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Almost 90% of patients with type 2 diabetes mellitus (DM2) are obese. Obesity increases the risk of developing DM2 several times. The calculation of anthropometric indices is used to diagnose the severity of obesity, as well as to assess the risk associated with obesity. The aim of the study is to study the relationship between Body Mass Index (BMI), waist circumference to hip circumference ratio (waist-to-hip ratio, WC/HR), Body Roundness Index (BRI) and Visceral Adiposity Index (VAI) with the risk of hypoglycemia in elderly and senile patients with DM2. The study included 122 elderly and senile patients (mean age 71±6,18 years) with DM2. The study participants were divided into 2 groups: patients with cases of hypoglycemia (n=65) and patients without a history of hypoglycemia (n=57). We have found that lower BMI, WC/HR, BRI, and VAI values are significantly associated with an increased risk of hypoglycemia in patients with DM2 of older age groups.

Type 2 diabetes mellitus is one of the most common non-infectious diseases in the world. Among people with type 2 diabetes, patients of the older age group predominate: 60,5% of all patients are over 65 years old, and the peak prevalence is at the age of 65-69 years. The treatment of this pathology in elderly patients has certain features, which is associated with a high level of polymorbidity in these patients. Therapy for type 2 diabetes should be aimed not only at compensating the level of glycemia, but also at treating and preventing complications of diabetes, and improving the quality of life of patients. The choice of hypoglycemic therapy should take into account the effect of drugs on the cardiovascular system and kidney function, as well as the risk of hypoglycemia, which is more common in older people and affects the cognitive function of such patients. This review discusses the possibilities of using various groups of antidiabetic drugs in elderly and old patients.

The concepts of atherosclerosis as afatly acids pathology, deficiency syndrome in cells ofpolyene fatty acids were expounded in 1990. The spirits cholesterol and glycerin play integrated physical chemical function in fatly acids' metabolism in transforming polar fatty acids into such non-polar form as ethers cholesterol and triglycerides. The amount of fatty acids transferred by lipoproteins to triglycerides significantly exceeds amount of fatty acids as ethers cholesterol. The triglycerides dominate in cells and ethers cholesterol outside cells. The hypertriglyceridemia is a disorder of transformation in blood of phylogenetically late insulin-dependent palmitic and oleinic lipoproteins of very low density and receptor apoE/B-100-endocytosis by cells of non-ligand lipoproteins of very low density. The hypertriglyceridemia is a disorder of support of cells with energy substrates, problem of cell "energetics", formalton of adenosine triphosphate. It is proposed to evaluate prognostic value of spirits cholesterol in blood plasma only in case of physiological level of triglycerides. The spirits cholesterol never exceeds content of triglycerides however high would be content of spirits cholesterol in blood plasma under family hypercholesterolemia. The increasing of concentration of triglycerides always results in increasing of content of spirits cholesterol and especially spirits cholesterol-lipoprotein of low density. If level of triglycerides and spirits cholesterol is increased normalization of content of triglycerides using diet is to be implemented To evaluate content of spirits cholesterol in blood plasma is rational only under physiological level of triglycerides. Quite often, after decreasing of content of triglycerides content of spirits cholesterol spontaneously decreases by itself. It is supposed that functions of phylogenetic early resident macrophages of intima and late monocytes-macrophages differs. The functional characteristics of second ones under surplus induction by substrate (non-ligand lipoproteins) forms atheromatosis. The increasing of content of apoC-III in blood plasma--test of accumulation of blood of a physiologicpal mitic lipoproteins of low density, compensatory activation of lipolysis of triglycerides in lipoproteins of low density, but not blockade of biological function of trophology, biological reaction of exotrophy.

Objective: Our aim was to examine the predictors of cardiovascular disorders in children affected by obstructive sleep apnea syndrome (OSAS) based on the results of polysomnography and continuous monitoring of blood glycose., Methods: Before the examination, parents filled in questionnaires concerning their children sleep quality. The procedure was followed by the study of the sleep by means of polysomnography (Embla s 7000, USA). A system of continuous monitoring of blood glucose was applied (Guardianreal-time, Medtronicminimed, USA) by means of which a glycemic profile tissue fluid was studied., Results: A night sleep research of 120 children aged 3-16 y.o. is presented. There were 4 groups depending on the pathology: diseases of the nervous system (n = 31), ENT-pathology (n = 18), bronchial asthma (n = 24) and overweight and obesity (n = 34). The comparison group consisted of 13 apparently healthy children. The study has shown that the parents of every second child with sleep disorders did not know about the fact. The 60 % of the patients with high body mass index (BMI) had a snore, which was significantly higher the in children with normal body mass index--35% (p = 0.012). The index of apnea-hypopnea (AHI) was higher in the patients with ENT-pathology 17 times (p < 0.001) and the patients with obesity 7 times (p < 0.001) in comparison to the comparison group. In the analysis of the overall sample (n = 120) was obtained significant negative correlation with heart rate variability and heart rate (r = 0.405; p < 0.001). It is also shown that among 14 investigated children with OSAS only 8 had episodes of hypoglycemia (less than 3.3 mmol/l) during night sleep. All of them were with a high body mass index and with above average stature (>1sd)., Conclusion: Children with ENT-pathology and with high high body mass index have high risk of cardio-vascular diseases. Children with above average stature and with increased body mass index affected by OSAS have additional backgrounds for cardiovascular diseases develop- ment as a result of the latent periods of hypoglycemia at night.

A review of the Russian and international publications on the frequency, risk factors and characteristics of ischemic stroke in patients with type 2 diabetes mellitus (DM-2) is presented. We present a detailed description of specific risk factors for DM-2 (chronic and acute hyperglycemia, recurrent hypoglycemia, insulin resistance and hyperinsulinemia). Current demands to targeted glucose control in patients who survived vascular events are presented. Attention is drawn to the high frequency of complex multiple vessel lesion in patients with DM-2.

The incidence of insulinoma, an insulin-producing tumour arising from pancreatic beta-cells and responsible for the development of fasting hypoglycemia, in the general population is 1-4 per 1,000,000 yearly, mostly at the age of 25-55 yr. Malignization of this neoplasm occurs in 10-15% of the cases. One third of the tumours produce metastases. The most characteristic clinical manifestation of insulinoma is the Whipple's triad, with episodes of fasting hypoglycemia (below 2.8 mmol/l) correctable by intravenous glucose injection or intake of sugar. The authors report a case of intravital diagnosis of malignant metastasizing insulinoma in a 82 year old woman with type 2 diabetes mellitus. A review of relevant literature is presented.

Twenty-five patients with type I diabetes mellitus (8 women and 7 men) aged 19 to 54 with a disease duration of 3 to 19 years were treated by Russian semisynthetic short-acting human insulin mono-H. The daily dose varied from 24 to 44 U. The drug therapeutic efficacy was assessed from the terms of attainment of carbohydrate metabolism compensation, glycosylated hemoglobin level, and changes in daily insulin requirement. Clinical safety of the drug was assessed from changes in antiinsulin antibody level, incidence and severity of hypoglycemia, absence of lipodystrophy and other adverse reactions. The drug was found effective for the treatment of patients with type I diabetes. Its hypoglycemic effect was similar to that of actrapid, a porcine insulin. Fractionated insulin therapy resulted in the majority of patients in a reduction of glycosylated hemoglobin level, of daily requirement in insulin, and of antiinsulin antibody titer.