Insulin-dependent diabetes mellitus (IDDM) is a genetically determined disease, in the mechanisms of which autoimmune processes are leading, leading to disruption of insulin production. At present, quite convincing data have been accumulated testifying to the importance of genetic factors in the development of IDDM. Their contribution to the development of the disease (heritability coefficient) is 0.6-0.7, if we take the complete dependence of the development of IDDM on genetic factors as 1.0. The realization of a genetic predisposition in many respects depends on environmental influences that are not yet fully understood. In the development of IDDM, 6 stages are distinguished: stage 1 - a genetic predisposition, stage 2 - a hypothetical starting moment, stage 3 - an active autoimmune process, stage 4 - a decrease in insulin secretion in response to glucose intake, 5 stage I - clinical manifestation, which develops after the death of 80-90% of b-cells, and stage 6 - complete destruction of b-cells. Complete destruction of b-cells, according to some authors, occurs after 5 years or more. Since the development of IDDM is, as a rule, a long multi-stage process that sharply manifests itself at some point, in recent years attempts have been made to predict the development of the disease and verify the asymptomatic preclinical period.

In the last decade, data have appeared in the literature, obtained mainly by researchers from Canada and Finland, due to which a new direction has been outlined in the study of the mechanism of development of insulin-dependent diabetes mellitus (IDDM) in children. The results of these studies revealed the effect of cow's milk proteins (CMP), which were ingested by the child during the neonatal period, on the development of later IDDM, namely, the trigger (trigger) role of the antigenic structures of some CMPs in autoimmune damage to pancreatic p-cells in genetically predisposed individuals. Based on the obtained experimental and clinical data, it can be assumed that in order to prevent the development of IDDM in children with an increased risk of developing this disease who are on artificial or mixed feeding, it is advisable to use products based on CMP hydrolysates devoid of antigenic properties or soy proteins, similar to already known hypoallergenic mixtures. Targeted selection of newborns in need of specialized nutrition, in our opinion, is possible by conducting certain diagnostic tests aimed at identifying children with an increased risk of sensitization with CMP antigens.

The leading pathology in endocrinology is diabetes mellitus, which is characterized by a high incidence of disability and high mortality. According to the data of A. G. Mazovetsky, by 2000 compared with 1985, an increase in the number of patients with diabetes mellitus is expected to be 2.9 times. The frequency of vascular lesions in diabetes is 68–91.3%. The results of D. Greene indicate that peripheral vascular damage in this group of patients is observed 30 times more often than in people of a similar age without diabetes mellitus. Free radical pathology. Recent studies of domestic and foreign authors indicate the important role of non-enzymatic free radical oxidation (FRO) of lipids in the pathogenesis of many chronic diseases of modern man. Before analyzing the role of free radical mechanisms in the pathogenesis of diabetes mellitus and diabetic angiopathies, it is necessary to briefly familiarize yourself with the general ideas about the nature of FRO lipids and their inhibition systems. Due to the spin properties of triplet oxygen, when it interacts with a pair of donor electrons, the probability of free radical formation is high. The one-electron form of reduced oxygen can be protonated — НО₂*(hydroperoxyl radical) and anionic — О₂^- (superoxide radical).

Cardiovascular disease is a common cause of death in patients with diabetes mellitus (DM). The likelihood of developing heart failure with this disease increases, even if you take into account the influence of factors such as age, blood pressure, plasma cholesterol, body weight and the condition of the coronary arteries. The term "diabetic cardiomyopathy" was proposed in 1972 by S. Rubier et al. They performed postmortem autopsy of patients with diabetes complicated by diabetic nephropathy and congestive heart failure without arterial hypertension and severe atherosclerosis of the coronary arteries. The hemodynamic parameters of a group of patients with diabetes without hypertension without significant atherosclerotic changes in the coronary arteries according to angiography were studied by T. Regan et al. In these patients, a decrease in stroke volume index and an increase in diastolic pressure in the left ventricle were detected. The observed changes, indicating a decrease in left ventricular myocardial extensibility, were interpreted as signs of subclinical cardiomyopathy. Based on the results of an echocardiographic examination of patients with insulin-dependent diabetes mellitus (IDDM) Ch. Dimitar proposed the following stages of development of diabetic cardiomyopathy: I - increased myocardial contractility; II - systolic and diastolic functions are not impaired; III - the beginning of the development of diastolic dysfunction, a decrease in the "compliance" of the left ventricular myocardium and dilatation of the left atrium; IV - progression of diastolic myocardial dysfunction (DDM) and the addition of systolic dysfunction.

