Almost 90% of patients with type 2 diabetes mellitus (DM2) are obese. Obesity increases the risk of developing DM2 several times. The calculation of anthropometric indices is used to diagnose the severity of obesity, as well as to assess the risk associated with obesity. The aim of the study is to study the relationship between Body Mass Index (BMI), waist circumference to hip circumference ratio (waist-to-hip ratio, WC/HR), Body Roundness Index (BRI) and Visceral Adiposity Index (VAI) with the risk of hypoglycemia in elderly and senile patients with DM2. The study included 122 elderly and senile patients (mean age 71±6,18 years) with DM2. The study participants were divided into 2 groups: patients with cases of hypoglycemia (n=65) and patients without a history of hypoglycemia (n=57). We have found that lower BMI, WC/HR, BRI, and VAI values are significantly associated with an increased risk of hypoglycemia in patients with DM2 of older age groups.

One of the risk factors for the development of sarcopenia is malnutrition. Impairment of the energy value of the diet, the balance of proteins, fats and carbohydrates, a decrease in the protein-amino acid component of the nutritional diet - all this can lead to the development of sarcopenia. The intestinal microflora plays an important role in the process of growth and development of muscle tissue, in preventing its degradation with age. Fatty hepatosis and cirrhosis of the liver can also cause the development of sarcopenia. The problem is urgent and modern, and needs to be studied, which is what this literature review is dedicated to.

The incidence of type 2 diabetes mellitus is constantly increasing throughout the world. It is known that type 2 diabetes is associated with the development of atherosclerotic cardiovascular diseases, chronic heart failure, and chronic kidney disease. Modern therapy for type 2 diabetes mellitus requires complex treatment and should be aimed not only at reducing glycemia, but also at managing the risks of cardiovascular and renal complications. The results of large scientific studies ADVANCE, ACCORD and VADT have clearly proven the role of glycemic control in the prevention of microvascular complications of diabetes. A number of studies have established that the parameters of glycemic variability are of independent importance in predicting diabetic retinopathy, nephropathy and cardiovascular complications. Hyperglycemia also plays an important role in the development of macrovascular complications. The modern approach to the management of diabetes as one of the most important methods of preventing micro-and macroangiopathies includes the need for mandatory self-monitoring of blood glucose. Self-monitoring of glycemia should be accurate, simple and convenient, allowing the patient to carry out effective and safe glucose-lowering therapy. One of the main aspects of self-monitoring of blood glucose is the choice of a glucometer. From the doctor’s point of view, the most important criterion for choosing a glucometer is compliance with accuracy standards, and from the patient’s point of view, convenience and ease of use. Thanks to the improvement of technology, the accuracy of blood glucose measurements increases, the procedure for self-monitoring of glycemia is simplified, which leads to increased adherence to treatment and the effectiveness of glucose-lowering therapy. Achieving and maintaining the target glycemic level, preventing micro-and macrovascular complications are impossible without the active full participation of the patient himself in the treatment of diabetes, self-monitoring of blood glucose using an accurate and patient-friendly glucometer, i.e., Contour Plus One.

The interaction between bone and muscle tissues extends beyond simple mechanical relations. Bone tissue performs an endocrine function and generates active metabolites and hormones that influence skeletal muscle, insulin sensitivity, adipose tissue, and metabolism in general. With aging, the risk of osteopenia, osteoporosis, and sarcopenia increases. The relationship between osteoporosis, sarcopenia, and aging in humans is of interest, as well as therapeutic and preventative measures aimed at avoiding these pathological conditions.

Adipose tissue is an active endocrine organ that regulates energy homeostasis throughout the body by releasing hundreds of biologically active substances called adipokines. Dysregulation of adipokines is a key feature of insulin resistance with the development of metabolic syndrome and type 2 diabetes mellitus, which is an age-dependent pathology. In turn, dysregulation of adipokines and insulin resistance are associated with the development of metabolic deficiency and senile asthenia syndrome in older age groups. Previous studies have shown that the absence of insulin resistance and low prevalence of diabetes among centenarians are metabolic prerequisites for increased lifespan, suggesting a possible role for adipokine homeostasis in healthy longevity. Among numerous adipokines, adiponectin is considered a protective factor, showing a negative correlation with major metabolic disorders associated with age and obesity, and a positive association with life expectancy and insulin sensitivity among centenarians. Despite all the apparent protective effects of adiponectin, large-scale epidemiological studies have revealed the opposite aspect of adiponectin as a predictor of all-cause mortality and cardiovascular disease in patients with heart failure as well as kidney disease. In this review, the clinical significance of adiponectin is considered in centenarians from the point of view of the development of the main geriatric syndrome - senile asthenia, as well as cardiovascular risk and mortality.

