BackgroundThis study used data from different sources to identify the extent of the unmet need for postprandial glycemic control in patients with type 2 diabetes mellitus (T2DM) after the initiation of basal insulin therapy in Europe, Asia Pacific, the United States, and Latin America.MethodsDifferent levels of evidence were used as available for each country/region, with data extracted from seven randomized controlled trials (RCTs), three clinical trial registries (CTRs), and three electronic medical record (EMR) databases. Glycemic status was categorized as “well controlled” (glycated hemoglobin [HbA1c] at target [<7%]), “residual hyperglycemia” (fasting plasma glucose [FPG] but not HbA1c at target [FPG <7.2/7.8 mmol/L, <130/140 mg/dL, depending on country‐specific recommendations]), or “uncontrolled” (both FPG and HbA1c above target). Predictor factors were identified from the RCT data set using logistic regression analysis.ResultsRCT data showed that 16.9% to 28.0%, 42.7% to 54.4%, and 16.9% to 38.1% of patients with T2DM had well‐controlled glycemia, residual hyperglycemia, and uncontrolled hyperglycemia, respectively. In CTRs, respective ranges were 21.8% to 33.6%, 31.5% to 35.6%, and 30.7% to 46.8%, and in EMR databases were 4.4% to 21.0%, 23.9% to 31.8%, and 53.6% to 63.8%. Significant predictor factors of residual hyperglycemia identified from RCT data included high baseline HbA1c (all countries/regions except Brazil), high baseline FPG (United Kingdom/Japan), longer duration of diabetes (Brazil), and female sex (Europe/Latin America).ConclusionsIrrespective of intrinsic differences between data sources, 24% to 54% of patients with T2DM globally had residual hyperglycemia with HbA1c not at target, despite achieving FPG control, indicating a significant unmet need for postprandial glycemic control.

The presented paper is a third revision of the clinical recommendations for the treatment of morbid obesity in adults. Morbid obesity is a condition with body mass index (BMI) 40 kg / m2 or a BMI 35 kg / m2 in the presence of serious complications associated with obesity. The recommendations provide data on the prevalence of obesity, its etiology and pathogenesis, as well as on associated complications. The necessary methods for laboratory and instrumental diagnosis of obesity are described in detail. In this revision of the recommendations, the staging of prescribing conservative and surgical methods for the treatment of obesity are determined. For the first time, a group of patients with obesity and type 2 diabetes mellitus is selected, in whom metabolic surgery allows a long-term improvement in the control of glycemia or remission of diabetes mellitus.

The paper presents the All-Russian consensus on the diagnosis and treatment of celiac disease in children and adults, which has been elaborated by leading experts, such as gastroenterologists and pediatricians of Russia on the basis of the existing Russian and international guidelines. The consensus approved at the 42nd Annual Scientific Session of the Central Research Institute of Gastroenterology on Principles of Evidence-Based Medicine into Clinical Practice (March 2-3, 2016). The consensus is intended for practitioners engaged in the management and treatment of patients with celiac disease. Evidence for the main provisions of the consensus was sought in electronic databases. In making recommendations, the main source was the publications included in the Cochrane Library, EMBASE, MEDLINE, and PubMed. The search depth was 10 years. Recommendations in the preliminary version were reviewed by independent experts. Voting was done by the Delphic polling system.

Biofilm of the gingival sulcus from 22 patients with type 2 diabetes mellitus and periodontitis, 30 patients with periodontitis not complicated by diabetes mellitus (reference group), and 22 healthy volunteers without signs of gingival disease (control group) was studied by quantitative PCR. Quantitative analysis for the content of P. gingivalis, T. forsythia, A. ctinomycetemcomitans, T. denticola, P. intermedia, F. nucleatum/periodonticum, and P. endodontalis in the dental plaque was performed with a Dentoscreen kit. The presence of other bacterial groups was verified by metagenomic sequencing of the 16S rRNA gene to evaluate some specific features of the etiological factor for periodontitis in type 2 diabetes mellitus. Specimens of the Porphiromonadaceae and Fusobacteriaceae families were characterized by an extremely high incidence in combined pathology. The amount of Sphingobacteriaceae bacteria in the biofilm was shown to decrease significantly during periodontitis. Metagenomic analysis confirmed the pathogenic role of microbiota in combined pathology, as well as the hypothesis on a possible influence of periodontitis on the course and development of type 2 diabetes mellitus.

