Dear Colleagues!We are glad to present the 12th (revised) Edition of the Standards of Specialized Diabetes Care.These evidence-based guidelines have been designed to standardize and facilitate diabetes care in all regions of the Russian Federation.The Standards are regularly updated to incorporate new data and relevant recommendations from national and international clinical societies, including World Health Organization (WHO), the Russian Association of Endocrinologists (RAE), the International Diabetes Federation (IDF), the European Association for the Study of Diabetes (EASD), the American Diabetes Association (ADA), the American Association of Clinical Endocrinologists (AACE), the International Society for Pediatric and Adolescent Diabetes (ISPAD), as well as the results of completed randomized clinical trials in patients with DM.The number of people with diabetes in the world has increased threefold over the past 20 years. In 2024, according to the International Diabetes Federation (IDF Atlas, 11th Edition, 2025), the number of people with diabetes in the world was 588.7 million people, 40% of whom were not diagnosed in time. More than 1 billion people have prediabetes (impaired glucose tolerance and/or impaired fasting glucose). Like many other countries, Russian Federation experiences a sharp rise in the prevalence of DM. According to the data of the Endocrinology Research Centre, obtained on the basis of the analysis of the “Clinical and Epidemiological Monitoring Database” (https://www.diaregistry.ru/) there were 5,814,928 people with DM in our country (3.9% of the population) on 01.01.2026: 92.3% (5,366,995) — type 2 diabetes mellitus, 5.3% (308,605) — type 1 diabetes mellitus and 2.4% (139,328) — other types of diabetes, including 20,982 women with gestational diabetes.However, these data underestimate the real number of patients, because they consider only registered cases of DM. Results of the Russian epidemiological study (NATION) confirmed that 54% of type 2 diabetes cases were undiagnosed. Thus, the real number of patients with diabetes in the Russian Federation is at least 11–12 million people (about 7% of the population). This represents an extreme threat. The most dangerous consequences of the global epidemic of diabetes are systemic vascular complications — nephropathy, retinopathy, coronary artery disease and peripheral vascular disease. These complications are responsible for the majority of cases of diabetes-related disability and death.This edition preserves the individualized approach to the selection of treatment goals in patients with diabetes and the choice of antihyperglycemic therapy. The most important updates:Type 2 Diabetes Mellitus remission criteria. Information on ICD-10 code E11.A has been added to indicate remission of type 2 diabetes in patients without complications.Type 2 Diabetes Mellitus. Treatment.Information on drugs available in the Russian Federation has been updated.In patients with ASCVD, tirzepatide (a dual GIP/GLP-1 receptor agonist) is considered as one of preferred options (based on the results of the SURPASS-CVOT study, which assessed the effect on cardiovascular risk compared to dulaglutide).The section on insulin therapy examines the possibilities of its deintensification; comments are provided for clarifying the role of concentrated insulin forms and ultra-rapid-acting insulins.Monitoring of patients with T2DM. HbA1c monitoring may be reduced to once every 6 months in patients who have consistently achieved target glycemic control (in patients without hypoglycemia or factors that could potentially distort HbA1c).Prevention of T2DM. A fasting plasma glucose level ≥ 6.1 mmol/L has been added as a criterion for the greater expected efficacy of metformin as the agent for pharmacological prevention.Diabetic nephropathy in T2DM. In antihyperglycemic therapy, SGLT2 inhibitors are prioritized due to their proven benefits in reducing the risk of CKD progression and cardiovascular events.Diabetic neuropathy. Visual materials with methods for assessing tactile and vibration sensitivity have been added.Diabetes and Heart Failure. Information has been added on the use of GLP-1 RAs (GLP-1 /GIP RAs) in patients with type 2 diabetes, obesity and heart failure.Diabetes mellitus and dyslipidemia. This section is presented as a separate part of manuscript for the first time. The feasibility of testing lipoprotein (а) levels for all patients to clarify cardiovascular risk once during life once during life has been determined. The position of bempedoic acid has been clarified for the first time. Approaches to the treatment of hypertriglyceridemia have been updated.Diabetes mellitus in children and adolescents. Type 1 diabetes mellitus. Glycemic targets have been revised according to ISPAD, 2024.Epidemiological data on diabetes mellitus in the Russian Federation have been updated.Some inaccuracies have been corrected.