AIMTo implement in 2009-2012 the RESULT observational program on the use of insulin glargine (Lantus) in combination with insulin glulisine (Apidra) as a basal-bolus regimen in patients with type 1 diabetes mellitus (DM) to evaluate the efficiency and safety of therapy with human insulin analogues.MATERIAL AND METHODSThe program covered 100 patients aged 19 to 25 years from 7 regions of the Russian Federation, who had had DM onset at the age of 9-13 years, were using human recombinant insulins as continuous insulin therapy, and had glycated hemoglobin (HbA1c) levels of 7 to 9%. The main inclusion criterion was switching to insulin therapy with the human insulin analogues Lantus and Apidra.RESULTSA total 41 men and 59 women were followed up. Their mean baseline HbA1c level was 8.3±0.7%. After 24 months of therapy, HbA1c was significantly decreased to 7.7±0.7%; its change compared with that at Visit 1 was -0.6±0.6% (p<0.001). There was a significant reduction in fasting and postprandial blood glucose levels at 3 months of a follow-up. The number of symptomatic and asymptomatic glycemic episodes declined. No nocturnal or severe hypoglycemic episodes were recorded at 24 months of therapy. Microvascular complications did not progress during the follow-up.CONCLUSIONThe use of human insulin analogues is effective and safe in treating young diabetic patients, improves their quality of life and confers no risk of asymptomatic or nocturnal hypoglycemic states.

There are presently no reliable methods for diagnostics of the early manifestations of the lesions in the peripheral nervous system. Only puncture biopsy of the skin and the nerves can be used at the preclinical stage. However, the application of these invasive methods is fraught with the risk of infectious complications. Confocal retinal microscopy is the new non-invasive morphometric technique that permits to reveal the early signs of the lesions in the peripheral nervous system and to study dynamics of the associated changes that can be used as a valid surrogate end point for the evaluation of the effectiveness of pharmacotherapy.

A pandemic expansion of diabetes mellitus (DM) observed nowadays across the globe is increasingly acknowledged as a disaster by all peoples of the world. Statistical analysis indicates an annual increase in prevalence of DM in Russian Federation that had reached 3 779 423 registered patients by 01.01.2013. Besides the humanitarian aspects, DM poses severe economic challenges for this country - challenges that stem both from high mortality and growing disability rate due to limb loss, decrease in visual acuity and need for hemodialysis, plaguing many DM patients.Aim. To produce an epidemiological evaluation based on the dynamics of prevalence of diabetic retinopathy in the Russian Federation - nationwide and in individual regions - across the last 13 years.Materials and Methods. Current survey included patients from various regions of the Russian Federation that were examined during epidemiological missions conducted by the federal Endocrinology Research Centre (2000- 2009), as well as National Programmes "Health" (2007) and "Diabetes - Learn In Advance" (2012-2013).Results. In the Russian Federation registered more than 630,000 patients with different stages of diabetic retinopathy. The prevalence of diabetic retinopathy among adults (18 years and older) with type 1 diabetes is 35.25%, while in type 2 diabetes - 16.67%. On average, this means that almost one in five patients (17.63%) with diabetes have certain eye problems.Conclusion. In summary, our data indicate a dramatic growth in the rate of diabetic ocular complications, with a particular increase in proliferative diabetic retinopathy, complicated cataract and neovascular glaucoma. These findings call for an even closer attention to early diagnostics, adequate management and, above everything else, timely prevention of ocular pathologies in patients with DM.

The present study included a total of 22 patients (44 eyes/orbits) presenting with endocrine ophthalmopathy (EOP) and Graves' disease. All of them underwent routine ophthalmological examination. The activity and severity of EOP were verified in accordance with the EUGOGO recommendations. The MRI protocol included obtaining T1-, T2-weighted, and STIR sequence images of the orbits. quantitative measurement of signal intensity (SI) from extraocular muscles (EOM), and the signal intensity ratio of EOM to ipsilateral temporal muscle (SIR value). The study has revealed the relationship of the minimal, maximum, and average EOM SI with EOP activity and severity. Moreover, it demonstrated direct correlation between SIR and clinical activity of EOP. It is concluded that MRI of the orbits with STIR sequence in the patients suffering EOP provides the additional criteria for the verification of the activity and severity of the disease as well as for prognostication of the response to the immunosuppressive treatment.

The present study included a total of 22 patients (44 eyes/orbits) presenting with endocrine ophthalmopathy (EOP) and Graves' disease. All of them underwent routine ophthalmological examination. The activity and severity of EOP were verified in accordance with the EUGOGO recommendations. The MRI protocol included obtaining T1-, T2-weighted, and STIR sequence images of the orbits. quantitative measurement of signal intensity (SI) from extraocular muscles (EOM), and the signal intensity ratio of EOM to ipsilateral temporal muscle (SIR value). The study has revealed the relationship of the minimal, maximum, and average EOM SI with EOP activity and severity. Moreover, it demonstrated direct correlation between SIR and clinical activity of EOP. It is concluded that MRI of the orbits with STIR sequence in the patients suffering EOP provides the additional criteria for the verification of the activity and severity of the disease as well as for prognostication of the response to the immunosuppressive treatment.

Aim. To evaluate results of panretinal laser coagulation (PLC) for severe non-proliferative and early proliferetaive diabetic retinopathy (DR) in patients with type 1 diabetes mellitus (DM1).Materials and methods. 58 patients with DM1 were observed. All of them were treated by panretinal laser coagulation after subtenon administration of triamcinolone (40 mg) under ultrasonic control.Results. PLC at the stage of severe non-proliferative DR stabilized its development in 35% of the patients and caused its reverse development with resolution of oedema and intraretinal hemorrhage, normalization of vein diameter, and improvement of visual acuity in 30%. In 35% of these cases PLC caused neovascularization within 1.6+-0.9 years after treatment. Reverse development of DR after PLC was documented in 46.3% cases with early proliferative DR but stabilization of DR occurred rarer than in the previous group (14.6%) and hemorrhage into the vitreous body more frequently (12 cases in 41 and 2 in 40 respectively, p = 0.0007). Patients with severe non-proliferative DR tended to have reduced requirement for vitrectomy after PLC compared with those having early proliferative DR (1 case of 40 and 6 of 41, p = 0.052).Conclusion: The above results suggest the necessity of early PLC in DM1 patients.