Since periodontitis and type 2 diabetes mellitus are complex diseases, a thorough understanding of their pathogenesis requires knowing the relationship of these pathologies with other disorders and environmental factors. In this study, the representability of the subgingival periodontal microbiome of 46 subjects was studied by 16S rRNA gene sequencing and shotgun sequencing of pooled samples. We examined 15 patients with chronic periodontitis (CP), 15 patients with chronic periodontitis associated with type 2 diabetes mellitus (CPT2DM), and 16 healthy subjects (Control). The severity of generalized chronic periodontitis in both periodontitis groups of patients (CP and CPT2DM) was moderate (stage II). The male to female ratios were approximately equal in each group (22 males and 24 females); the average age of the subjects was 53.9 ± 7.3 and 54.3 ± 7.2 years, respectively. The presence of overweight patients (Body Mass Index (BMI) 30–34.9 kg/m2) and patients with class 1–2 obesity (BMI 35–45.9 kg/m2) was significantly higher in the CPT2DM group than in patients having only chronic periodontitis or in the Control group. However, there was no statistically significant difference in all clinical indices between the CP and CPT2DM groups. An analysis of the metagenomic data revealed that the alpha diversity in the CPT2DM group was increased compared to that in the CP and Control groups. The microbiome biomarkers associated with experimental groups were evaluated. In both groups of patients with periodontitis, the relative abundance of Porphyromonadaceae was increased compared to that in the Control group. The CPT2DM group was characterized by a lower relative abundance of Streptococcaceae/Pasteurellaceae and a higher abundance of Leptotrichiaceae compared to those in the CP and Control groups. Furthermore, the CP and CPT2DM groups differed in terms of the relative abundance of Veillonellaceae (which was decreased in the CPT2DM group compared to CP) and Neisseriaceae (which was increased in the CPT2DM group compared to CP). In addition, differences in bacterial content were identified by a combination of shotgun sequencing of pooled samples and genome-resolved metagenomics. The results indicate that there are subgingival microbiome-specific features in patients with chronic periodontitis associated with type 2 diabetes mellitus.

ClinicalTrials.gov identifier: NCT01868594.

The article provides an overview of the current literature integrating clinical data on the role of androgen deficiency in pathogenesis of metabolic malfunctions and diabetes mellitus. The combination of androgen deficiency and diabetes mellitus is a risk factor of cardiovascular diseases. Due to the fact that general physicians, endocrinologist dont have knowledge of this problem most of androgen deficiency cases are not only remained without treatment but also not revealed.

2. ДИАГНОСТИКА ЗАБОЛЕВАНИЯ ИЛИ СОСТОЯНИЯ (ГРУППЫ ЗАБОЛЕВАНИЙ ИЛИ СОСТОЯНИЙ), МЕДИЦИНСКИЕ ПОКАЗАНИЯ И ПРОТИВОПОКАЗАНИЯ К ПРИМЕНЕНИЮ МЕТОДОВ ДИАГНОСТИКИ 2.1 ЖАЛОБЫ И АНАМНЕЗ 2.2 ФИЗИКАЛЬНОЕ ОБСЛЕДОВАНИЕ 2.3 ЛАБОРАТОРНЫЕ ДИАГНОСТИЧЕСКИЕ ИССЛЕДОВАНИЯ 2.4 ИНСТРУМЕНТАЛЬНЫЕ ДИАГНОСТИЧЕСКИЕ ИССЛЕДОВАНИЯ 2.5 ИНЫЕ ДИАГНОСТИЧЕСКИЕ ИССЛЕДОВАНИЯ 3. ЛЕЧЕНИЕ, ВКЛЮЧАЯ МЕДИКАМЕНТОЗНУЮ И НЕМЕДИКАМЕНТОЗНУЮ ТЕРАПИИ, ДИЕТОТЕРАПИЮ, ОБЕЗБОЛИВАНИЕ, МЕДИЦИНСКИЕ ПОКАЗАНИЯ И ПРОТИВОПОКАЗАНИЯ К ПРИМЕНЕНИЮ МЕТОДОВ ЛЕЧЕНИЯ 3.1 ТЕРАПЕВТИЧЕСКИЕ ЦЕЛИ 3.1.1 Показатели контроля углеводного обмена (индивидуальные цели лечения) 3.1.2 Целевые уровни показателей липидного обмена 3.1.3 Целевые уровни показателей артериального давления 3.2 КОНТРОЛЬ УРОВНЯ ГЛЮКОЗЫ 3.3 НЕМЕДИКАМЕНТОЗНЫЕ МЕТОДЫ ЛЕЧЕНИЯ 3.3.1 Рекомендации по питанию 3.3.2 Рекомендации по физической активности 3.4 МЕДИКАМЕНТОЗНАЯ ТЕРАПИЯ 3.4.1 Общие принципы медикаментозной терапии 3.4.2 Инсулинотерапия 3.5 ХИРУРГИЧЕСКОЕ ЛЕЧЕНИЕ