The modern system of medical and statistical observation, which has developed in Russia, does not allow a sufficiently complete assessment of the real epidemiological situation in relation to such a disease as diabetes mellitus (DM). Meanwhile, the damage associated with the incidence of diabetes mellitus, early disability and mortality from it, as well as the cost of treatment of patients are very significant. Planning specialized care for patients, providing them with a sufficient amount of medicines, as well as training the necessary number of specialists and specially trained average staff to work with patients with diabetes requires a clear knowledge of their needs. In this regard, there is a need for a more complete and systematic account of not only the fact of disease or death, but also the presence of complications of diabetes, the need for insulin, oral hypoglycemic agents, the causes of disability and death of patients with diabetes. In world practice, the above problems are solved by creating a register of SD. In its modern view, the diabetes register is an automated information system for recording the results of continuous medical-statistical monitoring of diabetes incidence and mortality in connection with it. The system provides for monitoring of the patient from the moment of his inclusion in the register until his death. The latter involves the registration of information about the patient with diabetes in various aspects: the presence of complications, their dynamics, treatment and availability of drugs, as well as the nature of the course of diabetes, the direct causes of death of the patient. The amount of information recorded depends on the objectives pursued by the organizers of the register.

The authors present data on the epidemiology of diabetes mellitus in the rural population of Daghestan living in different ecological zones. The incidence of the disease is the highest on the plains and the lowest in the highlands, although the morbidity increases more rapidly in the highlands. A correlation was traced between diabetes mellitus incidence and levels of use of pesticides, mineral and nitrogen-containing fertilizers in agriculture. A conclusion is made on the role of ecological factors in the prevention of diabetes mellitus.

Effects of acarbose (glucobai) in comparison with placebo were assessed in 180 patients with noninsulin-dependent diabetes mellitus (NIDDM, group II) and 120 ones with insulindependent diabetes (IDDM, group 1). Group I patients were followed up for 24 weeks, group 2 ones for 12 weeks. Drug efficacy was assessed by parameters of carbohydrate metabolism compensation, including HBA1 content, glycemia on an empty stomach and postprandial one, daily glycosuria, with the subjective and objective tolerance of the drug studied in detail. Time course of changes in body mass and lipid characteristics was followed up, clinical and biochemical analyses of the blood were carried out. Study of acarbose in a double blind test indicated its high efficacy in the treatment of patients with type II diabetes. Besides the influence on carbohydrate metabolism, a reduction of lipid concentration in the blood was observed in patients with NIDDM. Studies carried out in 120 patients with IDDM did not reveal any effect on carbohydrate metabolism in this type of diabetes. Acarbose was well tolerated by the patients. Only 24.4% of patients with NIDDM administered acarbose and 5.6% of those given placebo complained of meteorism; none of more grave gastrointestinal complications was observed.

Blood plasma lipoprotein spectrum and phospholipid spectrum of high density lipoproteins (HDLP) was studied in patients with newly detected noninsulin-dependent diabetes mellitus (NIDDM) and in patients with "secondary failure" of sulfanilamide drugs. Hyperlipidemia, mainly at the expense of increased concentration of triglycerides, very low density lipoproteins, total cholesterol, and low density lipoprotein cholesterol, was detected in the patients. HDLP phospholipid composition was disturbed, with sphyngomyelin level increased and lecithin content decreased. Glurenorm therapy led to reduction of the atherogenicity of blood plasma lipid spectrum despite the persistent basal and postload hyperinsulinemia, thus indirectly indicating an improved function of endogenous insulin. Antiatherogenic effect of glurenorm is evidently mediated by reduction of insulin resistance due to extrapancreatic effect of the drug. Intensive insulin therapy of patients with secondary failure led to a marked reduction of atherogenic components of lipid spectrum. The hypolipidemic effect of insulin therapy seems to be due to recovery of the inhibitory effect of insulin on lipolysis against the background of improved sensitivity to insulin and reduced insulin resistance. A positive effect of insulin therapy on lipid metabolism should not be regarded as an evidence in favor of theoretical assumptions and apprehensions about increased risk of atherogenesis as a result of exogenous hyperinsulinemia.

The formation of remote consequences of radiation effects on the thyroid status of the population exposed to low-dose radiation was studied. The authors analyzed epidemiological, clinical, biochemical, hormonal, ultrasonographic, immunological, and morphological characteristics of the prevalence and intensity of endemic goiter in children and adolescents living in two iodine-deficient districts of the Oryol region observed after contamination of their territory with 137-Cs in a dose of 1 to 5 Ci/km2 and in-corporation of 131-I in a dose of 20-30 rad and in a control district free from radiation contamination. The results indicate that under the effect of low-dose combined irradiation endemic goiter in the observed districts acquired atypical features in the six years that passed since the Chernobyl accident in comparison with that in the control region: 1) thyromegalia prevalence is increased, its level being disproportionate with the degree of the existent iodine deficiency; 2) sex-specific differences are completely absent; 3) the maximal strain is observed in children exposed to radioactive iodine in utero 4) morphologically, variants of diffuse goiter with a high risk of node formation predominate; 5) progressive growth of thyroid parenchyma is associated with increased thyroglobulin elimination, this increasing the strain of the humoral component of antithyroid autoimmunity. These data indicate that the modifying effect of low-dose exposure on endemic goiter resulted in the disease pathomorphism associated with oncological risk and increased risk of autoimmune thyroiditis.