“Standards of Specialized Diabetes Care” have been a reference book for almost a quarter of a century not only for endocrinologists, but also for a wide range of doctors of other specialties. The advantages of the “Standards” are a concise, structured and visual presentation of information, and due to regular updates, every 2 years, a quick presentation of the most relevant data. This is the result of the work of a large team of authors and therefore allows us to cover a wide range of problems of patients with such a heterogeneous disease as DM.The working group draws attention to the fact that the information contained in the “Standards of Specialized Diabetes Care” reflects the key positions of approved clinical guidelines, but at the same time the “Standards” are not regulatory legal documents mandatory for execution in the territory of the Russian Federation, but are generally informational and advisory in nature. Legally binding documents that have priority are the current versions of the relevant clinical recommendations posted in the rubricator of the Ministry of Health of the Russian Federation (https://cr.minzdrav.gov.ru).On behalf of the Working Group
Metabolic diseases are currently significant factors of disability and mortality in the Russian Federation. Modern pharmacology offers many tools for glycemic control, but their effects on weight loss in patients are limited. There is currently no therapy for lipodystrophies except for symptomatic therapy. In this regard, the development of tissue engineering in combination with genetic technologies is a key factor in creating new approaches to the treatment of metabolic diseases. The presented review article describes various approaches to tissue engineering for the formation of grafts of adipocyte origin. Today, a variety of cells are used for these purposes — these are adipose-derived mesenchymal stromal cells (ADSC), which are progenitors of mature adipocytes and components of the cellular niche of adipose tissue, and metabolically healthy adipocytes, and thermogenic adipocytes. Cells are used both in a native state and can be genetically modified. The presented review integrates knowledge about transplantation of various adipose tissue derivatives in different tissue-engineered formats for the treatment of major metabolic diseases, which include lipodystrophies, obesity, and type 2 diabetes mellitus. The results of the review can give a significant impetus to the development of new approaches to the treatment of metabolic diseases.
BACKGROUND: The problem of achieving target glycemic control in patients with diabetes mellitus type 1 (T1DM) remains relevant. Currently, new, more technologically advanced methods of insulin therapy (IT) are being actively developed — one of them is the IT method of a closed loop (do-it-yourself closed loop system, DIY-CLS). This type of therapy is not registered in Russia, however, patients install these systems themselves, in connection with which it seems important to discuss the principle of DIY-CLS operation, the possibilities and prospects of their use.OBJECTIVE: To evaluate the glycemic control indicators, the frequency of acute complications of diabetes in patients with type 1 diabetes on different types of therapy.MATERIALS AND METHODS: We observed 98 patients who were divided into 3 groups: patients using MII (n=40), patients with CSII (n=40) and patients with DIY-CLS (n=18). All groups were comparable in age, sex and the duration of T1DM history.RESULTS: The majority of patients were women (73.47%), the average age was 33.3±2.4 years, the duration of diabetes was 17.1±2.2 years. It was found that in patients from the DIY-CLS group, compared with the MII and CSII groups, according to continuous glucose monitoring, the time in range was significantly higher, the mean glucose, standard deviation, time above range 10.1–13.9 mmol/l and time above range >13.9 mmol/l were significantly lower. The number of hypoglycemic states and hyperglycemic events leading to the development of ketosis was comparable.CONCLUSION: Glycemic control values were significantly better in patients using DIY-CLS. Patients in the DIY-CLS group more often achieved target time above range and coefficient of variation levels.
