Pub Date : 2023-05-10DOI: 10.15829/2713-0177-2023-9
A. Arefyeva, A. Volkova, A. Lisker, E. N. Ostroukhova, T. A. Kholudeeva
Klinefelter syndrome (KS) is a genetic disease associated with the presence of an extra X-chromosome in the karyotype of men. The most common karyotype is 47XXY, however, other genetic variants are also possible, as well as mosaic forms.The clinical picture is most often represented by bilateral gynecomastia, decreased in the volume testicles and infertility (azoospermia). Laboratory revealed hypergonadotropic hypogonadism. Testosterone replacement therapy is used to ensure virilization and the proper quality of life. Assisted reproductive technologies with preliminary hormonal preparation are used to restore fertility.This article presents a clinical case of KS and considers options for realization of reproductive plans in the case of non-obstructive azoospermia.
{"title":"Klinefelter syndrome: a case report","authors":"A. Arefyeva, A. Volkova, A. Lisker, E. N. Ostroukhova, T. A. Kholudeeva","doi":"10.15829/2713-0177-2023-9","DOIUrl":"https://doi.org/10.15829/2713-0177-2023-9","url":null,"abstract":"Klinefelter syndrome (KS) is a genetic disease associated with the presence of an extra X-chromosome in the karyotype of men. The most common karyotype is 47XXY, however, other genetic variants are also possible, as well as mosaic forms.The clinical picture is most often represented by bilateral gynecomastia, decreased in the volume testicles and infertility (azoospermia). Laboratory revealed hypergonadotropic hypogonadism. Testosterone replacement therapy is used to ensure virilization and the proper quality of life. Assisted reproductive technologies with preliminary hormonal preparation are used to restore fertility.This article presents a clinical case of KS and considers options for realization of reproductive plans in the case of non-obstructive azoospermia.","PeriodicalId":274852,"journal":{"name":"FOCUS. Endocrinology","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116114025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-10DOI: 10.15829/1560-4071-2023-12
T. Demidova, V. V. Titova
Primary hyperaldosteronism (PA) is a disorder with excessive secretion of aldosterone, uncontrolled of regulation of the renin-angiotensin system. Excess secretion of aldosterone leads to the development of hypertension, hypokalemia and specific damage to the cardiovascular system and kidneys. The prevalence of PA was previously underestimated, but at the moment, according to studies, it is the most common cause of secondary arterial hypertension. The most common causes of PA are adrenal adenoma and adrenal hyperplasia. The importance of timely diagnosis of PA lies not only in solving the problem of high blood pressure, but because of the extremely adverse effect of excess aldosterone on the cardiovascular system and kidneys, which can even lead to death. The aldosterone-to-renin ratio (ARR) has long been a selective test for PA screening, but the complexity of its interpretation, the lack of clear cut-off level, and the confusion of measurement units make it difficult to evaluate, which has led some researchers to look for new ways for PA screening. The distinction between idiopathic adrenal hyperplasia (IAH) and aldosterone-producing adenoma (APA) is important for choosing the appropriate treatment. Therefore, imaging exams such as computed tomography and invasive studies such as adrenal catheterization are required to identify the PA subtype. Depending on the subtype of PA, it is necessary to use the optimal treatment — surgical for APA or pharmacological for hypertension, using drugs such as mineralocorticoid receptor antagonists.
{"title":"Difficulties in diagnosing primary hyperaldosteronism","authors":"T. Demidova, V. V. Titova","doi":"10.15829/1560-4071-2023-12","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-12","url":null,"abstract":"Primary hyperaldosteronism (PA) is a disorder with excessive secretion of aldosterone, uncontrolled of regulation of the renin-angiotensin system. Excess secretion of aldosterone leads to the development of hypertension, hypokalemia and specific damage to the cardiovascular system and kidneys. The prevalence of PA was previously underestimated, but at the moment, according to studies, it is the most common cause of secondary arterial hypertension. The most common causes of PA are adrenal adenoma and adrenal hyperplasia. The importance of timely diagnosis of PA lies not only in solving the problem of high blood pressure, but because of the extremely adverse effect of excess aldosterone on the cardiovascular system and kidneys, which can even lead to death. The aldosterone-to-renin ratio (ARR) has long been a selective test for PA screening, but the complexity of its interpretation, the lack of clear cut-off level, and the confusion of measurement units make it difficult to evaluate, which has led some researchers to look for new ways for PA screening. The distinction between idiopathic adrenal hyperplasia (IAH) and aldosterone-producing adenoma (APA) is important for choosing the appropriate treatment. Therefore, imaging exams such as computed tomography and invasive studies such as adrenal catheterization are required to identify the PA subtype. Depending on the subtype of PA, it is necessary to use the optimal treatment — surgical for APA or pharmacological for hypertension, using drugs such as mineralocorticoid receptor antagonists.","PeriodicalId":274852,"journal":{"name":"FOCUS. Endocrinology","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131701490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-10DOI: 10.15829/1560-4071-2023-22
F. Ushanova, T. Demidova, T. N. Korotkova
Cardiovascular disease is the leading cause of death in patients with diabetes mellitus. It has been established that the period of menopause, associated with an increase in age and a change in the metabolic background, increases the risk of developing cardiovascular diseases in women with diabetes mellitus. Despite tentative expectations, a number of studies have shown conflicting evidence regarding the beneficial effects of menopausal hormone therapy on CV risk markers in diabetes mellitus. In this connection, therapy with hormonal preparations containing estrogen is currently not recommended for the prevention of cardiovascular diseases in the absence of specific indications. At the same time, estrogen therapy can be used in this group to minimize menopausal symptoms. At the same time, the risk of adverse events associated with the use of menopausal hormone therapy can be estimated using calculation methods for determining cardiovascular risk and breast cancer risk using specific calculators, especially in the group of women with type 2 diabetes.The main principles of cardiovascular risk management continue to focus on lifestyle modification and achieving target levels of cardiovascular risk parameters such as lipid levels, glycemia, and blood pressure. The use of pharmacological therapy to address these risk factors, especially some pleiotropic antihyperglycemic drugs, may provide additional options for the prevention of cardiovascular disease.
