BackgroundThe association of type 2 diabetes mellitus (T2DM) with the KCNJ11, CDKAL1, SLC30A8, CDKN2B, and FTO genes in the Russian population has not been well studied. In this study, we analysed the population frequencies of polymorphic markers of these genes.MethodsThe study included 862 patients with T2DM and 443 control subjects of Russian origin. All subjects were genotyped for 10 single nucleotide polymorphisms (SNPs) of the genes using real-time PCR (TaqMan assays). HOMA-IR and HOMA-β were used to measure insulin resistance and β-cell secretory function, respectively.ResultsThe analysis of the frequency distribution of polymorphic markers for genes KCNJ11, CDKAL1, SLC30A8 and CDKN2B showed statistically significant associations with T2DM in the Russian population. The association between the FTO gene and T2DM was not statistically significant. The polymorphic markers rs5219 of the KCNJ11 gene, rs13266634 of the SLC30A8 gene, rs10811661 of the CDKN2B gene and rs9465871, rs7756992 and rs10946398 of the CDKAL1 gene showed a significant association with impaired glucose metabolism or impaired β-cell function.ConclusionIn the Russian population, genes, which affect insulin synthesis and secretion in the β-cells of the pancreas, play a central role in the development of T2DM.

We are glad to present the 7th Edition of Standards of Diabetes Care.These evidence-based guidelines were designed to standardize and facilitate diabetes care in all regions of the Russian Federation.The Standards are updated on the regular basis to incorporate new data and relevant recommendations from national and international clinical societies, including World Health Organization Guidelines (WHO, 2011, 2013), International Diabetes Federation (IDF, 2011, 2012, 2013), American Diabetes Association (ADA, 2012, 2015), American Association of Clinical Endocrinologists (AACE, 2013), International Society for Pediatric and Adolescent Diabetes (ISPAD, 2014) and Russian Association of Endocrinologists (RAE, 2011, 2012).Current edition of the ?Standards? also integrates results of completed randomized clinical trials (ADVANCE, ACCORD, VADT, UKPDS, etc.), as well as findings from the national studies of diabetes mellitus (DM), conducted in close partnership with a number of Russian hospitals.Latest data indicates that prevalence of DM increased during the last decade more than two-fold, reaching some 387 million patients by the end of 2014. According to the current estimation by the International Diabetes Federation, 592 million patients will be suffering from DM by 2035. These observations resulted in the UN Resolution 61/225 passed on 20.12.2006 that encouraged all Member States "to develop national policies for the prevention, treatment and care of diabetes".Like many other countries, Russian Federation experiences a sharp rise in the prevalence of DM. According to Russian State Diabetes Register, there are at least 4.1 million patients with DM in this country. However, the epidemiological survey conducted by the Federal Endocrinology Research Centre during 2002-2010 suggests that actual prevalence is 3 to 4 times greater than the officially recognized and, by this estimate, amounts to 9-10 million persons, comprising 7% of the national population.Severe consequences of the global pandemics of DM include its vascular complications: nephropathy, retinopathy, coronary, cerebral and peripheral vascular disease. These conditions are responsible for the majority of cases of diabetes-related disability and death.Current edition of the "Standards" emphasizes the patient-oriented approach in making decisions on therapeutic goals, such as levels of glycaemia and blood pressure. It also features updated guidelines on the management of vascular complications.This text represents a consensus by the absolute majority of national experts, achieved through a number of fruitful discussions held at national meetings and forums. These guidelines are intended for endocrinologists and diabetologists, primary care physicians, cardiologists and other medical professionals involved in prevention and treatment of diabetes mellitus.

IntroductionThe aims of this study were: (1) to investigate the association of vascular endothelial growth factor isoform A (VEGF-A) concentration in the anterior chamber liquid (ACL) with vascular proliferation in patients with diabetic retinopathy (DR) who had undergone surgical treatment for cataract and neovascular glaucoma; (2) to analyze the association of VEGF-A level in ACL with the cataract surgery outcomes.Materials and MethodsUndiluted aqueous fluid samples were obtained from 207 eyes of patients who underwent intraocular surgery, 136 patients with diabetes mellitus (DM) and 22 patients without DM. The ACL samples were obtained during operation. The VEGF-A levels were analyzed by enzyme-linked immunosorbent assay.ResultsThe lowest VEGF-A levels were in diabetic patients without signs of DR [22.75 pg/mL (10.78; 63.36)]. More severe DR tended to occur in diabetic patients with higher VEGF-A levels in ACL. In diabetic patients with proliferative DR (PDR), VEGF-A levels were significantly higher [336.6 pg/mL (232.3; 410.74)] than in patients without DR P < 0.0001. In patients with terminal stage of DR [neovascular glaucoma (NG)], VEGF-A levels were dramatically higher and attained 1,634.01 pg/mL (610.69; 2657.33). In non-diabetic patients, VEGF-A levels were 95.07 pg/ml (60.92; 129.22). The best visual acuity results in post-operative period were observed in the group of diabetic patients without DR. In the group of patients with PDR, post-operative visual acuity [0.26 (0.1; 0.42)] was similar to visual acuity before operation [0.29 (0.13; 0.44)]. There was no significant increase in visual acuity due to cataract surgery. In 52.4% patients, no complications had occurred by the end of the follow-up period. In 40% patients, retinal laser coagulation was performed, and in 7.6% patients NG had developed.ConclusionVEGF-A level in ACL increases with DR progression and may be of prognostic value in evaluating the potential risk of further neovascularization progression in diabetic patients.

Несмотря на появление новых сахароснижающих препаратов, вопросы лечения СД 2-го типа по-прежнему остаются актуальными. С целью стандартизации и оптимизации оказания медицин-ской помощи больным СД разработаны международные и отечественные алгоритмы лечения СД 2-го типа [1, 2]. В современных алгоритмах основной акцент сделан на индивидуальный подход, безопасность и эффективность в лечении пациентов. Необходимо соблюдать баланс между дости-жением оптимального контроля гликемии и безопасностью терапии.