HLA antigens were studied by 67 markers in 95 children and adolescents with diabetes mellitus of at least 5 years standing. Screening of late complications of diabetes was carried out in this group. Analysis of correlations revealed HLA markers of discrete predisposition to various complications of the disease. Relationship between diabetes duration and the development of retinopathy, nephropathy, and development of more than one complication was revealed. At the same time, limited mobility of the joints (diabetic cheiropathy) was found to be unrelated to HLA antigens or diabetes duration.

It is known that patients with insulin-dependent diabetes mellitus (IDDM) have a violation of insulin secretion. When insulin is discontinued or when exposed to stress, they can quickly develop diabetic ketoacidosis. The reason for this is a decrease in the content of free insulin in the blood. Patients with pancreatic diabetes (PD) (according to the WHO classification: diabetes associated with pancreatic disease) also have an endogenous violation of insulin secretion. However, they have less frequent diabetic ketoacidosis. Of 92 patients with chronic pancreatitis and PD, 11 (12%) patients had a history of positive reaction to ketone bodies at least once, and only 3 patients had ketoacidosis. When studying the excretion of a C-peptide with urine, it turned out that its content was not determined or was very insignificant both in patients with PD and patients with IDDM. Consequently, the origin of ketoacidosis cannot be associated only with the ability of the pancreas to secrete insulin. This article examined the mechanisms of ketoacidosis in patients with PD and IDDM. The activity of 3-hydroxybutyric acid (3-HMC) in the blood was determined as an indicator. At the same time, the content of free insulin and glucagon was measured.

The problem of development of diabetic myocardiodystrophy is analyzed. Thirty-seven patients with type 1 diabetes running a grave course with various disease duration were examined. The major parameters of intracardiac hemodynamics were examined by echolocation; exercise tolerance was studied by bicycle ergometry. The data indicate the development of diastolic rigidity, reduced volume of leftventricular myocardium, and decreased stroke and minute output at the early stages of the disease. Bicycle ergometry showed reduced exercise tolerance. These changes were in direct proportion to disease duration, presence of microangiopathy, and compensation status. These parameters may appreciably improve in recovery of the disturbed metabolic processes with restoration of the age-specific norm in patients with not long disease standing. Hence, echolocation of the heart and bicycle ergometry may be regarded among the criteria of diabetes mellitus compensation.

The authors analyze the experience gained in the treatment of more than 1000 diabetics with pyonecrotic complications on the soles. Elements of diabetic osteoarthropathy, indicative of osteomineralopenia and collagenopathy, were detected in 61.1% of patients. Repair osteogenesis in diabetes mellitus is incomplete and does not lead to repair of bone mass and structure.

Sixty-one patients with newly detected insulindependent diabetes mellitus (IDDM) and 16 normal subjects were examined. Levels of glycemia, HbAlc, basal and stimulated C- peptide, insulin requirement, and lipid peroxidation (LPO) were assessed before and 3, 6, and 12 months after the follow-up was started. Activation of lipid peroxidation detected as early as at the debut of the disease permitted the authors to propose antioxidants, alfa-tocopherol acetate and nicotinamide, among other agents, for the correction of the disorders detected. The best results characterizing the clinical course, hormonal and metabolic markers, and function of the intact beta-cells in patients with newly detected IDDM were observed in the group of patients treated with insulin, nicotinamide, and vitamin E. The number of remissions was reliably higher in this group of patients in comparison with other groups: complete remission was attained in 33%, partial in 67% of patients; stimulated C-peptide level 6 months after treatment (0.41 ± 0.06 nmol/liter) was reliably (p < 0.01) higher than in group IV (0.14 ± 0.02 nmol/liter). In group III the minimal levels of LPO products (hydroperoxides and malonic dialdehyde) and normalization of red cell membrane resistance were observed, as well as the highest activities of superoxide dismutase and glutathion peroxidase.

The levels of autoantibodies to total extract of the thyroid were assessed using passive hemagglutination test and of antibodies to thyroglobulin (TG) and thyrocyte microsomal fraction (TMF) by indirect solid-phase enzyme immunoassay in 62 adolescent girls with diffuse enlargement of the thyroid and autoimmune thyroiditis. The efficacies of the two methods were compared. Autoantibodies to thyroid tissue antigens were reliably better detected by enzyme immunoassay. The mean levels of autoantibodies to TG and TMF measured by enzyme immunoassay were reliably increased in patients with autoimmune thyroiditis, whereas in the group of adolescent girls with diffuse enlargement of the thyroid they did not differ from the norm.

Hyperparathyroid (hypercalcemic) crisis develops with adenomas of the parathyroid glands or their hyperplasia, malignant non-endocrine tumors that secrete parathyroid hormone. The calcium level at which a crisis develops can be different. The clinical picture of the crisis is due to calcium intoxication and other symptoms and electrolyte disorders associated with it. It is very variable and therefore there are diagnostic difficulties. A differential diagnosis in this situation has to be carried out with comas of a different etiology, which have similar symptoms, with diseases of the cardiovascular system, respiratory system, gastrointestinal tract, kidney pathology and conditions caused by diseases of the neuropsychic sphere.