Obesity is an important medical and social problem, it occupies one of the leading places among cardiovascular risk factors. Obesity is a major component of the metabolic syndrome. It has a close pathogenetic relationship with its other manifestations, as a result of which a portrait of a comorbid patient is formed. The article presents data on the prevalence, criteria for diagnosing obesity, the relationship of obesity with other components of the metabolic syndrome is shown. The role of adipose tissue dysfunction in obesity on the development and progression of insulin resistance, atherosclerosis, as well as its relationship with non-alcoholic fatty liver disease and arterial hypertension is discussed. It is shown that obesity is a comorbidity factor and the basis of the metabolic syndrome, the leading pathogenetic mechanism in the formation and progression of its components, preceding their occurrence. This allows us to conclude that weight loss can reduce cardiovascular risks, reduce the manifestations of the metabolic syndrome, and in some cases even eliminate them completely.

Autoimmune polyglandular syndromes are a group of rare multi-organ pathologies resulting from autoimmune aggression and characterized by polymorphic endocrine and non-endocrine organ lesions. Depending on the combination of organs involved in the autoimmune process, there are 4 types of autoimmune polyglandular syndrome. Type 1 has an autosomal recessive type of inheritance, more common in children and adolescents. Types 2–4 are associated with the expression of antigens the HLA system and manifest typically in adult patients. The article provides a brief description of all types of autoimmune polyglandular syndromes, in more detail describes type 2 (Schmidt syndrome), the clinical case of which is addressed in this article. The following is a clinical case: observation of a 46-year-old male hospitalized in the endocrinological department of Samara City Hospital No. 5 with autoimmune polyglandular syndrome type 2 with decompensation of adrenal insufficiency and hypothyroidism. Submitted complaints, anamnesis, laboratory and instrumental examination of the patient, results of screening for the presence of antibodies that confirm the diagnosis of autoimmune polyglandular syndrome type 2. Surveys have been conducted to eliminate other causes of primary adrenal insufficiency. Additional surveys carried out to identify other possible components of autoimmune polyglandular syndrome type 2 are described. The prescribed treatment according to the nationalclinical recommendations, as well as the features of the prescription of hormone replacement therapy, described further dynamic observation at the outpatient stage and given laboratory control indicators. Conclusions are made about possible difficultiesin the diagnosis and treatment of this pathology.

Objective: to study and clinically substantiate the relationship between overweight and the dynamics of CKD progression in patients with type 2 diabetes of different age groups using the diagnostic parameter Index of glomerular filtration rate reduction. Material and methods: a single-stage cross-sectional observational study of clinical indicators in a population sample of patients with type 2 diabetes of different age groups was performed, patterns of relationships, significance of differences in mean values and measures of influence (OR (95%CI)) were studied between the indicators of BMI, the stage of obesity and the presence of a diagnosis of obesity in the anamnesis and the original calculated diagnostic parameter, the Index of glomerular filtration rate reduction (RI_GFR), which allows to give an objective quantitative characteristic of the rate of progression of CKD. Results: significant correlations were established between RI_GFR and indicators of age, BMI, DM experience and duration of insulin therapy, a significant inverse relationship with BMI was noted only in the older group; when analyzing differences in the average values of clinical indicators in the groups of rapid and slow progression of CKD, divided by the threshold value of RI_GFR, significant factors affecting the rate of progression were determined CKD: DM experience, duration of insulin therapy, BMI; the logistic regression analysis determined the measure of the influence of the above factors on the dynamics of GFR reduction, confirmed its significance; when analyzing the factors of drug treatment in the elderly group, it was revealed that an integrated approach to the appointment of antihypertensive therapy (prescribing drugs of three or more groups) significantly reduces the risk of rapid progression of CKD. Conclusions: the most significant risk factors for the high rate of progression of CKD in patients with type 2 diabetes and overweight in the general sample and in patients of the older age group are the length of diabetes and duration of insulin therapy; the dynamics of GFR reduction in patients with type 2 diabetes of different age groups is interrelated with BMI, and in patients with overweight CKD progresses more slowly; an integrated approach to prescribing antihypertensive therapy (prescribing drugs of three or more groups) in elderly patients with type 2 diabetes significantly reduces the risk of rapid progression of CKD.