BACKGROUND: Type 2 diabetes mellitus (T2DM) is one of the major risk factors for severe COVID-19 and increased mortality. The long-term consequences of the infection remain unclear.AIM: To assess mortality and risk factors for death in patients with T2DM after COVID-19, both in acute phase and long-term follow-up.MATERIALS AND METHODS: This was a retrospective observational case-control study. Study included patients over 18 years of age with T2DM and recorded history of COVID-19 in clinical-epidemiological diabetes monitoring database from 2020 to 2022. Control group consisted of patients with T2DM who died between 2020 and 2022 from causes not related to COVID-19. Statistical analysis performed using RStudio 2024.04.02 (Posit Software, PBC) with R programming language, version 4.3.3.RESULTS: The study included 7,625 patients with T2DM who had recovered from COVID-19 and 212,352 patients with T2DM without a documented history of COVID-19. From 2020 to 2022, the mortality rate in the post-COVID group was 24.6%, of which 21.7% occurred during the acute phase. This was significantly higher than in the control group (14.1%, p<0.001).In the long-term period after COVID-19, the following factors were associated with increased mortality risk: older age (OR 1.06; 95% CI 1.04–1.07, p<0.001), longer diabetes duration (OR 1.03; 95% CI 1.01–1.05, p<0.05), and older age at diabetes onset (OR 1.04; 95% CI 1.02–1.05, p<0.001).A lower risk of death in the long-term period was associated with the use of SGLT2 inhibitors (HR 0.45; 95% CI 0.29–0.70, p<0.001) and metformin (HR 0.40; 95% CI 0.30–0.54, p<0.001).CONCLUSION: Mortality was higher among patients with history of COVID-19 compared to control group. Increase in mortality was primarily due to deaths in acute phase of infection. After adjusting for sex, age, following factors were independently associated with increased long-term mortality in T2DM patients after COVID-19: older age, male sex, insulin therapy. Protective factors included use of SGLT2 inhibitors and metformin.
BACKGROUND: With the onset of the COVID-19 pandemic, restrictions were introduced on the availability of planned medical care, which could negatively affect the compensation of children, especially with newly diagnosed type 1 diabetes mellitus (T1DM). During this period, there was a need to improve the methods of dynamic monitoring of children with the manifestation of type 1 diabetes using modern remote technologies from the first days of discharge from the hospital.AIM: To evaluate the effectiveness of methods for dynamic observation of children with manifestation of T1DM, optimized in conditions of limited availability of planned medical care.MATERIALS AND METHODS: A single-center, 12-month prospective comparative study was conducted in three populations of children under 17 years of age with manifestation of T1DM during the COVID-19 pandemic, who were monitored using a standard approach, as well as methods optimized with the use of telemedicine consultations (TMC) and CGM and assessment of the HbA1c level and the proportion of patients with HbA1c<7.0% at the endpoint of observation.RESULTS: The study included 137 children: 61 — standard observation (SO) group; 25 — TMC group and 51 — TMC+CGM group, which were comparable with each other by age, gender, proportion of children in puberty, anthropometric data, as well as by the severity of T1DM manifestation and daily insulin doses (p>0.05). After 12 months of observation, a significant decrease in the HbA1c level was found in the TMC and TMC+CGM groups compared to the SO group (7.1% and 6.7% vs. 8.3%; p=0.000), while HbA1c did not differ between the TMC and TMC+CGM groups (p=0.642). The proportion of patients who achieved HbA1c<7.0% in the TMC and TMC+CGM groups statistically significantly exceeded the proportion of patients in the SO group at the endpoint of observation (48.0% and 56.9% vs. 27.9%; p<0.001), however, the TMC and TMC+CGM groups did not differ from each other (p=0.466).СONCLUSION: Methods of remote dynamic monitoring of children with manifestation of T1DM demonstrated better efficiency in achieving and maintaining glycemic control compared to standard monitoring, which dictates the need for their wider use in clinical practice. The main factor contributing to the achievement of compensation of T1DM in children is the availability of specialized medical care and regular consultations with a doctor.
