Alternative approach to the treatment of diabetes mellitus.

The influence of insulin preparations (Actrapid and Ransulin) on the glucose and insulin blood level has been studied in patients with diabetes mellitus. It has been shown that comparable changes in the measured parameters are achieved in most patients with oral doses of Ransulin that are two to three times higher than the doses of Actrapid.

[Oral insulin preparations for the regulation of the glucose level in the blood].

Oral administration of diluted solutions of insulin results in the absorption of the hormone into bloodstream. After oral administration of diluted insulin solutions to healthy volunteers and animals with experimental diabetes insulin does not undergo hydrolytic degradation under the action of proteolytic enzymes and its absorption is sufficient to produce the hypoglycemic effect. This approach gives a chance of creating of novel strategy for diabetes treatment.

[Changes of gustatory perception in elderly patients with type II sugar diabetes. Surgical section].

In 73 elderly patients with type II sugar diabetes there were found changes of gustatory perception of sweet that were most pronounced on primary stage of the disease and that can be considered as manifestation of diabetic neuropathy of oral cavity organs and tissues.

[Oral administration of protein solutions].

Experiments on animals showed that native proteins may diffuse into the blood flow after oral administration of diluted protein solutions. An in vitro study led us to hypothesize that treatment with diluted solutions is accompanied by a decrease in the rate of protein proteolysis and accelerated protein diffusion through the intestinal mucosa.

[Inflammatory diseases of the parodontium in patiens with metabolic syndrome]. / Vospalitel'nye zabolevaniia parodonta u bol'nykh s metabolicheskim sindromom.

Comprehensive stomatologic examination of 45 patients with chronic generalized parodontitis (CGP) was combined with parallel determination of immunoreactive insulin (IRI) in blood. In 30 patients CGP developed on the background of metabolic syndrome (MS). Clinical and X-ray examination of periodontal tissues disclosed that CGP in patients with MS was characterized by active and aggressive course. A correlation between CGP severity degree and level of IRI in blood was established.

[Study of free-radical processes and antioxidant defense parameters during hirudotherapy of patients with diseases of salivary glands]. / Izuchenie pokazatelei svobodnoradikal'nykh protsessov i antioksidantnoi zashchity u lits s zabolevaniiami sliunnykh zhelez, poluchaiushchikh girudoterapiiu.

Hirudotherapy was used in the treatment of 39 patients (10 male and 29 female) aged 28-58 years with chronic sialadenitis and sialadenosis. Control group consisted of 15 normal subjects without diseases of salivary glands. Lipid peroxidation (LPO) and antioxidant defense (AOD) parameters were under study. Hirudotherapy led to improvement of the clinical status in the majority of patients with sialadenosis; the content of superoxide dismutase (SOD) normalized and ceruloplasmin (CP) level increased. The status of patients with sialadenitis also improved; catalase and glutathione peroxidase levels normalized and SOD and CP levels increased. The best therapeutic effect was attained in patients with sialadenitis. No appreciable improvement was observed in patients with chronic parenchymatous parotitis in the presence of Sjogren's syndrome.

[Changes in vascular wall, blood insulin spectrum and hemostasis system in patients with type II diabetes mellitus and relevant correction]. / Izmeneniia sosudistoi stenki, insulinovogo spektra krovi i sistemnogo gemostaza u bol'nykh sakharnym diabetom II tipa i vozmozhnosti ikh korrektsii.

AIM: The study of insulin blood spectrum, capillary morphology (by evidence of skin biopsies), antithrombogenic activity of the vascular wall in patients with non-insulin-dependent diabetes mellitus; assessment of possible corrective therapy. MATERIALS AND METHODS: 65 patients with type II diabetes mellitus (DM) entered the trial. Concentrations of free, bound, immunoreactive insulin (IRI) and C peptide were measured before and 10, 30, 60, 120 min after intravenous injection of glucose. Microcirculatory bed condition was evaluated by the data from skin biopsies. Antithrombogenic characteristics of the vascular wall were investigated at-test. RESULTS: The tests discovered that DM patients had high IRI and low free insulin in high glucose levels; disorders of hemostasis, active proliferation in the microvessels. In patients with microangiopathy tiklid therapy given for 45 days reduced the speed and degree of platelet aggregation, improved fibrinolysis and clinical course of the disease. CONCLUSION: High level of IRI may be due to emergence of insulin-like substances dissociation of which produces peptides enhancing proliferative processes.

[C-peptide and insulin ratio in patients with juvenile dyspituitarism in varying symptomatology]. / Sootnoshenie C-peptida i insulina u bol'nykh s iunosheskim dispituitarizmom pri razlichnoi klinicheskoi simptomatike.