Metabolic associated fatty liver disease (MAFLD) is currently the most common liver disease. The main risk factors for its development are poor nutrition, sedentary lifestyle and obesity. MAFLD is associated with various cardiometabolic conditions – lipid metabolism disorders, cardiovascular pathology and carbohydrate metabolism disorders. The association of MAFLD and type 2 diabetes mellitus (DM) is common among patients, since these diseases have a common pathogenesis link – insulin resistance. The combination of these diseases has a mutual negative effect on each other and increases the risks of cardiovascular diseases, hospitalizations, as well as the risks of liver fibrosis progression. Therefore, the detection of MAFLD and its treatment in type 2 DM are extremely important to improve the patient’s prognosis. Diagnostics of MAFLD includes laboratory and instrumental research methods. The “gold standard” of diagnostics is considered to be liver biopsy, but due to the fact that this method is invasive, it is rarely used and only for differential diagnostics of MAFLD with other liver pathologies. The most accessible instrumental method for detecting liver steatosis is ultrasound. Treatment of MAFLD primarily involves lifestyle changes (rational nutrition with limitation of simple carbohydrates and animal fats, adequate physical activity) and weight loss. Also, hypoglycemic drugs used to treat type 2 diabetes (metformin, pioglitazone, glucagon-like peptide-1 agonists) can have a certain positive effect on MAFLD. Essential phospholipids, which have membrane-stabilizing, antioxidant and antifibrotic effects, are also an important component of MAFLD treatment. A number of domestic and foreign studies have shown the high efficiency of Essential Phospholipids both in relation to biochemical parameters in patients with a combination of type 2 diabetes and MAFLD, and in relation to ultrasound signs, improving the function and structure of the liver in MAFLD, as well as slowing the progression of liver fibrosis.

The thyroid gland is an important organ of the endocrine system. Its hormones influence all human organs and systems. Among thyroid dysfunctions, the most common variant is primary hypothyroidism. Since during pregnancy the mother's thyroid gland undergoes changes and the need for thyroid hormones increases, the risk of hypothyroidism increases. Particular attention should be paid to women who are carriers of antithyroid antibodies, as they are more likely to have thyroid dysfunction during pregnancy. In this regard, such patients should have their thyroid function examined in each trimester of pregnancy. It is known that hypothyroidism, both manifest and subclinical, has a negative impact on pregnancy outcomes and the subsequent psycho-physical development of the child. With obvious hypothyroidism, the risk of premature birth, arterial hypertension, preeclampsia and other complications increases. Therefore, treatment for hypothyroidism during pregnancy should begin immediately. The basis of treatment for this pathology is the prescription of replacement therapy with L-thyroxine immediately in a full replacement dose. For women who were already taking the drug before pregnancy, the dose of L-thyroxine increases by 20-30% with the onset of gestation. Also during pregnancy, there may be a decrease in thyroid hormones, usually thyroxine (T4w), with normal TSH. This condition is called isolated hypothyroxinemia. Its causes may be insufficient iodine intake, as well as increased levels of thyroxine-binding globulin. Its increase leads to an increase in the concentration of the total fractions of the hormones T4 and T3, but at the same time the true level of T4fr is underestimated. Isolated hypothyroidism does not require treatment if TSH levels are normal.

Polycystic ovary syndrome (PCOS) is a common endocrine disease in women of reproductive age. The prevalence of this pathology is approximately 15-20%. PCOS is characterized by hyperandrogenism, hirsutism, menstrual irregularities, and polycystic ovaries. More than half of patients with PCOS have a metabolic syndrome, the main component of which is visceral obesity and insulin resistance, which play an important role in the pathophysiology of PCOS. Insulin resistance is a marker of cardiometabolic risk and can lead to cardiovascular disease and carbohydrate metabolism disorders up to type 2 diabetes mellitus (DM2). Therefore, in the treatment of patients with PCOS, an important aspect is the impact on insulin sensitivity and body weight. This review focuses on various groups of drugs that can potentially have a positive effect on metabolic disorders in PCOS. Among them are metformin, drugs with an incretin effect, as well as drugs for weight loss. Given the similarity of the metabolic and pathological features of PCOS and DM2, as well as the diversity of therapeutic options, there is a potential for expanding the strategy for the treatment of metabolic disorders in PCOS, including through antidiabetic drugs, which, however, requires further study. It should be noted that surgical treatment of obesity also has a beneficial effect and contributes to the normalization of the menstrual cycle and the normalization of the hormonal and metabolic profile in patients with PCOS and severe obesity.