A total of 434 children aged 4 to 7 living under ecologically adverse conditions were examined. Diffuse enlargement of the thyroid was detected in 35% of children (I degree in 62%, II degree in 38%), with equal frequency in boys and girls. This research was aimed at assessing the immune status of children with enlargement of the thyroid of different degree and at estimation of the functional activity of the thyroid by clinical and laboratory signs (T3, T4, TSH, whose concentrations were measured by standard radioimmunoassay and enzyme immunoassay). Preschool children with diffuse enlargement of the thyroid presented with immunocyte depression in the blood, which was evidently a result of thyroid hormone deficiency at the level of cellular metabolism, because the function of tire enlarged thyroid was frequently reduced, that is, compensated or decompensated hypothyroid state was present. Immunologic disturbances depended on the degree of diffuse enlargement of the gland and on the presence and degree of thyroid activity reduction. A close correlation between blood T4 and TSH levels and immunity status parameters was detected.

Dermatoglyphic parameters were studied in 86 patients with diffuse toxic goiter (66 women and 20 men). Palmar impressions were obtained with printing ink by contact method on paper. The position of the axial palmar triradius, skin pattern on the fingers and palm surfaces were assessed, digital and palmar crest count was analyzed. A statistically reliable distal dislocation of the axial palmar triradius and low incidence of patterns on the thenar were detected. Dermatoglyphic parameters characteristic of diffuse toxic goiter indicate that it is a genetically determined disease and may be used in medicogenetic counselling.

Monitoring the normal growth of a child is one of the primary tasks of a pediatric endocrinologist. The most common abnormality of growth is a variety of options for its delay, detected in 3% of children. Much less often, the reason for a visit to the doctor is tallness. The most adverse cause of gigantism in children for health and life is conditions accompanied by hyperproduction of growth hormone (GH). In pediatric practice, the latter, admittedly, constitute an endocrine rarity. Thus, according to 11-year observations of more than 800 children at the Outpatient Center for Pediatric Endocrinology at North Shore University Hospital in the United States, in the structure of the growth pathology, the height rate was 2.5% - approximately 75 cases per 100,000 children. At the same time, for each case of seeking advice about excessive growth, there were about 40 appeals due to its delay. True gigantism is found only in every 5th child with unusually high growth, or less than 0.5% among children with deviations in body length. On the other hand, according to M. I. Balabolkin, only 9% of patients with acromegaly debut of the disease occurs at the age of 20. These statistics once again emphasize the extreme rarity of diseases occurring with abnormal excess growth in childhood.

The creation of methods of radioimmunological analysis (RIA) to determine hormones had a decisive influence on the development of modern endocrinology and especially thyroidology. Since 1973, RIA methods have become routine diagnostic methods for the determination of thyroxine (T4), triiodothyronine (T3) and thyroid stimulating hormone (TSH). However, for a long time they made it possible to determine only the fractions of hormones associated with transport proteins, and RIA methods for determining TSH did not allow to determine its low (< 0.1 Mme/l) concentrations. Later, variants of RIA were developed based on the immunometric principle, using solid-phase carriers and monoclonal antibodies. This made it possible to determine, along with the general T4 and T3, also their free forms. Namely free T4 and T3 (FT4 and FT3) provide the entire spectrum of biological activity. Their definition is the most informative in assessing the functional state of the hypothalamus-pituitary-thyroid gland. The IRMA principle allowed to increase the sensitivity of the method for determining TSH to 0.16 mIU/L. This level of sensitivity satisfied clinicians in assessing the euthyroid state and hypothyroidism, but it did not allow to differentiate the normal level of TSH from subnormal in patients with thyrotoxicosis. In the last decade, fundamentally new non-isotopic technologies of hormonal immunoassay have been created. The sensitivity of this method in determining TSH was brought to 0.03 mIU/L. Currently, the determination of FT4 and TSH using the hypersensitive method is a strategic diagnostic approach to assessing the hormonal status of the thyroid gland.

Study of the time course of protein synthesis by intact liver and brain mitochondria in rats of different age exposed to thyroxin in physiological concentrations (10^-8 M) and cytoplasmic thyroxin-binding protein (modulator of thyroxin effect — MDT4) showed that thyroxin did not influence protein synthesis in liver and brain mitochondria. On the other hand, MDT4 stimulated protein synthesis, this stimulation correlating with the age of rats. In brain cells MDT4 enhanced labeled leucin incorporation in the embryonal and early postnatal periods. MDT4 is proposed to be involved in the mechanism of tissue-specific effect of thyroxin and in the formation of age-specific sensitivity to it.