BACKGROUND: Diabetic neuroosteoarthropathy (Charcot foot) is a severe complication of diabetes mellitus, leading to foot deformity and loss of function. The pathogenesis involves disturbances in bone metabolism; however, the role of vitamin D metabolism, particularly its individual metabolites, in Charcot foot remains poorly understood.AIM: To investigate the levels of vitamin D metabolites and their relationship with phosphate-calcium metabolism parameters and bone tissue status in patients with type 1 and type 2 diabetes mellitus complicated by Charcot foot.MATERIALS AND METHODS: A single-center cross-sectional study was conducted, including 30 patients with Charcot foot. All participants underwent a comprehensive examination, which included assessment of a wide range of vitamin D metabolites using liquid chromatography with tandem mass spectrometry (LC-MS/MS), bone turnover markers, bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA), and evaluation of clinical and laboratory parameters.RESULTS: Deficiency or insufficiency of 25(OH)D was detected in 64% of patients (median 17.1 ng/mL). Low levels of the active metabolite 1,25(OH)₂D₃ and the catabolite 24,25(OH)₂D₃ were observed, indicating systemic dysregulation of vitamin D metabolism. A statistically significant negative correlation was found between BMI and 3-epi-25(OH)D₃ levels (R=-0.43; p=0.041), as well as between the duration of insulin therapy and folate levels (R=-0.58; p=0.037). Patients with diabetic nephropathy had significantly higher levels of the bone resorption marker β-crosslap (p=0.003). Expected negative correlations were found between femoral neck BMD and parathyroid hormone (PTH) levels (R=-0.56; p=0.010) and albumin-corrected calcium levels (R=-0.50; p=0.016).CONCLUSION: Patients with Charcot foot exhibit profound, multi-level disturbances in vitamin D metabolism that are universal and weakly associated with other microvascular complications. The presence of diabetic nephropathy is associated with significantly increased bone resorption. These findings justify the need for routine screening and correction of vitamin D and folate deficiencies in the comprehensive management of these patients.
Interest in studying intermediary metabolic products and cellular bioenergetics is driven by the global increase in the prevalence of metabolic diseases. Structural features of bone tissue associated with an increased risk of fragility fractures in diabetes mellitus are associated with complex disorders of bone metabolism, including the accumulation of advanced glycation end products, suppression of osteoblastogenesis, increased sclerostin expression, development of oxidative stress and enhancement of catabolic processes under the influence of hyperglycemia. Pathogenetic changes in osteoporosis, in turn, are associated with complex alterations in cellular energy metabolism, mitochondrial function, and purine homeostasis, which contribute to a progressive imbalance in bone remodeling and a decrease in the biomechanical properties of bone tissue. This literature review provides information on the main sources and pathways of adenosine triphosphate synthesis in bone cells, the mechanisms of energy metabolism regulation under normal conditions, as well as under conditions of hyperglycemia in diabetes mellitus and under conditions of age-related changes in the body with the development of osteoporosis. The presented data reveal promising prospects for the development of targeted therapies aimed at the described metabolic alterations, offering a potential approach for the prevention and management of bone disorders.
The prevalence of obesity and its associated diseases continues to grow steadily worldwide, despite significant improvements in various treatment approaches. The advent of GLP-1 and GIP agonists and the development of bariatric surgery have significantly improved obesity treatment options, complementing dietary interventions, physical exercise, and a number of drugs that have long been used in clinical practice. At the same time weight loss strategies differ in their effects on fat and muscle tissue. It is well known that subcutaneous (SAT) and visceral (VAT) adipose tissues make unequal contributions to metabolic disorders in obesity, and reducing visceral adipose tissue is the most important goal during weight loss. Maintaining metabolically active muscle tissue and prevention of sarcopenia is also a very important issue. The question of different obesity treatment strategies impact on adipose and muscle tissue has attracted interest among researchers and clinicians, and therefore we have considered it in this review.