In recent years, it has become apparent that autoimmune mechanisms play a leading role in the development of insulin-dependent diabetes mellitus (IDDM). According to modern concepts, IDDM is a classic organ-specific autoimmune disease in which β-cells are destroyed by mechanisms mediated by T-lymphocytes and circulating autoantibodies. However, there is experimental evidence that the primary mechanism of damage to the p-cell is the action of cytokines. Thus, the destruction of β-cells occurs in two phases: the first - independent of lymphocytes, the initial, the second - mediated by the action of T-lymphocytes. According to the Copenhagen model of the pathogenesis of IDDM, environmental and internal factors (viruses, chemicals, food factors, interleukin-1) trigger the activation of free radical oxidation in β-cells. Under the influence of free radicals (O₂^-, NO), p-cell proteins change their natural properties (“denature”) and become antigens for their own immune system. The increased sensitivity of the β-cell to the action of free radicals is due to the fact that it reduces the activity of antioxidant defense systems (superoxide dismutase, glutathione peroxidase, catalase). "In other words, β-cells in IDDM die because they are b-cells." Toxic free radicals of oxygen (O₂^-) and nitric oxide (NO) cause disturbances in the DNA structure of insulin-producing cells, stimulate the pathological activation of poly (ADP-ribose) synthetase, responsible for DNA replication, which leads to increased utilization of NAD + with subsequent depletion of its reserves in the cell: this causes a decrease in the synthesis of proteins, including proinsulin, and the subsequent death of the β-cell.

Obesity remains the most common disease in the population of economically developed countries. 16-25% of the inhabitants of these countries have a body weight exceeding the norm by more than 15%. There has been an increase in the incidence of obesity over the past 20 years. The connection between overweight and such formidable diseases as hypertension, coronary heart disease, and non-insulin-dependent diabetes mellitus (NIDDM) is well known. The current state and especially long-term results of the treatment of obesity remain unsatisfactory. It is known that in more than 80% of patients the initial body weight is restored within the first 3-6 months after the end of the course of treatment. The mechanisms of the development of diseases associated with obesity have not been fully studied, and therefore pathogenetically substantiated treatment regimens have not been developed. After the classic work of J. Vague, performed more than 40 years ago, there are many studies showing that the risk of developing diseases associated with obesity depends not only on the degree of excess body weight, patient age, duration of the disease, but also on the distribution of fat. According to some reports, the dependence on the distribution of fat is more pronounced than the dependence on other factors, in particular on the degree of obesity. It turned out that complications are more characteristic for patients with a predominant accumulation of fat on the trunk and in the abdominal cavity (android, or abdominal, or visceral, or upper obesity) and are less typical for patients with a predominant deposition of fat on the buttocks and hips (gynoid, or gluteofemoral, or lower obesity).

Pancreatic (islet-cell) and gastrointestinal endocrine tumors are quite rare diseases - the incidence of new cases is from 0.4 to 1.5 per 100,000 inhabitants. Instead of the broader term «APUDomе», the term «gastroenteropancreatic endocrine tumors» (GEPET) has recently become more commonly used in clinical literature for practical reasons. As a result of numerous clinical and fundamental studies, about 19 types of GEPET and more than 40 products of their secretion are currently described. Most tumors are characterized by multihormonal secretion, but the development of the endocrine syndrome clinic is determined by the predominance of the production of a single hormone. The main GEPETs are insulinoma, gastrinoma, glucagonoma, VIPoma, tumors causing the development of carcinoid syndrome, and hormone-inactive endocrine tumors. Hormone-inactive GEPET refers to tumors originating from endocrine cells, but lacking the ability to secrete one or another hormone. GEPETs differ not only in the production of a particular hormone, but also in the nature of tumor growth. With the exception of insulin, it is mainly a malignant tumor (see table), but compared with other carcinomas, spontaneous tumor growth is often relatively slow. The essential clinical significance, which largely determines the therapeutic approaches, has a very different rate of tumor growth. Cases of spontaneous course of the process for more than 10 years are described, as well as rapid growth of the tumor, leading to death in literally months. In recent years, interest in GEPET has increased significantly, which is probably due to the creation of more advanced methods of topical diagnosis and treatment, which significantly improved the prognosis.