{"title":"Principles of cardiovascular risk management in perimenopausal women with type 2 diabetes","authors":"F. Ushanova, T. Demidova, T. N. Korotkova","doi":"10.15829/1560-4071-2023-22","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-22","url":null,"abstract":"Cardiovascular disease is the leading cause of death in patients with diabetes mellitus. It has been established that the period of menopause, associated with an increase in age and a change in the metabolic background, increases the risk of developing cardiovascular diseases in women with diabetes mellitus. Despite tentative expectations, a number of studies have shown conflicting evidence regarding the beneficial effects of menopausal hormone therapy on CV risk markers in diabetes mellitus. In this connection, therapy with hormonal preparations containing estrogen is currently not recommended for the prevention of cardiovascular diseases in the absence of specific indications. At the same time, estrogen therapy can be used in this group to minimize menopausal symptoms. At the same time, the risk of adverse events associated with the use of menopausal hormone therapy can be estimated using calculation methods for determining cardiovascular risk and breast cancer risk using specific calculators, especially in the group of women with type 2 diabetes.The main principles of cardiovascular risk management continue to focus on lifestyle modification and achieving target levels of cardiovascular risk parameters such as lipid levels, glycemia, and blood pressure. The use of pharmacological therapy to address these risk factors, especially some pleiotropic antihyperglycemic drugs, may provide additional options for the prevention of cardiovascular disease.","PeriodicalId":274852,"journal":{"name":"FOCUS. Endocrinology","volume":"67 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122541791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-10DOI: 10.15829/2713-0177-2023-6
T. Demidova, K. Lobanova, T. N. Korotkova
Hypercalcemia is a common laboratory finding. The most common causes of high blood calcium are primary hyperparathyroidism, tertiary hyperparathyroidism, parathyroid cancer, malignant neoplasms, long-term therapy with lithium and thiazide diuretics, vitamin D intoxication, which require a different approach to treatment. Therefore, it is important for a doctor to be able to conduct a differential diagnostic search for hypercalcemia syndrome in order to establish the cause of high blood calcium and determine the correct tactics for managing patients.
{"title":"Hypercalcemia syndrome: differential diagnostic search and treatment tactics","authors":"T. Demidova, K. Lobanova, T. N. Korotkova","doi":"10.15829/2713-0177-2023-6","DOIUrl":"https://doi.org/10.15829/2713-0177-2023-6","url":null,"abstract":"Hypercalcemia is a common laboratory finding. The most common causes of high blood calcium are primary hyperparathyroidism, tertiary hyperparathyroidism, parathyroid cancer, malignant neoplasms, long-term therapy with lithium and thiazide diuretics, vitamin D intoxication, which require a different approach to treatment. Therefore, it is important for a doctor to be able to conduct a differential diagnostic search for hypercalcemia syndrome in order to establish the cause of high blood calcium and determine the correct tactics for managing patients.","PeriodicalId":274852,"journal":{"name":"FOCUS. Endocrinology","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126381041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-10DOI: 10.15829/2713-0177-2023-18
V. Larina
The article discusses the modern approaches to a glycemic control among outpatients with prediabetes. The risk factors for prediabetes, the possibilities of its screening, and the issues of treatment non-adherence are discussed. An attention is paid to the aspects of teaching patients the skills of competent self-monitoring of glycemia, and the use of glucometers integrated with smartphones at home. Modern features and advantages of the glucometer for self-control over the disease are discussed.