BACKGROUND. The system for clinical and epidemiological monitoring of diabetes mellitus (DM) in the Russian Federation (RF) was established by Endocrinology Research Centre in 1996 as part of the Federal Program "Diabetes Mellitus." The DM database (previously the registry) has become a key tool for analyzing the most important indicators of patients with DM, necessary for assessing the clinical status and the effectiveness of therapeutic strategies to improve the quality of care and make management decisions in healthcare.AIMS. To analyze epidemiological and clinical-therapeutic DM indicators: prevalence, incidence, age of onset, carbohydrate metabolism control and the proportion of obese patients, changes in the structure of hypoglycemic therapy (HLT), the prevalence of diabetic complications in the Russian population of DM patients in the RF.MATERIALS AND METHODS. Research object: "Database of Clinical and Epidemiological Monitoring of Diabetes Mellitus in the Russian Federation," including patients with diabetes mellitus from 89 regions of the Russian Federation (Registration Certificate No. 2020622447, http://diaregistry.ru), copyright holder: Endocrinology Research Centre. Data extraction date: January 1, 2026. The data are presented as of 01.01.2026 and in dynamics.RESULTS. The total number of DM patients in the RF as of 01.01.2026 was 5,814,928 (3.9% of the Russian population), of which 308,605 (5.3%) had type 1 diabetes (T1DM), 5,366,995 (92.3%) had type 2 diabetes (T2DM), and 139,328 (2.4%) had other types of diabetes. Over 30 years of clinical and epidemiological monitoring in the period 1996–2025, the prevalence increased as follows: T1DM by 3.3 times from 62.0 to 205.7/100 thousand population, T2DM by 8.6 times — from 416.6 to 3569.0/100 thousand population. The incidence increased in T1DM by 1.3 times from 6.3 to 8.1/100 thousand population; in T2DM by 4 times from 55.9 to 259.8/100 thousand population. Among the causes of death, cardiovascular (CV) pathology (heart attack, stroke, heart failure, acute CV disorders) ranks first, accounting for 36.9% T1DM and 51.1% of T2DM. Life time with diabetes in the period 2010–2025 increased: T1DM 15.3→20.4 years, T2DM 10.2→11.8 years. The number of patients with the target HbA1c level <7% in 2010–2025: T1DM 24.4%→32.5%, T2DM 41.4%→48.4%. The dynamics of prevalence of the main diabetic complications in adult patients in 2010→2025 with T1DM/T2DM was: diabetic coma 2.5%→1.4%/0.15%→0.03%, neuropathy 43.8%→47.4%/22.3%→22.9%; chronic kidney disease (CKD) 21.0%→26.3%/5.1%→23.1%; diabetic retinopathy 38.5%→32.3%/17.2%→10.7%; diabetic foot syndrome 5.2%→2.9%/2.3%→1.0%; myocardial infarction 1.5%→1.1%/4.0%→3.4%; coronary heart disease (CHD) 5.1%→2.3%/14.9%→8.3%; chronic heart failure (CHF) 0.1%→0.9%/0.5%→3.8%; cerebrovascular disease 1.9%→1.3%/4.6%→4.0%; amputations 1.4%→1.3%/0.7%→0.79%. Traditional medications predominate in the structure of cardiovascular diseases in T2DM: metformin accounted for 75.7%, sulfonylureas 36.9%, and insulins 17.7%. iDPP4, iSGLT2 and arGLP1 were more often prescribed in patients with concomitant CKD, CHF, and high CV risk.CONCLUSIONS. The obtained data, based on long-term dynamic clinical and epidemiological monitoring of diabetes mellitus, demonstrate the effectiveness of systematization and control the most important characteristics of diabetes on a single platform, which allows for the implementation of disease management strategies in clinical practice by optimizing the patient management algorithms.
The article is devoted to the pharmacological and impairment features of finerenone, a new non-steroidal antagonist of mineralocorticoid receptors (AMR), like other drugs, suppresses the activity of the renin-angiotensin-aldosterone system (RAAS), which plays a key role in the pathogenesis of cardiovascular diseases (CVD). Compared to other AMRs, finerenone more selectively and more tightly binds to mineralocorticoid receptors, which causes its pronounced anti-inflammatory, antifibrotic, antioxidant and other effects not only in the kidneys, but also in the heart and blood vessels. In several randomized trials — FIDELIO-DKD, FIGARO-DKD — in patients with type 2 diabetes mellitus (DM2) and chronic kidney disease (CKD) with albuinuria (AU), finerenone demonstrated a significant reduction of renal dysfunction progression, and in the treatment of FINEARTS-HF in patients with heart failure (HF) with a left ventricular ejection fraction ≥40%, finerenone was associated with a relatively low incidence of worsening HF and cardiovascular mortality compared with placebo. Pooled data from these three studies show a reduction of all-cause mortality, worsening HF, and renal adverse outcomes with finerenone.In current guidelines, the finerenone is recommended for patients with DM2 and CKD with AU during cardiovascular events and renal failure. The article describe three clinical cases in which patients were prescribed finerenone as part of the preparation of the evidence base for this. One of these examples shows an improvement in renal function after the addition of finerenone alone.