Altogether 24 adolescents with pubertal juvenile dyspituitarism (PJD) were investigated in the course of an oral GTT for 3 hours. The patients were divided into 3 groups: (1) with liver dysfunction and normal BP; (2) with normal liver and arterial hypertension; (3) with normal BP and normal liver function. The levels of glycemia, immunoreactive insulin, C-peptide and a molar C-peptide/insulin ratio were measured. All the examinees were characterized by basal and stimulated hyperinsulinemia against a background of a normal C-peptide value, the absence of a tendency to IRI reduction by the end of the GTT. A decrease in the C-peptide/IRI ratio was marked in the 1st group. One of the reasons of hyperinsulinemia in PJD in parallel with high insulin secretory pancreatic function can be a decrease in the metabolic clearance of liver insulin, especially noticeable in patients with hepatocyte dysfunction.

[Use of finoptin in patients with non-insulin-dependent diabetes mellitus with concomitant essential hypertension]. / Primenenie finoptina u bol'nykh insulinnezavisimym sakharnym diabetom s soputstvuiushchei gipertonicheskoi bolezn'iu.

The paper is devoted to a study of the time course of lipid metabolism, analysis of glucose tolerance, change in indices of immunoreactive insulin, glucagon and C-peptide before the start of verapamil therapy and 6 mos. after it during monotherapy with this drug. These parameters were investigated in the blood serum using biochemical methods and radioimmunoassays. A marked antihypertensive effect was achieved in patients suffering from noninsulin dependent diabetes mellitus with concomitant essential hypertension of the 2nd degree. No negative effect on the pancreatic hormone secretion was noted. Lipid transport indices were improved.

[ADP-induced aggregation of human platelets in diabetes mellitus]. / ADF-indutsiruemaia agregatsiia trombotsitov cheloveka pri sakharnom diabete.

Dilution of thrombocyte-rich blood plasma (down to 2.5 x 10(8) thrombocytes/ml) enabled to avoid an irreversible phase of the ADP-induced thrombocyte aggregation; the reversible phase of aggregation was followed by deaggregation. The reversible aggregation of thrombocytes was studied in healthy persons and patients with diabetes mellitus within wide ranges of ADP concentrations (including 10 microM) using the diluted blood plasma. Thrombocytes of the patients with diabetes mellitus of the I and II types were found to be 1.6- and 2.33-fold more sensitive to the ADP aggregating effect as compared with thrombocytes of healthy persons. The elevated rate of thrombocytes aggregation in diabetes mellitus appears to be related to early decrease in activity of thrombocyte guanylate cyclase and to its ability to be activated.

[The nature of the pancreatic hormone secretion and of the metabolic indices during the acute and chronic administration of peroral hypoglycemic preparations]. / Izuchenie kharaktera sekretsii gormonov podzheludochnoi zhelezy i nekotorykh metabolicheskikh pokazatelei pri ostrom i khronicheskom vvedenii peroral'nykh sakharoponizhaiushchikh preparatov.

A comparative study of the effect of acute and chronic administration of sulfanilureal sugar lowering drugs (glipizide and glibenclamide) on the secretion of the pancreatic hormones, indices of microcirculation, the level of triglycerides and nonesterified fatty acids was conducted. Patients with primary detected diabetes mellitus with normal body mass and obesity of I-III degrees were investigated. The principal differences in insulinotropic action of sugar lowering drugs in various groups of patients and significant differences in the mechanism of their hypoglycemic action at varying time of treatment indicate the necessity of a strictly differentiated approach to subscription of these drugs for patients with primary detected diabetes mellitus.

[Reaction of specific cell populations of hypothalamic paraventricular nuclei of the rat to carbohydrate loading and fasting]. / Reaktsiia otdel'nykh kletochnykh populiatsii paraventrikuliarnykh iader gipotalamusa krys na uglevodnuiu nagruzku i golodanie.

The structural correlates of the cell responses in subnuclei of the hypothalamic paraventricular nuclei (PVN) in fasting and carbohydrate loaded adult male rats were studied using light microscopic morphometric methods. The data obtained revealed difference in responsiveness of the subnuclei studied to alternative shifts in the carbohydrate homeostasis: histophysiological features in five of ten cell-divisions, distinguished in the rat RVN, demonstrated their dependence on impaired carbohydrate homeostasis.

[Human thrombocyte guanylate cyclase in diabetes mellitus]. / Guanilattsiklaza trombotsitov cheloveka pri sakharnom diabete.