Diabetic osteoarthropathy (DOAP) is a serious complication of diabetes mellitus (DM) and occurs, as a rule, in people over 30 years old. In most cases, DOAP is observed in women with insulin-dependent diabetes and with a disease duration of more than 10 years. The frequency of this complication ranges from 0.2 to 0.5%. DOAP is characterized by a unilateral lesion of the feet. Early clinical symptoms are thickening and erythema of the skin. As the disease progresses, deformations of bones and joints develop. Radiologically in these cases, osteolysis, osteoporosis, bone fragmentation, joint disintegration are determined. A histological examination, as a rule, reveals an increase in osteoclastic activity with bone resorption and proliferation of connective tissue, as well as aseptic vascular necrosis.

Sexual dysfunctions in men are associated with the defeat of one or more components that ensure the copulative cycle: neurohumoral, mental, erection, ejaculatory. Sexual dysfunctions in diabetes mellitus are a fairly common phenomenon (according to various authors 24-74%). In addition to the well-known patterns of the development of sexual disorders, diabetes mellitus leaves a specific imprint associated with the degree of compensation of carbohydrate metabolism, the development of microangiopathies, visceral and distal polyneuropathies. In this regard, timely diagnosis of the nature of sexual dysfunction, its effective treatment, and sustainable rehabilitation of the sexual sphere in patients with diabetes are an urgent problem.

Analysis of the status of ATP-dependent K+ channels of pancreatic beta cells functionally attenuated under the effect of streptozotocin and simultaneous assessment of their reaction to sulfonylamide agents glybenclamide, glipizid, and glyclazid showed highly specific response of the tested ionic channels under the effect of both glucose and sulfonylurea agents. Analysis of the time course of electrophysiological processes coursing in them showed appreciable changes in the time of the channel closing, which led to deceleration of insulin secretion starting from the moment of exposure to glucose or sulfonylurea agents till exocytosis of insulin quantum. Glybenclamide proved to be the most active of the tested agents as regards their secretogenic properties.

Effects of chorionic gonadotropin (CG) on the functional activity of antigen-specific T-suppressors generated in CBA mice on day 14 by supraoptimal dose of thymus-dependent antigen were studied. The activity of T-suppressors was assessed by the level of antibody-producing (ABP) cells forming in the organism of suppressor cell recipients immunized with the same antigen. CG was injected to intact and oophorectomized recipient mice or was directly incubated in a one-hour cell culture with antigenspecific suppressor cells which were then transplanted to intact female mice. CG in a dose of 40 or 200 IU did not influence the capacity of T-suppressors to suppress primary immune response in intact females. In oophorectomized animals the hormone statistically reliably decreased the activity of T-suppressors, no matter what its dose were, and depressed the splenocyte activity. In a cell culture CG similarly depressed T-suppressor functional activity without influencing their homing.

The status of subnuclei of the paraventricular and ventromedial nuclei of the hypothalamus in the pathogenesis of experimental diabetes mellitus was studied in Wistar rats by morphohistochemical, radioimmunological, immunocytochemical, and electrophysiological methods. A close correlation was revealed between morphohistochemical and hormonal characteristics of the neuronal status of the studied hypothalamic subnuclei, on the one hand, and of their bioelectrical activity, on the other. The reactions of the subnuclei of paraventricular and ventromedial nuclei during development of diabetes were found to differ. The hypofunction of the ventrolateral subnucleus of the ventromedial nucleus was shown to be one of the mechanisms of compensation of diabetes mellitus, directed, together with other mechanisms, at stimulation of insulin biosynthesis. The results confirm the important role of the hypothalamic structures in the regulation of the endocrine function of the pancreas and in the pathogenesis of diabetes mellitus.

It is believed that thyroid cancer is quite rare, accounting for less than 1% of the total number of malignant tumors in the population in all countries of the world. However, studies in recent years have revealed a significant increase in the incidence of thyroid cancer and its pronounced geographical differences. Therefore, while in Japan it is 0.5 per 100,000 of the population for men and 1.9-3.0 per 100,000 of the population for women, in Norway it is 2.0 and 5.8 per 100,000 of the population, respectively. In addition, there was information about the high frequency of the latent thyroid cancer. In Japan, in particular, latent thyroid cancer is found in 5.6–35.6% of autopsies included in the statistics. We are talking about random finds in people who died from non-endocrine diseases. The clinical significance of latent cancer is still unknown. This is evidence that malignant tumors of the thyroid gland are not a rare disease and are often not diagnosed during the patient’s life.

The lesion of the cardiovascular system is a frequent and serious complication of diffuse toxic goiter, which often comes to the fore in the clinical picture and determines the course and outcome of the disease. To refer to this lesion, R. Kraus introduced the term “thyrotoxic heart” in 1899, and now it refers to the symptom complex of disorders of the cardiovascular system caused by the toxic effects of excess thyroid hormones and characterized by the development of hyperfunction, hypertrophy, dystrophy, cardiosclerosis and heart failure.