We report a rare clinical case of the coexistence of two autoimmune diseases: type 1 diabetes mellitus and granulomatosis with polyangiitis. Both conditions share a common target — small-caliber blood vessels — which contributes to overlapping mechanisms of tissue injury, progressive microcirculatory impairment, and the development of multiple diabetes-related complications. The requirement for systemic glucocorticosteroids as pathogenetic therapy represents a particular therapeutic challenge: while indispensable for the control of vasculitis, they simultaneously impair glucose metabolism, exacerbate glycemic variability, and slow wound healing. The concurrence of these pathologies is exceedingly uncommon and typically manifests as a syndrome of mutual aggravation with a poor clinical prognosis. In cases of lower-limb ulcerations, lesions should be regarded as potentially chronic and treatment-refractory, thereby raising the question of amputation. Comprehensive monitoring, including advanced glycemic control technologies and regular evaluation of vasculitis activity, is essential in such patients. This case highlights the clinical features, management strategy, and pathogenetic mechanisms underlying complications, underscoring the need for individualized, multidisciplinary approaches.
BACKGROUND: Patients with prediabetes have an increased risk of developing type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). However, the economic impact of using medications to treat prediabetes has been insufficiently studied.AIM: The purpose of the study is to perform a clinical and economic evaluation of extended-release (XR) metformin for the treatment of prediabetes, assess its healthcare budgetary impact, and determine its potential to contribute to achieving the target indicators of Federal healthcare programs.MATERIALS AND METHODS: We compared XR metformin therapy with no medication therapy among patients aged 40–59 years with prediabetes, for whom lifestyle interventions had failed to achieve adequate glycemic control. A Markov model was developed to describe the number of patients with prediabetes over a 10-year horizon using comparison variants, the incidence of adverse cardiovascular events, and mortality from all and cardiovascular causes. The analysis accounted for out-of-pocket expenditures for pharmacotherapy and public healthcare system costs for the management and monitoring of prediabetes and its complications, including T2DM.RESULTS: Over a 10-year period, the use of XR metformin in patients with prediabetes could prevent 63 524 deaths, including 41.6 thousand from CVD. The estimated additional annual out-of-pocket expenditures for 100% coverage with XR metformin are approximately 4.3 billion RUB. Due to reducing the incidence of T2DM and CVD, budget savings on T2DM and CVD treatment, outpatient care, and the purchase of medical devices over 10 years are estimated at 4.7 billion RUB per year. From a healthcare system perspective (public healthcare + out-of-pocket expenditures), the average net annual savings are 410 million RUB.CONCLUSION: The use of XR metformin in patients with prediabetes can reduce the rate of progression to T2D, the incidence of serious CVD events, and mortality (both all-cause and cardiovascular) and thus contribute to achieving the goals set in the federal projects "Combatting Cardiovascular Diseases" and "Combatting Diabetes Mellitus." Moreover, using XR metformin in patients with prediabetes could lead to a net reduction in public healthcare expenditures, with the long-term savings exceeding the additional costs borne by individuals for metformin therapy.