Clear differences in properties of platelet guanylate cyclase from healthy donors and patients with diabetes mellitus were identified; departure from the norm was more pronounced in the case of the II-type of this disease, than the I-type. We have registered the decrease in the Mg-activity (basal) of guanylate cyclase by 30 and 50 per cent, Mn-activity--by 20 and 30 per cent, the state of guanylate cyclase activation by 0.1 mM sodium nitroprusside to 2 and 3-fold in patients with I and II-type of diabetes mellitus, consequently. The possible causative factors of these disturbances are discussed. It is suggested that the decrease in guanylate cyclase activation by nitroprusside is due to the enzyme heme-deficiency rising with the diabetes mellitus.

[Early detection of nephroangiopathy in patients with diabetes mellitus and approaches to its correction]. / Rannee vyiavlenie nefroangiopatii u bol'nykh sakharnym diabetom i puti ee korrektsii.

Patients with types I and II diabetes mellitus without the clinical signs of nephroangiopathy were subjected to a comprehensive study of renal function. Using the method for determination of endogenous creatinine clearance (140 patients), radionuclide methods (in 350 patients) and beta-2-microtest (in 130 patients) the impairment of renal filtration function was established in 30.8, 67.6 and in 52% of the patients, respectively. In 16.3% of the patients, there was an impairment of the proximal part of the canaliculi. The determination of proteinuria selectivity in polyacrylamide gel revealed latent proteinuria in 70% of the patients and enabled one to specify the spectrum of uroproteins. The informative value of the methods suggested was supported by the results of morphologic studies of biopsy specimens of the kidneys and skin. The importance of the specification of the preclinical stage of diabetic nephroangiopathy was determined by the possibility of the reverse development of the pathological alterations at the given stage. The authors describe the experience gained with the correction of functional disorders by means of programmed administration of insulin using the apparatus Biostator, application of diamicron and angioprotectors.

[Pancreatic hormone secretion in patients with newly detected diabetes mellitus]. / Izuchenie sekretsii gormonov podzheludochnoi zhelezy u bol'nykh s vpervye vyiavlennym sakharnym diabetom.

The level of pancreatic hormones was studied in 10 healthy persons and in 40 patients with diabetes mellitus detected for the first time by GTT, their body mass being normal. For assessment of immunoreactive insulin (IRI), the level of proinsulin and biological activity of serum insulin were determined, and these indices were compared with glucose and C-peptide levels. The examinees' inhomogeneity was shown; on the basis of the findings obtained 2 groups were identified. A decrease in the levels of IRI, C-peptide and biological activity of serum insulin in the 1st group indicated a possibility of type I diabetes mellitus in such patients. Hyperinsulinemia, not correlating with glucose and C-peptide, a high percentage of proinsulin and low biological activity of serum insulin were noted in the 2nd group. The study permitted a differentiated approach to assessment of patients and a choice of therapeutic tactics.

[The role of gastrin in regulating insulin and glucagon secretion in patients with diabetes mellitus]. / Rol' gastrina v reguliatsii sekretsii insulina i gliukagona u bol'nykh sakharnym diabetom.

The paper is concerned with the results of investigation of 26 donors and 85 patients with diabetes mellitus, type II, with normal body mass and obesity during GTT and a test breakfast to reveal correlation of IRI and IRG levels with the level of gastrin. Comparative analysis of indices during OGTT and food intake has shown that an increase in the levels of gastrin in patients with diabetes mellitus, type II, does not correlate with body mass and the total level of insulin, but it may correlate with a metabolically active form of insulin. During food intake the levels of gastrin rise and do not change during GTT. A rise of the level of gastrin in patients with diabetes mellitus, type II, during a test breakfast is accompanied by change in the level of insulin, its peak being lower than that during GTT. Attention was focused on a group of patients with a history of obesity in whom by the time of investigation body mass returned to normal and the level of glucose was decreased. However, gastrin and insulin levels were still high, and metabolic regulation was disturbed. Therefore, body mass normalization did not eliminate causative and pathogenetic factors of diabetes mellitus.

[Hemostasis and microcirculation in patients with diabetic ketosis]. / Gemostaz i mikrotsirkuliatsiia u bol'nykh s diabeticheskim ketoatsidozom.

Indices of acid-base equilibrium (ABE), the level of ketone bodies, coagulation and platelet procoagulant hemostasis, and erythrocyte aggregation were studied in 102 patients with diabetes mellitus, of them in 58 patients with diabetic ketoacidosis and in 10 practically healthy persons. The most frequent cause of the development of diabetic ketoacidosis was poorly controlled treatment of diabetes and infections. The most frequent type of ABE disorder in patients with diabetic ketoacidosis was metabolic acidosis with secondary compensatory respiratory alkalosis. Ketoacidosis was characterized by hemostatic disorders after hypercoagulation type, an increase in platelet and erythrocyte aggregation activity with secondary activated fibrinolysis.