidence-based guidance

Karonova T.L.


The article focuses on contemporary view on vitamin D deficiency role in impaired glucose metabolism and diabetes mellitus development. Effects of vitamin D therapy on glucose metabolism parameters and their place in complex treatment of diabetes mellitus patients are discussed. Presented data would be of interest not only for endocrinologists but also for other health specialists.
Consilium Medicum. 2018;20(4):33-35
pages 33-35 views

Main types of diabetic neuropathies

Pizova N.V.


The article describes the main diabetes mellitus type 1 and 2 complications. In-depth attention is given to diabetic neuropathy as it is one of the most widespread chronic complications and occurs approximately in 50% of diabetes patients. Pathogenic mechanisms of their development are discussed. Diagnostic criteria for diabetic neuropathies are presented. Classification, main clinical and paraclinical criteria and severity stages of the most common neuropathy type - diabetic distal symmetric polyneuropathy are reviewed. Differential-diagnostic characteristics of diabetic neuropathies are described. Main clinical manifestations of autonomic nervous system damage in diabetes mellitus patients are presented. Pasic principles and medications used in diabetic neuropathies treatment are described. The question of thioctic acid use in diabetic neuropathies treatment is addressed.
Consilium Medicum. 2018;20(4):36-42
pages 36-42 views

Treatment options of vitamin D deficiency in adults

Pigarova E.A., Petrushkina A.A.


Due to various extraskeletal effects of vitamin D, vitamin D deficiency is a pathologic condition which affects not only bone health, but disturbes a lot of physiologic processes. It is a pandemic condition at the same time. Maintaining adequate vitamin D status is essential for people of all ages. In this article we discuss treatment options of vitamin D deficiency in adults.
Consilium Medicum. 2018;20(4):43-46
pages 43-46 views

News on menopausal hormone therapy

Demidova T.Y., Zenina S.G., Gasanzade P.A.


About 1/3 of a modern woman's life falls on menopause. Perimenopausal transition period is a critical period and it is essential to inform patients on possibilities of modern hormone therapy that allows not only to manage unfavorable menopausal symptoms and estrogen deficiency consequences but also to maintain woman's social activity and improve her quality of life. The article presents contemporary view on menopausal hormone therapy based on most recent relevant guidelines.
Consilium Medicum. 2018;20(4):47-51
pages 47-51 views

Autoimmune thyrotoxicosis syndrome (clinical case and literature review)

Altashina M.V., Panfilova E.A., Terekhova M.A., Troshina E.A.


Thyrotoxicosis syndrome may have different ethiopathogenesis. Differential diagnosis of immune and non-immune thyrotoxicosis forms is crucial for treatment tactics development. The article describes a clinical case of female patient with Graves disease characterized with thyrotropic hormone receptor antibodies variability, who went into sustained remission against the background of conservative therapy with thyrostatics. The clinical impression is complemented with literature review that summarizes data on mechanisms that underlie thyroid gland autoimmune disease development or activate it.
Consilium Medicum. 2018;20(4):52-58
pages 52-58 views

Multiple endocrine neoplasia type 1 syndrome

Demidova T.Y., Kishkovich Y.S.


Multiple endocrine neoplasia type 1 syndrome is a rare genetic endocrine disease that requires timely diagnosis, early treatment and follow-up. Cancer awareness in patients with diagnosed and genetically confirmed multiple endocrine neoplasia type 1 syndrome relatives plays an important role. The article presents a clinical case with described disease course, laboratory and instrumental diagnostic tests results and disease treatment options.
Consilium Medicum. 2018;20(4):59-62
pages 59-62 views

Chromogranin A in the diagnosis of pheochromocytoma: review

Yukina M.Y., Davtyan D.A., Troshina E.A., Platonova N.M.


Pheochromocytoma is a tumor of neuroectodermal origin, which arises from chromaffin cells of the sympatho-adrenal system of the adrenal or extra-аdrenal localization, secreting an excessive amount of catecholamines, and accompanies with the syndrome of hypertension of varying degrees of severity and diverse metabolic disorders. In addition to the synthesis and secretion of catecholamines, these tumors are able to produce a variety of biologically active peptides, including chromogranin A (neuroendocrine secretory protein), which, along with other laboratory tests, can help in the diagnosis of pheochromocytoma.
Consilium Medicum. 2018;20(4):63-6
pages 63-6 views

Seven etiologic factors of insulin resistance syndrome development

Titov V.N.


Biological role of insulin is metabolic processes regulation of, firstly, fatty acids (FA) and, secondly, of glucose. Insulin is known to regulate phylogenetic transformation of sarcophagous (ichthyophagous) animals of the ocean to herbivorous animals on land. Seven etiologic factors of insulin resistance syndrome: 1) somatic cells do not absorb glucose while they are able to absorb FA; FA absorption is always more active. To force cells to absorb glucose insulin deprives them of FA in non-esterified FA form (NEFA) absorption opportunity; 2) insulin warrants the highest mitochondria productivity in adenosine triphosphate (ATP) production and high animal unit kinetics parameters. Insulin indirectly regulates glucose metabolism; glucose is a substrate for olein monounsaturated FA synthesis. Among long chain FA mitochondria oxidize it most actively, producing ATP; 3) insulin cannot block NEFA release if lipolysis in visceral fatty omentum cells was activated by phylogenetically earlier hormone. Isulin blocks lipolysis only in subcutaneous adipocytes; 4) biochemical activity of palmitic saturated FA (SFA) is low; it is high in olein monounsaturated FA (MFA). In such biological function as locomotion development insulin expresses de novo synthesis of two enzymes: palmytoil-CoA-elongase and stearoyl-CoA-desaturase. These enzymes turn all hepatocyte synthesized palmitate SFA to highly active olein MFA; 5) insulin turns to olein MFA only palmitate SFA which was synthesized from glucose de novo but not from meat food SFA; 6) cells absorb FA in olein triglycerides form by apoE/В-100-endocytosis more actively than palmitate triglycerides by apoВ-100-endocytosis; 7) lack of ATP mitochondria production in trophology biologic function in mitochondria oxidation of palmitate SFA is to be compensated by biologic adaptation function activation, biologic endotrophy reaction, lypolysis in visceral fatty omentum cells and NEFA release. High NEFA serum level is the most common reason for insulin resistance syndrome.
Consilium Medicum. 2018;20(4):68-74
pages 68-74 views

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