[Comparative evaluation of the microcirculatory disorders in diabetes mellitus]. / Sravnitel'ania otsenka mikrotsirkuliatornykh narushenii u bol'nykh sakharnym diabetom.

Parallel studies of different microcirculatory channel parts were performed in 700 patients with diabetes mellitus. Clinical manifestations of disturbed microhemodynamics of the eye fundus, conjunctiva, kidneys, lower limbs were investigated by means of bulbar conjunctival biomicroscopy, ophthalmoscopy, fluorescent retinal angiography, nail-bed capillaroscopy and polarography, and radioisotopic renography. Ultrastructure of the leg muscular capillaries was studied by electron microscopy. The injury of the conjunctival vessels was seen in 81.9% of cases, of the eye fundus in 49.7%, of the kidneys in 45.6%, of the lower limbs in 84.3% and of the capillary muscular ultrastructure in 100%. Phasic character of the microcirculatory channel disorders was revealed. The data obtained are indicative of the possibility of early preclinical diagnosis of diabetic microangiopathies, determination of the degree of vascular lesions, whose prophylaxis and treatment should be carried out systematically and purposefully, beginning from the time of their revealing.

[Use of naphthylimidoacetic acid in experimental diabetes mellitus in rats]. / Primenenie naftilimidouksusnoi kisloty pri eksperimental'nom diabete u krys.

Experiments were conducted on rats with prolonged (6-9 months) alloxan diabetes; a study was made of the effect of naphthylimidoacetic acid (NIAA) on the blood glucose, fructose, cholesterol and sorbitol dehydrogenase level and also on the intensity of developing microangiopathies, according to biomicroscopy of the iris and electron microscopy of the muscle capillaries. Intramuscular injection of NIAA in a dose of 50 mg/kg of body weight for 30 days failed to alter the blood sugar level, but there was a significant fall of the fructose, cholesterol, sorbitol dehydrogenase content; the intensity of microvascular affection was also considerably diminished.

[Comparison of the morphological changes in the capillaries and the state of the renin-angiotensin-aldosterone system in diabetes mellitus]. / Sopostavlenie morfologicheskikh izmenenii kapilliarov i sostoianiia sistemy renin-angiotenzin-al'dosteron u bol'nykh sakharnym diabetom.

Microangiopathies were the earliest and most frequent complications of diabetes mellitus; however, their pathogenetic mechanisms are still obscure. Electron microscopic study of the capillaries of the gastrocnemius was conducted in 11 patients with diabetes mellitus at the state of decompensation and in 8--of clinical compensation; blood aldosterone level and the plasma renin activity were determined by the radio-immunological method. A marked thickening of the capillary basal membrane (the most marked sign of microvascular affection) was revealed in all the patients under study; there was also an increase in the aldosterone level and renin activity. The mentioned changes were to the greatest degree (statistically significant values) expressed in the patients at the state of decompensation. Analysis of the data obtained revealed a direct correlative relationship of these changes.

[Diabetes mellitus and cardiovascular system diseases in middle age]. / Sakharnyi diabet i bolezni serdechno-sosudistoi sistemy v pozhilom vozraste.

The data on the interrelationship of diabetes mellitus and atherosclerosis are shown. To characterize the frequency of cardiovascular lesions and their different character according to age in patients with diabetes, the results of clinical analysis of 2,540 patients and the findings of thorough clinical and laboratory examination of 1,154 individuals, 20.1% of whom were over 60, are presented. The high frequency of angiopathies (84.6%) confirms the "atherogenics" effect of diabetes mellitus. The age differences consist in the predominance of organic lesions among elderly persons. The frequent occurrence of a disturbed glucose tolerance test and the development of diabetes mellitus in these patients are evidence of the "diabetogenic" effect of atherosclerosis. Some hormonal and metabolic mechanisms are investigated for the interpretation of the pathogenesis of cardiovascular lesions in diabetes. The contribution of contrainsular hormones (somatotrophic hormone, adrenal hormones) and hyperlipidemia to the development of diabetic angiopathies is substantiated. The difference between diabetic macroangiopathies and atherosclerosis in nondiabetic individuals is discussed on the strength of the results of electron microscopy of the mucle capillaries. It is concluded that these two diseases, which are widely encountered among elderly individuals, have hormonal, metabolic, and genetic developmental mechanisms in common.