BACKGROUND. Continuous glucose monitoring (CGM) is becoming the standard of care for children with type 1 diabetes (T1D), yet data on its use in children under 4 years old remain limited. FreeStyle Libre 2 (FSL2) is approved for use from the age of 4, but there is a clinical need for use in younger age groups.OBJECTIVE. To evaluate the accuracy and safety of the FSL2 system when used off-label in children aged 1–4 years with T1D.MATERIALS AND METHODS. The study included 20 children with T1D (mean age 2.8±0.7 years, diabetes duration 1.2±0.8 years, HbA1c 7.1±1.4%). Participants consecutively used two FSL2 sensors over a 28-day period. Accuracy was assessed by comparing FSL2 data to reference capillary blood glucose measurements (≥6 times daily). Analyses included mean absolute relative difference (MARD), agreement rates, and distribution across zones of the Parkes consensus error grid.RESULTS. A total of 2,554 paired measurements were analyzed. Overall MARD was 11.5% (95% CI: 10.6–12.3%). Agreement rates: 74.6% of readings were within ±15%/15 mg/dL, and 84.2% within ±20%/20 mg/dL. A total of 99.9% of readings fell within Zones A+B of the consensus error grid. MARD remained stable over the 14-day sensor wear period (11.9%, 11.1%, 11.7% in the initial, middle and final periods of use). The average sensor wear time was 285.7±95.9 hours. No serious adverse events were reported; local skin reactions were mild and resolved fully without any treatment.CONCLUSION. FSL2 demonstrated clinically acceptable accuracy and a high safety profile in children aged 1–4 years with T1D. The findings support potential extension of FSL2 use in this age group to improve glycemic control and family quality of life.
RELEVANCE. Type 2 diabetes mellitus (DM2) is closely related to obesity and insulin resistance (IR). Semaglutide, glucagon-like peptide-1 receptor agonist, exhibits pronounced effects on glycemic control and body weight. However, data on its effect on various surrogate IR indices in routine practice are limited.AIM. To evaluate the effect of semaglutide (Semavic®) on metabolic control and IR in patients with DM2 and obesity who did not achieve the target values of carbohydrate metabolism on metformin monotherapy.MATERIALS AND METHODS. The prospective study included 31 patients aged 40–65 years with DM2, BMI 30.0–39.9 kg/m2 and HbA1c 7.0–9.0% on metformin treatment; 28 patients completed a 24-week follow-up. Anthropometric parameters, bioimpedance body composition, HbA1c, fasting glycemia, insulin, C-peptide, free fatty acids were evaluated. HOMA-IR, QUICKI, TyG, Adipo-IR indices, C peptide/insulin molar ratio were calculated.RESULTS. After 24 weeks of semaglutide therapy, there was a significant decrease in body weight (median -8.2% or 8.58 kg), BMI, waist circumference and fat mass as well as an improvement in carbohydrate metabolism: HbA1c had decreased from 7.63% to 6.25%, 85.7% of patients reached HbA1c <7.0%. There was a significant decrease of HOMA-IR, TyG, Adipo-IR indices, an increase of QUICKI and C peptide/insulin molar ratio indicating a decrease of IR in the liver, adipose and peripheral tissues. Adverse events were observed in a small proportion of patients and were mainly of a temporary dyspeptic nature.CONCLUSIONS. Semaglutide in patients with DM2 and obesity in real clinical practice provides a significant reduction of body weight, improves glycemic control and leads to multicomponent reduction of IR with a favorable safety profile.
Erratum: "Rotary activity as the main electrophysiology mechanism of the persistent form of atrial fibrillation of patients with type 2 diabetes mellitus" by Irina A. Bulavina, Igor A. Khamnagadaev, Nikolay I. Tyurin, Ekaterina K. Melkozerova, Leonid A. Belousov, Irina Z. Bondarenko, Olga A. Shatskaya, Ilya L. Ilyich, Viktor Y. Kalashnikov published in Diabetes Mellitus. 2025;28(6):314-320. doi: 10.14341/DM13412.An error occurred in the author list of the original article: Natalia G. Mokrysheva was inadvertently omitted from the author list. The correct list of authors is as follows: Irina A. Bulavina, Igor A. Khamnagadaev, Nikolay I. Tyurin, Ekaterina K. Melkozerova, Leonid A. Belousov, Irina Z. Bondarenko, Olga A. Shatskaya, Ilya L. Ilyich, Viktor Y. Kalashnikov, Natalia G. Mokrysheva. The Editorial Office regrets this error. The original version of the article has been replaced.
