Vol 17, No 4 (2015)

New technologies of modern medicine make it possible to improve not only the treatment but also patients monitoring under the conditions of health care facilities. The invention of Internet-based technologies brings medical care to the patient, in their homes. Remotely observation of patients requiring constant medical supervision becomes an integral part of the "doctor-patient" relationship. The compensation of carbohydrate metabolism in people with diabetes is based not only on medical knowledge, but also on the patient desire to achieve results. This article discusses the new approaches to control glycemia using the Accu-Chek Connect Online portal.

The article describes the role of sulfonylurea medications in modern recommendations concerning the treatment of patients with diabetes mellitus type 2. We showed the characteristics of mechanism of action and pharmacokinetics of glimepiride associated with positive differences in the efficacy of treatment, the frequency of hypoglycemic reactions, effects on weight, the frequency of side effects and complications of the treatment. We described the results of clinical studies concerning extrapancreatic effects of glimepiride (effect on the synthesis of glycogen, lipid metabolism, ischemic preconditioning, insulin resistance index). We studied the efficacy of glimepiride (Amaryl) in combination with the rapid-release metformin fixed combination of Amaryl and metformin (Amaryl M).

Interview with Shestakova Marina Vladimirovna - MD, professor, corresponding member of RAS, director of Institute ofDiabetes FSI Endocrinology Research Center of the Ministry of Health of the Russian Federation

Diabetes mellitus is a significant background disease, associated with frequent complications of an inflammatory nature. The review deals with the modern data on structure of inflammatory diseases of the upper respiratory tract in patients with diabetes mellitus, the characteristics of etiopathogenesis, therapy and prevention opportunities.

The review article deals with the latest scientific data and with results of our own clinical studies and have shown the issues on pathogenetic links of obesity, insulin resistance and disorders of male reproductive function. All analyzed problems are extremely important andrological trend today associated with the continuing growth of obesity and insulin resistance frequency as well the growth of infertility among male population, which, of course, show the close pathogenetic links between them. Obesity and insulin resistance are system factors of sperm oxidative stress regardless of other (including urological) possible causes of male infertility; and clinical experience has shown that without timely diagnosis and pathogenetic drug therapy the reproductive function improvement in infertile males should not be expected. On the other hand, there are effective and safe drugs for reproductively obesity and insulin resistance correction in the arsenal of endocrinologists today and this treatment can be recommended for wider application in andrological routine practice. Solution of the problem concerning the drug therapy of male infertility in patients with metabolic disorders is possible only on the basis of an interdisciplinary approach, which requires inform practicing andrologists in detail about the obesity and insulin resistance mechanisms of affecting the spermatogenesis and modern pathogenetic approaches to eliminate them in men with infertility.

The development of diabetes mellitus (DM) affects liver, disrupts the protein metabolism, amino acids, fats and other substances in hepatocytes, and predisposes to the non-alcoholic fatty liver disease. The treatment using oral hypoglycemic drugs can also make negative effect on the functional state of the liver. In some cases the combined drug treatment is prescribed, because of low efficacy of monotherapy and/or the presence of a patient with several diseases, particularly concerning the older people. Polypharmacy is one of the factors increasing the hepatotoxicity of drugs.Thus, not only the etiology and pathogenesis of the DM but also the application of complex long-term multi-component drug therapy requires the early hepatoprotectors application to prevent significant functional disorders of the liver in patients with DM. The drugs possessing metabolic type of action are advantageous now. The literature and experimental studies data let us suggest the reasonability of the complex therapy application using taurine - the sulfurcontaining amino acids, in patients with DM, which possess the hepatoprotective, and hypoglycemic effect.