Aim to assess the prevalence of low muscle mass and low bone density in elderly patients with type 2 diabetes (T2DM), depending on the level of glycated hemoglobin (HbA1c). Material and methods.The study included 187 patients (mean age 65.16 4.31 years), who were tested for fasting blood glucose, HbA1c, osteocalcin (OC), procollagen type 1 N-terminal propeptide (P1NP), C-terminal type I collagen telopeptides (B-CTX), 25-hydroxyvitamin D, body composition and bone mineral density. Results.The prevalence of low muscle mass, osteopenia, and osteoporosis in elderly patients with T2DM was 35.8%, 38.5%, and 30.5%, respectively. The prevalence of low muscle mass was significantly higher in women with HbA1c 9.0% (p =0.035). Osteopenia and osteoporosis prevailed in men with HbA1c 9.0% (p=0.007 and p=0.048, respectively). The appendicular skeletal muscle index (ASMI), bone mineral content (BMC) and bone mineral density (BMD) of the lumbar spine, BMC and BMD of the thigh were significantly reduced in the osteoporosis and osteopenia groups (p0.05); while B-CTX, P1NP were significantly increased. In men, both ASMI (p=0.007) and P1NP levels (p=0.001) were important risk factors for osteopenia/osteoporosis, and in women such risk factor was ASMI (p=0.019). Conclusion.In T2DM patients, the high HbA1c levels were associated with higher rates of low muscle mass in women and osteoporosis in men, and ASMI was a risk factor for osteoporosis in both sexes.

Aim to determine the risk factors for sarcopenia in elderly patients with type 2 diabetes (T2DM). Material and methods. The study included 395 elderly patients with T2DM (mean age 65.1 2.7 years). The probable sarcopenia group (n = 185) included participants with low muscle strength, the control group (n = 210) included participants without sarcopenia. In all participants we registered the anthropometric indicators; fasting blood glucose; glycated hemoglobin (HbA1c); albumen; creatinine; body composition; handgrip strength. The food diary was used to calculate total daily calories, the amount of carbohydrates, proteins and fats eaten per day, as well as the proportion of calories provided by these macronutrients. Results. Compared with the controls, the male and female patients with probable sarcopenia were older (p0.001) and had lower waist-to-hip ratio (p=0.038 and p=0.018, respectively) and BMI (p=0.001 and p0.001 respectively), eGFR (p=0.030 and p=0.018, respectively), bone mineral content (p0.001), basal metabolic rate (p=0.016 and p0.001, respectively), appendicular skeletal muscle mass (p=0.043 and p0.001, respectively), appendicular musculoskeletal mass index (p=0.002 and p0.001, respectively) and muscle quality (p0.001), high fasting plasma glucose (p=0.017 and p=0.007, respectively) and HbA1c (p0.001 and p=0.004, respectively). In men with probable sarcopenia, the percentage of calories provided by carbohydrates was lower (p=0.041), while the percentage provided by fats (p= 0.012) was higher than in the control group. Conclusion. The multivariate logistic regression analysis showed that age (OR = 1.517, 95% CI: 1.127-2.043, p=0.006), male sex (OR = 0.196, 95% CI: 0.142-0.271, p0.001), BMI 28 kg/m2 (OR = 0.683, 95% CI: 0.467-0.998, p=0.049), HbA1c level 10% (OR = 1.396, 95% CI: 1.018-1.915, p=0.038), diabetic nephropathy (OR = 1.439, 95% CI: 1.033-2.006, p=0.031) and decreased serum albumin (OR = 0.917, 95% CI: 0.883-0.953, p0.001) were risk factors associated with low muscle strength in patients with type 2 diabetes type.