OBJECTIVE. To analyze and describe existing methods for the diagnosis and treatment of diabetic neuroosteoarthropathy.MATERIALS AND METHODS. A search and analysis of clinical trials, meta-analyses, systematic reviews and clinical guidelines on the diagnosis and treatment of Charcot neuroarthropathy was conducted. The literature search was carried out across the MEDLINE, ELibrary, PubMed, Web of Science, Google Scholar, and Clinical Key databases. The search covered a 20-year period; publications of historical significance were also included.RESULTS. A total of 165 publications were incorporated into this review. The paper outlines key features of the clinical presentation and course of diabetic neuroosteoarthropathy, and summarizes current scientific understanding of its etiology, classification, diagnostic criteria and treatment options.CONCLUSION. Implementation of the proposed algorithms will help to objectify the diagnosis and improve the quality of medical care provided to patients with Charcot neuroarthropathy.
February 12, 2026, marks the 85th birthday of Academician of the Russian Academy of Sciences Ivan Ivanovich Dedov. He serves as President of the State Research Center of the Russian Federation – Endocrinology Research Centre, Chief NonStaff Endocrinologist of the Russian Ministry of Health, Hero of Labour of the Russian Federation, and is a full holder of the Order "For Merit to the Fatherland".
BACKGROUND: There has been an increasing focus on the use of digital systems for remote monitoring (RM) of patient health recently.AIM: To evaluate the clinical effectiveness of the RM system in patients with type 1 and type 2 diabetes (T1D and T2D) compared to traditional outpatient care.MATERIALS AND METHODS: a non-randomized prospective open comparative multicenter study with parallel groups was conducted in 7 regions of the Russian Federation from March to September 2024. The study included patients with T1D, T2D on non-insulin therapy, and T2D on insulin therapy. The intervention group used a glycaemia RM system, which included a glucometer with a data transmission set, a mobile application that received data from the glucometer via Bluetooth technology, and a data transmission system for the doctor. In the control group, glycemia was assessed as part of routine clinical practice (in-person visits with a self-monitoring diary).RESULTS: A total of 1,572 patients were included in the study. After a 180-day follow-up, the overall completion rate was 48% (754 patients). The primary endpoint, HbA1c levels, decreased comparably in the RM and control groups in patients with T1DM and in both cohorts of patients with T2DM. The proportion of individuals who achieved HbA1c target values was higher in the RM group compared to the control group in patients with T1DM (26.06% vs. 10.91%, respectively, p=0.023) and T2DM on non-insulin therapy (51.5% vs. 33%, respectively, p=0.003). RM use was associated with a reduction in unscheduled medical interventions.CONCLUSION: RM has shown clinical efficacy in increasing the proportion of patients achieving HbA1c target values in the group of patients with T1D and T2D on non-insulin antidiabetic therapy.
Slowly developing immune-mediated diabetes mellitus in adults combines the phenotypic and immunological characteristics of type 1 and type 2 diabetes mellitus, which often complicates the correct diagnosis and timely initiation of appropriate glucose-lowering therapy. The article presents a clinical case of a 46-year-old patient with slowly evolving immune-mediated diabetes with multiple complications, initially diagnosed as type 2 diabetes mellitus, upon hospitalization in a surgical hospital for phlegmon of the right foot. A feature of the clinical case is the complications, the severity of which did not correspond to the known duration of the disease and was due to a "hidden", long-term course. The correct diagnosis established during the diagnostic search will avoid attempts to prescribe incorrect therapy to the patient in the future, which can lead to decompensation of carbohydrate metabolism and progression of late complications. With this article, we want to draw the attention of endocrinologists and doctors of other specialties to the complexity, diversity of the clinical course of LADA diabetes and the need for differential diagnosis, a detailed collection of the disease history, as well as the importance of determining autoantibodies in the atypical course of type 2 diabetes mellitus.
