The results of comparative analysis of the data on sensitivity and specificity of different methods for topical diagnostics of insulinomas are presented. It is concluded that MSCT and intraoperative ultrasound study are the most sensitive and specific methods for this purpose among the non-invasive and invasive techniques, respectively. An optimal algorithm for diagnostics of the tumours is proposed.

Subclinical hypercorticism is characterized by increased cortisol secretion in the absence of the specific clinical manifestations of the disease. The prevalence of subclinical hypercorticism has been estimated at 8 cases per 10,000 population even though the frequency of subclinical hypercorticism may be higher among certain groups of the patients. We observed 111 patients presenting with type 2 diabetes mellitus and 40 ones with alimentary obesity. As a result, subclinical hypercorticism was diagnosed in 4 (10%) patients with obesity and in 12 (12%) ones with diabetes mellitus. In two of these cases, the diagnosis was later changed to clinically manifested hypercorticism. The imaging studies revealed pathological changes in pituitary and adrenal glands in six of the 16 patients presenting with subclinical hypercorticism. An algorithm for the examination of the patients with type 2 diabetes mellitus and alimentary obesity for the purpose of diagnostics of subclinical hypercorticism is proposed.

Leukoses and tumours of the central nervous system (CNS) are the leading malignant neoplasms encountered in the childhood. The combined treatment of these diseases including radiotherapy and polychemotherapy may have negative consequences for the functioning of the male reproductive system. The objective of the present study was to estimate the influence of therapy of acute lymphoblastic leukemia (ALL) and malignant tumours of the posterior cranial fossa (PCF) in the childhood on the endocrine and reproductive systems of the adult men. The study included 17 male patients who had undergone the treatment of PCF neoplasms and 6 men after therapy of ALL. The most widespread disorders in the patients of the former group were the small testicle size and the low inhibin B level. The combined treatment of PCF tumours produced a more pronounced adverse gonadotropic effect than ALL therapy.

Aim. The nalysis of peculiar features of obesity and metabolic disorders in the children presenting with Prader-Willi syndrome (PWS). Results of clinical, hormonal, and metabolic studies are presented obtained by the observation of 45 children of the prepubertal age suffering from obesity despite the normal body weight. The control group was comprised of 47 children presenting with exogenous constitutional obesity. The percent content of fatty mass in the patients with PWS and obesity was higher than in those with exogenous constitutional obesity (p=0.01) despite a similar degree of obesity. In contrast, the percent content of lean mass in the patients of the former group was significantly smaller (p<0.01). The prevalence of insulin resistance among the children with PWS and obesity was 11.1% compared with 42.5% in those with exogenous constitutional obesity (p=0.013). The blood leptin level, occurrence of dyslipidemia. and percent content of fatty mass in the children with PWS in the absence of obesity were similar to those in the patients with exogenous constitutional obesity.

The study included 127 patients with type 2 diabetes (T2D) risk factors, who underwent oral glucose tolerance test (75 g glucose) with pancreatic and incretin hormones estimated in fasting state, at 30 and 120 minutes after glucose load. According to the test results the population was divided into 3 groups: group with normal glucose tolerance (NGT), group with high risk of diabetes developing (impaired glucose tolerance (IGT) and impaired fasting glycemia (IFG)) and newly-diagnosed T2D. The stimulated glucagon secretion was suppressed in NGT group, whereas in T2D patients there was an increase in glucagon levels at 30 min after the glucose load. Within high risk group the area under curve (AUC) of glucagon secretion was significantly elevated in IFG patients comparing to IGT (0,52 vs 0,07 ng·ml-1·min-1, р=0,0005). AUC of glucagon secretion was positively related only to fasting glucagon-like peptide 2 (GLP-2) level (r=0,61, р=0,0001), that suggests glucagonotropic properties for GLP-2. We conclude that glucagon stimulation by GLP-2 may play a role in decreased glucagon suppression in T2D patients and IFG state development.

The study population of 127 patients with type 2 diabetes mellitus (T2DM) risk factors underwent oral glucose tolerance test (OGTT) and HbA1c measurement for diagnostic reasons. HbA1c revealed less diabetic patients than OGTT (31% vs 43%). HbA1c >7% and OGTT were similar in confirming diabetes, but HbA1c <7% suggests the need for OGTT performance to validate the diagnosis.

Aim of the study. To estimate the effectiveness of the new program of structured diabetes education for the groups of the patients with type 1 diabetes mellitus (DM1) during their transition to sensor-augmented pump (SAP) therapy in terms of improvement of the glycemic control and quality of life (QL). Material and methods. The study included 35 patients presenting with DM1: 14 men, mean age 26.5 years (24; 36). The patients were divided into two groups. Those in the study group received a structured diabetes education (n=19), those in the control group were given conventional education (n=16). The patients of group 1 were transferred to SAP therapy in the framework of group education based on the specialized structured program. The education of control patients was carried out on an individual basis in the previous period at the places of residence. Quality of life and emotional well-being were estimated with the use of the validated Russian versions of the SF-36, ADDQoL, and WB-Q12 questionnaires. The effectiveness of glycemic control and QL were evaluated within 4 months after the completion of education and transition to SAP. Results. The patients of both groups were not initially different in the HbA1c level: 8.1 (8.0; 9.2) versus 8.8 (7.7; 9.0) (p>0.05). The HbA1c level: decreased in the two groups within 4 months after the initiation of SAP therapy: 7.3 (6.3; 7.8) versus 8.0 (6.3; 8.5) (p>0.05). The decrease was more pronounced in the group of the patients who received the structured diabetes education than in the control group (p=0.036). The patients transferred to SAP in the framework of the structured education program tended to have higher indices of QL and emotional well-being than the patients given the standard education. Conclusion. The use of the specialized structured program for the education for the groups of the patients with type 1 diabetes mellitus during transition to SAP therapy results not only in a more pronounced improvement of glycemic control indices but also in the positive changes of certain QL characteristics.

The ultimate rarity of ACTH-ectopic syndrome caused by a caecal tumour, its diversified clinical picture, and difficulty of topical diagnostics are the main causes of many diagnostic errors and the resulting unsuccessful treatment of this condition. The present paper was designed to report 3 our experience with the management of the patients presenting with this pathology.

Monogenic forms of diabetes mellitus make up a group of rare pathologies associated with various forms of carbohydrate metabolism disorders. This group includes genetically determined dysfunction of pancreatic Β-cells and/or factors participating in glucose metabolism. Mutations in the HNFIA gene encoding for the nuclear transcription factor are responsible for the development of MODY3, one of the most widespread forms of monogenic diabetes mellitus. We present the description of the cases of MODY3 caused by mutations in the HNFIA gene reported from this country.

Neonatal diabetes mellitus (NDM) develops within the first 6 months of life. It occurs with a frequency of 1 cases per 300,000 - 500,000 newborn infants. Pathogenesis of NDM involves over 10 different genes. Of greatest clinical significance are mutations in KCNJII and ABCC8 genes responsible for the activity of ATP-dependent potassium channels and regulating their activation. It was shown that the intake of oral sulfonylurea (SU) preparations results in the closure of these channels and thereby stimulates the release of insulin from beta-cells. For this reason, SU therapy can be applied as an alternative to insulin injections. SU preparations ensure the efficacious control of metabolic processes and substitute insulin in the majority of the cases of transient and permanent NDM associated with mutations in KCNJII and ABCC8 genes. The original observations demonstrating the relationship between the type of mutation in the KCNJII gene and the dose of SU preparations are presented.