A total of 50 patients presenting with type 1 diabetes mellitus (DM1) were available for the clinical and immunological examination. They were allocated to two groups, one comprised of 25 patients with DM1 and lipoid necrobiosis (LN), the other consisting of 25 patients with DM1 without LN. Expression of Toll-like receptors (TLR2, TLR3, and TLR4) was evaluated in monocytes and neutrophils obtained from peripheral blood. In addition, the state of peripheral circulation and innervation of the lower extremities was evaluated. It was shown that the impairment of expression and fluorescence of TLR2 and TLR4 in monocytes as well as TLR3 in neutrophils was associated with the manifestations of skin lesions in the patients with DM1 and LN. It is concluded that the measurement of Toll-like receptors in the patient presenting with type 1 diabetes mellitus and lipoid necrobiosis can be used in clinical practice for the prediction of the development of dermatosis.

The issues pertaining to etiology, pathogenesis, clinical manifestations, and treatment of endocrine ophthalmopathy (EOP) are discussed. EOP is a heterogeneous autoimmune eye disease most frequently associated with Graves’ disease even though it is just as well encountered both in the patients presenting with chronic autoimmune thyroiditis and in the absence of thyroid dysfunction. Although pathogenesis of EOP remains to be elucidated its autoimmune nature with the involvement of sensitized T-lymphocytes and autoantibodies against orbital tissues leaves no doubt. The understanding of mechanisms underlying the development of EOP gave impetus to the creation of new groups of medicines selectively acting on various pathogenic processes associated with this disease. The management of EOP remains a challenging problem requiring a multi-disciplinary approach for its solution.

The rapid increase in the number of patients with type 2 diabetes mellitus and renal pathology necessitates the revision of the presently adopted approaches to renal replacement therapy with a view of relieving the economic and financial burden imposed by the use of expensive therapeutic methods on the health budgets of the developed countries. The importance of achievement and maintenance of the target blood sugar levels for the prevention of the development and progression of renal lesions has been demonstrated in a series of large-scale clinical studies. Compensation of disorders of carbohydrate metabolism at the late stages of chronic renal disease in the patients presenting with diabetes mellitus encounters difficulties arising from the danger of hypoglycemia associated with the impairment of renal gluconeogenesis, cumulation of antiglycemic agents and their metabolites, decreased clinical significance of glycated hemoglobin levels under conditions of developing anemia and marked hyperglycemia. Discontentedness with the currently available means for the control of carbohydrate metabolism that fail to meet the up-to-date-requirements for the effectiveness and safety in a given clinical situation accounts for the ever increasing interest in the possibility of using innovative incretin-based medicines taking into account their pharmacological profile (they are known to change insulin secretion in response to variations in blood glucose levels, improve the function of beta-cells, have beneficial effect on the cardiovascular system, and control body weight).

The advantages of combined therapy of diabetes mellitus (DM) with the use of fixed combinations, such as glybenclamide plus metformin are discussed. The principal ones are the lowered dose of each component without the loss of therapeutic efficacy, marked reduction in the frequency of adverse reactions affecting the gastrointestinal tract, minimal risk of hypoglycemic episodes, etc. The fixed combination of glybenclamide plus metformin makes it possible to prescribe flexible dosage regimes, enhanves compliance, ensures psychological comfort, and improves the quality of life. 

Cardiovascular disorders are the main cause of high disability and mortality rates among the patients with diabetes mellitus. The objective of the present work was to estimate the clinical and hemodynamic characteristics during the treatment of arterial hypertension with the use of olmesartan (hypertension/angiotensin II receptor antagonist, ARA) in the patients with type 2 diabetes mellitus suffering diastolic heart failure. The study included 56 patients (26 men and 30 women) of the mean age 58.2±5.3 years. They were given a course of olmesartan (cardosal) therapy 40 weeks in duration. This treatment was shown to result in positive dynamics of structural and geometric characteristics of the left ventricle and its diastolic function in conjunction with the improvement of the vasomotor function of arterial endothelium.