Сахарный диабет 2-го типа является распространенным хроническим метаболическим возраст-ассоциированным заболеванием. Среди лиц с сахарным диабетом 2-го типа преобладают пожилые пациенты старше 65 лет. Данная патология развивается у 70 % пациентов с преддиабетом в течение жизни. В статье представлены данные по распространенности сахарного диабета 2-го типа и преддиабета в РФ. Отражено влияние образа жизни и старения на прогрессирование нарушений углеводного обмена. Представлены исследования, доказывающие возможность предотвращения перехода преддиабета в диабет. Рассматриваются различные методы профилактики сахарного диабета 2-го типа, включающие изменение образа жизни, применение лекарственных препаратов и метаболическую хирургию у пациентов с преддиабетом. Особое внимание в статье уделено эффективности и возможности в целом применения этих методов профилактики у лиц пожилого возраста. Type 2 diabetes mellitus is a common chronic metabolic age-associated disease. Elderly patients over 65 years of age predominate among those with type 2 diabetes. 70 % of patients with prediabetes develop type 2 diabetes during their lifetime. The article presents data on the prevalence of type 2 diabetes mellitus and prediabetes in the Russian Federation. It also refl ects information about the impact of lifestyle and aging on the progression of carbohydrate metabolism disorders. The paper presents studies that prove the possibility of preventing the transition of prediabetes to diabetes. Various methods of preventing type 2 diabetes mellitus, including lifestyle changes, medications, and metabolic surgery in patients with prediabetes, are being considered. Particular attention is paid to the effectiveness and possibility of using these methods of prevention in the elderly in general.

Adequate nutrition with a high protein content is one of the main conditions in the complex treatment of sarcopenia. This review article considers strategies for maintaining the dietary derived protein and amino acids value in patients with sarcopenia. The features of nutritious diet in young, middle-aged and older people including those with sarcopenia are compared and outlined. The possibilities of nutritional supplements of proteins and amino acids in the diet of geriatric patients with sarcopenia are given.

Type 1 diabetes mellitus (DM) is a disease characterized by hyperglycemia due to an absolute insulin deficiency caused by autoimmune destruction of insulin-producing β-cells. The disease occurs at a young age, is characterized by a labile course, a tendency to ketoacidosis and leads to the development of vascular complications that contribute to disability and early death of patients. To date, insulin therapy is the only treatment for type 1 diabetes. However, this method of treatment is not perfect. Patients need to adjust their diet, conduct frequent glycemic control and multiple injections of insulin. In this regard, the search for more effective methods of treating type 1 diabetes continues. The transformation of stem cells as a potential source of αand β-cells and their transplantation to the patient seems promising. However, it is not enough to simply obtain α- and β-cells from any stem cell. An important role is played by the interaction between the cells of the pancreatic islets. Currently, attempts are being made to develop functional in vitro models of pancreatic islets in which the cellular microenvironment would be completely preserved. The possibility of culturing and monitoring cells in a permeable three-dimensional microenvironment has been demonstrated. Combining different types of cells with each other in biologically suitable protein hydrogels allows the formation of spatial tissue systems. Cell microvascularization is also important, which is critical for adequate glucose homeostasis. 3D bioprinting can help ensure proper cell distribution in the scaffold and help reduce hypoxia through vascularization. 3D bioprinting technology will solve the problems of creating a natural environment for pancreatic islets with extracellular matrix and vasculature, since this technology will help to create organs in fully controlled conditions in vitro. However, this technology is still developing and further research is required in this direction.

Diffuse toxic goiter is one of the frequent endocrine pathologies that lead to damage to the cardiovascular system. The prevalence of thyrotoxicosis in people over 65 years of age is 15%. The clinic of thyrotoxicosis among elderly patients is nonspecific and asymptomatic. Asthenic symptoms prevail – increasing muscle weakness, weight loss, neurological symptoms, expressed in lethargy and depression, changes in the gastrointestinal tract, cardiovascular system. Elderly patients often have tachycardia, atrial fibrillation, atrial fibrillation, increasing heart failure, which is associated with age-related changes in the myocardium, concomitant atherosclerosis-associated diseases. Atrial fibrillation in patients with thyrotoxicosis increases the risk of thromboembolic complications. Low-symptomatic manifestations of thyrotoxicosis require a more thorough examination, including laboratory, hormonal and instrumental methods. This article considers a clinical case of an elderly patient with diffuse toxic goiter. The features of the clinical picture with the predominance of disorders from the cardiovascular system -interruptions in the work of the heart, increased shortness of breath, signs of increasing cardiovascular insufficiency are presented. Diagnostic studies, differential diagnostic search, confirming the presence of thyrotoxicosis and cardiovascular insufficiency were conducted. Appropriate treatment has been prescribed. An integrated approach in the treatment of patients with diffuse toxic goiter in combination with ischemic heart disease significantly improves the condition of patients, normalizes the thyrotoxic status, and, consequently, the state of the cardiovascular system against the background of the use of thyrostatics. Also, the wellbeing of patients improves because of correction of cardioprotective therapy, the heart rate is normalized, the signs of chronic heart failure are significantly compensated.

