Insulin therapy is a pharmaceutical treatment used for patients with diabetes to normalize blood glucose level. In patients receiving insulin therapy, optimization of blood glucose levels can be achieved using various types of insulin and various methods, such as MDI (multiple daily injections) and CSII (continuous subcutaneous insulin infusion). This review describes actual key features of CSII for diabetes patients.

In 1973 and 1976 2 cases of endocrine ophthalmopathy (EO) after external irradiation of the anterior surface of the neck due to a tumor (Hodgkin's lymphoma) was described. Further observations showed that treatment of Graves' disease (BG) with radioactive iodine (¹³¹I) can worsen the course of EO. So, L. De Groot et al., Observing 264 patients after exposure to ¹³¹I for BG, found progression of EO in 4% of patients after the 1^st course of therapy and in 12% after subsequent sessions.

Later the appearance or significant progression of EO in  patients treated with ¹³¹I has been observed. Some studies have shown that the progression of EO after treatment with ¹³¹I without glucocorticoids administration can be observed in 18–30% of cases. Along with this, there is an opinion that ¹³¹I does not affect the incidence of clinical symptoms in the orbit and that hypothyroidism that occurs after it does not lead to the progression of eye symptoms. The relationship between treatment and the onset or progression of EO is not clear. Nevertheless, there is evidence of an adverse effect of an elevated level of antibodies to the thyroid stimulating hormone receptor in the blood serum after ¹³¹I training for EO.

Weight-based dosing of growth hormone (GH) is the standard of therapy in short children although insulin-like growth factor-I (IGF-I) is a major mediator of GH actions on growth. Objective: to test whether the IGF-I levels achieved during GH therapy are determinants of the growth responses to GH therapy. This was a two-year open-label, randomized IGF-I concentration-controlled trial. Prepubertal short children [n = 172; mean age 7.53 years; mean height SD score (HT-SDS - 2.64] with low IGF-I levels (mean IGF-I SDS - 3.56) were randomized to receive one of two GH dose-titration arms in which GH dosage was titrated to achieve an IGF-I SDS at the mean [IGF(low) group, n = 70) or the upper limit of the normal range [+2 SDS, IGF(high) group, n = 68] or to a comparison group of conventional GH dose of 40 mg/kg/day (n = 34). The multicenter study was performed in the outpatient centers. The primary outcome measure was to determine changes in HT-SDS during 2-year therapy. One hundred and forty-seven patients completed the trial. Target IGF-I levels were achieved in the dose-titration arms within 6-9 months. The changes in HT-SDS were +1.0, +1.1, and +1.6 for conventional, IGF(low), and IGF(high), respectively, with IGF(high) showing significantly greater linear growth response (p < 0.001), compared with the two other groups). The IGF-I(high) arm required higher doses ( > 2.5 times) than the IGF-I(low) arm, and these GH doses were highly variable (20-346 mg/kg/day). Multivariate analyses suggest that the rise in IGF-I SDS significantly impacted height outcome along with the GH dose and the pretreatment peak-stimulated GH level. IGF-I-based GH dosing is clinically feasible and allows maintaining serum IGF-I concentrations within the desired target range. Titrating the GH dose to achieve higher IGF-I target results in improved growth responses, although at higher average GH doses.

The effects of Dibicor (taurine) were studied in 20 patients with type 2 diabetes (T2D) with a disease duration of 1 to 9 years and a mean body weight of 93.8±16 kg who received concomitant therapy (monotherapy with sulfonylurea (n = 7), novonorm (n = 1), sulfonylurea with metformin (n = 7); one patient was on diet therapy). Addition of Dibicor to the therapy following 3 months caused a statistically significant reduction in fasting and postprandial glycemia (from 7.9 to 6.3 mmol/l and from 7.9 to 6.9 mmol/l, respectively). Glycated hemoglobin decreased from 7.8 to 7.05% (p = 0.062). Lipid metabolic parameters improved after 3-month course of therapy. There was also a statistically significant fall in microalbuminuria from 0.082 to 0.054 g/day (p = 0.042). The administration of Dibicor can significantly improve T2D compensation.

The Wilms tumor gene (WT1) encodes a transcription factor that plays a key role in the laying and differentiation of the kidneys and gonads. Mutations of the WT1 gene were detected in patients with the WAGR complex (Wilms tumor, aniridia, urogenital pathology, mental retardation), Denis-Drach syndrome (early renal failure, diffuse mesangial sclerosis, varying degrees of gonadal dysgenesis, high risk of Wilms tumor) and Fraser syndrome. The latter is characterized by a fully female phenotype with karyotype 46XY, focal segmental glomerulosclerosis with the development of renal failure in the 2^nd decade of life, gonads in the form of cords and a high risk of gonadoblastoma. The presence of a heterozygous point mutation, which alters the donor site of splicing of the intron 9 of the WT1 gene, is also typical of Fraser syndrome. We present a case of characteristic clinical manifestations of Fraser syndrome in a patient in whom the diagnosis was confirmed by the detection of a mutation in the WT1 gene.

November 10, 2008 marks the 80th anniversary of the birth and 61 years of work as an academician! NAS and AMS of Ukraine, the Russian Academy of Medical Sciences, Honored Worker of Science and Technology of Ukraine, laureate of the State Prize of Ukraine, Doctor of Medical Sciences, Professor, Head of the Department of Diabetology, Deputy Director for Clinic of the Institute of Endocrinology and Metabolism named after V.P. Komissarenko of the Academy of Medical Sciences of Ukraine Andrey  Efimov.