Despite the rapid progress of endocrinology in the last quarter of the 20th century, it should be noted that no other gland of internal secretion, to the extent that the pineal gland, is honored to be "titular" in the scientific community or scientific journal. Indeed, the European Society for the Study of the Pituitary Gland has been actively working for many years, the Melatonin Club was founded, the Journal of Pineal Research, Advances in Pineal Research, and the European Pineal Society News are published, and international conferences and symposiums are held annually in the last decade. dedicated to the pineal gland and melatonin. The rapid development of chronobiology led to the establishment of the leading role of the pineal gland and its main hormone melatonin in the implementation of the circadian, seasonal and annual rhythms of many functional systems of the body. The monograph under review, written by the famous English researcher of the pineal gland, Josephine Arendt, is a unique publication in which one author has systematized and critically analyzed the vast amount of factual material accumulated to date on the physiological effects and mechanisms of action of melatonin. The book consists of 9 chapters, unequal both in volume and in terms of circle and the importance of the issues addressed in them. The very brief chapter 1 summarizes the history of the study of the pineal gland and the discovery of melatonin and its functions in the body. Unfortunately, there was no place in it to mention such important events as the first description of the morphological picture of the hypofunction of the pineal gland (B.P. Kucherenko, 1941), the pioneering study of A.M. Khelimsky, who in 1953 first came to conclusion about age-related involution of the pineal gland.

The III All-Russian Congress of Endocrinologists was held in Moscow from June 4 to 7, 1996. The scientific program of the congress included almost all sections of endocrinology: diabetes mellitus, diseases of the hypothalamic-pituitary system, diseases of the thyroid and parathyroid glands, pathology of the adrenal glands and gonads. A separate symposium at the congress was devoted to endocrine pathology as a consequence of radiation disasters. The first plenary lecture at the congress was dedicated to the late complications of diabetes, which was presented by the president of the Russian Acad Endocrinologists Association. RAMS I.I. Dedov. The report noted that one of the most pressing issues in diabetology is the prevention and treatment of late complications of diabetes, which lead to early disability, while remaining the main cause of mortality in this disease. Modern diagnostics of diabetes complications and complex therapy can already change the fate of patients with diabetes. In particular, the report provided compelling data on the early diagnosis of nephropathy at the stage of hyperfiltration and microalbuminuria.
Optimal compensation of carbohydrate metabolism and the use of antihypertensive drugs, and primarily angiotensin-converting enzyme inhibitors (renitec, ramipril, enalapril, capoten, etc.) allow the development of nephropathy to be slowed down for a considerable time.
The treatment tactics for diabetic retinopathy have changed. Laser coagulation is deservedly highlighted; it leads to a halt in the progression of retinopathy and preservation of vision for many years.

70 years old, the famous endocrinologist Viktor Petrovich Fedotov, doctor of medical sciences, professor honored scientist of the Russian Federation, head of the laboratory for biological studies of hormonal compounds of the Endocrinology Research Center of the Russian Academy of Medical Sciences, editor-in-chief of the journal “Problems of Endocrinology”, is 70 years old. After graduating from the 2nd Moscow Medical Institute, V.P. Fedotov entered graduate school at the Institute of Biophysics of the USSR Ministry of Health, which he successfully completed by completing his dissertation on the effect of polonium on the carbohydrate function of the liver. Later, the scientific interests of V.P. Fedotov were concentrated in the field of experimental endocrinology; his doctoral dissertation (1972) was devoted to the reaction of the endocrine system to radiation exposure and demonstrated the importance of the pituitary and adrenal cortex in the formation of symptoms of radiation sickness. In 1982, V.P. Fedotov was awarded the title of professor, in 1994 - the title of Honored Scientist of the Russian Federation. Since 1966 V.P. Fedotov heads the laboratory he created. The main focus of her work was the study of the complex of biological properties of hormones and their analogues, as well as the correlation between their structure and functions. For the first time in the country, the laboratory developed methods for radioimmunoassay of peptide hormones in humans and rats. V.P. Fedotov and his collaborators obtained important results regarding the regulation of proliferative and secretory processes in the pituitary and pancreas, and their changes in ontogenesis. The laboratory developed and put into practice an original method for determining autoantibodies to surface antigens of islet cells of the pancreas.