Diabetes mellitus (DM) is a global medical and social problem, its prevalence is steadily increasing throughout the world. The significance of DM is due to early disability and high mortality, primarily from macro- and microvascular complications of diabetes mellitus. Adequate therapy and its timely intensification in order to achieve an optimal individual level of glycemic control is an important aspect in this regard. Insulin therapy is indicated for all patients with type 1 diabetes mellitus. In type 2 diabetes the appointment of basal insulin is necessary if it is impossible to adequately control glycemia with oral drugs. Treatment of diabetes all over the world and in our country requires significant healthcare costs. The problem of reducing the cost of drug therapy in all countries of the world is currently being solved by the admission to the market of biosimilar drugs (biosimilars). A biosimilar (biosimilar) medicinal product (biosimilar, biosimilar) is a biological product similar in terms of quality, efficacy and safety to a reference biological medicinal product in the same dosage form and having an identical route of administration. Insulin glargine is one of the commonly used drugs in clinical practice and is of interest for reproduction. Biosimilar currently registered. This is a biosimilar of domestic production of insulin glargine with proven bio- and therapeutic equivalence, immune safety, good tolerance, recognized as interchangeable with the original insulin glargine. Indications and contraindications for use can be extrapolated to biosimilar without fear of reducing efficacy and the development of adverse events.

Новая коронавирусная инфекция COVID-19 вызывает поражение многих органов и систем, является полиорганным заболеванием. Многие исследователи изучают связь новой коронавирусной инфекции с полиморбидной патологией, старческой астенией, саркопенией. Вирус SARSCoV-2 обладает свойством тропности к нервной ткани, поэтому в спектр клинических проявлений и последствий перенесенной болезни могут присоединяться ольфакторные, вкусовые нарушения, а также нарушения когнитивных функций. Болезнь Альцгеймера является самой частой причиной деменции в мире. Представляет интерес наличие связи между перенесенной коронавирусной инфекцией и развитием когнитивных нарушений, в том числе болезни Альцгеймера. The new coronavirus infection COVID-19 causes damage to many organs and systems, is a multi-organ disease. Many researchers are studying the relationship of the new coronavirus infection with polymorbid pathology, frailty, sarcopenia. The SARS-CoV-2 virus has the property of neurotropism, therefore, olfactory, taste disorders, as well as cognitive impairments can join the spectrum of clinical manifestations and consequences of the disease. Alzheimer’s disease is the most common cause of dementia in the world. It is of interest that there is a link between the coronavirus infection and the development of cognitive impairment, including Alzheimer’s disease.

Introduction . Type 2 diabetes is a significant medical problem. The solution to this problem lies not only in lowering the patient’s blood glucose level, but also in preventing the complications of diabetes, influencing insulin resistance and normalizing body weight. Aim . To develop an effective and safe treatment regimen for elderly women with type 2 diabetes, which is aimed at compensating carbohydrate metabolism, improving lipid metabolism and anthropometric parameters. Materials and methods . The study involved 80 women with type 2 diabetes aged 60 to 74 years, who were divided into 2 groups of 40 people. Group 1 included patients with type 2 diabetes receiving traditional therapy for type 2 diabetes. Patients of the group 2 received the method of treatment developed by us, including, in addition to the traditional regimen, the drug Subetta®, cholecalciferol drops. All women collected complaints and anamnesis, assessed anthropometric parameters, glucose, glycated hemoglobin, vitamin D, lipid profile. Results . All patients with type 2 diabetes initially were not compensated for carbohydrate metabolism, had abdominal obesity, atherogenic dyslipidemia, and vitamin D deficiency. Anthropometric parameters significantly improved, glucose and HbA1c levels decreased to target values in patients of group 2 after 6 months against the background of the use of Subetta® and cholecalciferol. Also in this group, the indicators of lipid metabolism improved: the levels of cholesterol, LDL, triglycerides decreased, and the levels of HDL increased. Vitamin D levels reached target range. No episodes of hypoglycemia were recorded. Conclusions . The addition of Subetta® and cholecalciferol to the treatment of patients with type 2 diabetes contributed to the achievement of target indicators of carbohydrate metabolism, improved lipid profile, and weight loss. This method of treatment is well tolerated and has a low risk of hypoglycemia, which is especially important for elderly patients.