Changes in blood serum progesterone, thyrotropic and thyroid hormone levels in white outbred rats during development of a subfebrile state induced by a single injection of complete Freund's adjuvant containing killed and dried Mycobacteria butyricum were studied. A rise of body temperature in males and females was associated with an increased level of progesterone and a decreased content of thyrotropic and thyroid hormones in the blood. After normalization of body temperature (4 days after drug injection), the content of progesterone did not differ from the baseline level. Hyperthermia arrest by indomethacin failed to appreciably influence the blood level of this hormone.

Nutrition is one of the constantly acting environmental factors that have a powerful effect on a number of biological constants of the body. Due to the absence of etiotropic therapy for diabetes mellitus (DM), the only real preventive measure for the occurrence and development of vascular complications at the present stage is the maximum compensation of various metabolic disorders characteristic of this disease. Diet therapy not only helps lower blood pressure (BP), but can also reduce the risk of coronary heart disease due to its lipid-lowering effect.

Diabetes mellitus (DM) is one of the most common diseases, the frequency of which is steadily increasing every year. In industrialized countries, the prevalence of DM is 4-5%. Despite the large number of existing forms of diabetes associated with various syndromes and diseases, the main ones are two that are characterized as spontaneous: insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes (NIDDM). Statistical data on the prevalence of the disease are based on the registration of a medical diagnosis of diabetes and in general reflect mainly the prevalence of spontaneous forms of IDDM and NIDDM. In 1991, 1 826 758 patients with DM were registered in the Russian Federation, of which 295 333 (16.2%) suffered from IDDM. Compared with 1990, the number of patients with diabetes increased by 5.78%. However, the figures do not reflect the actual prevalence of diabetes. The conducted epidemiological studies on the frequency of diabetes show that the true number of patients with diabetes is 3-4 times higher compared to the registered one. These include people with a mild form of NIDDM who do not need medical treatment, as well as people with impaired glucose tolerance. In these groups, disorders of carbohydrate metabolism occur in a subclinical form, and the recorded prevalence of diabetes is largely determined by the quality of the medical examination. A more accurate picture of the prevalence of various types of diabetes can be obtained only with the State Register for diabetes, its development is necessary in the near future.

On November 13, 1994, science suffered a heavy loss - an outstanding Russian scientist, professor, doctor of medical sciences, the founder of a number of original directions in world neuroendocrinology Evgeny Vladimirovich Naumenko prematurely passed away. In the 60s, the scientific interests of E.V. Naumenko were focused on studying the role of biogenic brain amines in the neurochemical regulation of the hypothalamic-pituitary-adrenocortical system. In particular, he proved for the first time that one of the final hypothalamic neural pathways stimulating the synthesis and secretion of corticoliberin is serotonergic in nature. The results of these widely known studies at home and abroad brought well-deserved fame to a neuroendocrinologist from Siberia. In the last 20 years, the main work of E.V. Naumenko concerned the study of genetic evolutionary and ontogenetic aspects of stress, the role of neuroendocrine mechanisms in animal domestication processes, the role of neurochemical brain mechanisms in the dominant behavior of individuals in micropopulations, and the study of a new model of hereditary arterial hypertension. Professor E.V. Naumenko has published over 300 works, including more than a dozen major monographic publications published at home and abroad. These publications are widely known among specialists, they have made a significant contribution to the development of neuroendocrinology and brought well-deserved recognition to their author.

On November 13, 1994, science suffered a heavy loss - an outstanding Russian scientist, professor, doctor of medical sciences, the founder of a number of original directions in world neuroendocrinology Evgeny Vladimirovich Naumenko prematurely passed away. In the 60s, the scientific interests of E.V. Naumenko were focused on studying the role of biogenic brain amines in the neurochemical regulation of the hypothalamic-pituitary-adrenocortical system. In particular, he proved for the first time that one of the final hypothalamic neural pathways stimulating the synthesis and secretion of corticoliberin is serotonergic in nature. The results of these widely known studies at home and abroad brought well-deserved fame to a neuroendocrinologist from Siberia. In the last 20 years, the main work of E.V. Naumenko concerned the study of genetic evolutionary and ontogenetic aspects of stress, the role of neuroendocrine mechanisms in animal domestication processes, the role of neurochemical brain mechanisms in the dominant behavior of individuals in micropopulations, and the study of a new model of hereditary arterial hypertension. Professor E.V. Naumenko has published over 300 works, including more than a dozen major monographic publications published at home and abroad. These publications are widely known among specialists, they have made a significant contribution to the development of neuroendocrinology and brought well-deserved recognition to their author.