{"title":"Glucometry and self-control skills as necessary components in the management of a patient with prediabetes in the outpatient settings","authors":"V. Larina","doi":"10.15829/2713-0177-2023-18","DOIUrl":"https://doi.org/10.15829/2713-0177-2023-18","url":null,"abstract":"The article discusses the modern approaches to a glycemic control among outpatients with prediabetes. The risk factors for prediabetes, the possibilities of its screening, and the issues of treatment non-adherence are discussed. An attention is paid to the aspects of teaching patients the skills of competent self-monitoring of glycemia, and the use of glucometers integrated with smartphones at home. Modern features and advantages of the glucometer for self-control over the disease are discussed.","PeriodicalId":274852,"journal":{"name":"FOCUS. Endocrinology","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134287035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-10DOI: 10.15829/2713-0177-2023-7
E. Bibik, E. Dobreva, A. Eremkina, N. Mokrysheva
Primary hyperparathyroidism (PHPT) is characterized by disorders of not only mineral metabolism, but also other kinds of the human metabolism. Due to the increased frequency of cardiovascular risk factors among patients with PHPT, the study of the carbohydrate metabolism pathology in this cohort of patients will allow developing optimal approaches to their timely diagnosis and treatment.Aim. To determine the frequency and describe the clinical features of carbohydrate metabolism disorders in patients with PHPT.Material and methods. A single-center retrospective study of adults with PHPT was carried out with an assessment of the main parameters of mineral and carbohydrate metabolism before surgical treatment of the disease. The exclusion criteria were the absence of PHPT remission or a recurrence of the disease after parathyroidectomy; pregnancy, lactation. The frequency of various disorders of carbohydrate metabolism in PHPT, the comparative characteristics of mineral parameters in patients with and without them, as well as the severity of type 2 diabetes mellitus in PHPT were determined. In addition, potential relationships between the parameters of various types of metabolism have been studied.Results. The study was based on a clinical information of 367 patients with PHPT, most of whom had a symptomatic form of the disease. The overall incidence of prediabetic disorders was 4,9% (95% CI: 3-8). Type 2 diabetes mellitus was previously diagnosed in 45 patients (12%, 95% CI: 9-16), there were no cases of first diagnosed diabetes mellitus. Individuals with impaired carbohydrate metabolism had a statistically significantly higher body mass index and lower values of osteocalcin (27,2 [24,2; 30,4] kg/m2 vs 32,7 [28,1; 39,4 kg/m2 and 48,1 [34; 76,3] ng/mL vs 33,1 [20,8; 51,8] ng/mL, respectively, for all parameters p<0,001). Among patients with type 2 diabetes mellitus, 36 people (80%) took hypoglycemic therapy, 14 of which received metformin monotherapy and 8 received two-component therapy, including metformin. 5 people were on insulin therapy. Diabetic nephropathy was diagnosed in 36,4% of patients, 15,4% had signs of diabetic retinopathy, symptoms of diabetic distal neuropathy were observed in 61,9% of patients with PHPT. Fasting glucose and glycated hemoglobin were negatively correlated with bone metabolism, and also expectedly depended on the glomerular filtration rate.Conclusion. Among patients with PHPT, type 2 diabetes mellitus is more common than in the general population. The likely reason of this may be insulin resistance, that can be caused by the effects of bone metabolites, primarily osteocalcin. In most cases, metformin makes it possible to achieve compensation for diabetes mellitus in PHPT.
{"title":"Pathology of carbohydrate metabolism in primary hyperparathyroidism: epidemiological and clinical characteristics","authors":"E. Bibik, E. Dobreva, A. Eremkina, N. Mokrysheva","doi":"10.15829/2713-0177-2023-7","DOIUrl":"https://doi.org/10.15829/2713-0177-2023-7","url":null,"abstract":"Primary hyperparathyroidism (PHPT) is characterized by disorders of not only mineral metabolism, but also other kinds of the human metabolism. Due to the increased frequency of cardiovascular risk factors among patients with PHPT, the study of the carbohydrate metabolism pathology in this cohort of patients will allow developing optimal approaches to their timely diagnosis and treatment.Aim. To determine the frequency and describe the clinical features of carbohydrate metabolism disorders in patients with PHPT.Material and methods. A single-center retrospective study of adults with PHPT was carried out with an assessment of the main parameters of mineral and carbohydrate metabolism before surgical treatment of the disease. The exclusion criteria were the absence of PHPT remission or a recurrence of the disease after parathyroidectomy; pregnancy, lactation. The frequency of various disorders of carbohydrate metabolism in PHPT, the comparative characteristics of mineral parameters in patients with and without them, as well as the severity of type 2 diabetes mellitus in PHPT were determined. In addition, potential relationships between the parameters of various types of metabolism have been studied.Results. The study was based on a clinical information of 367 patients with PHPT, most of whom had a symptomatic form of the disease. The overall incidence of prediabetic disorders was 4,9% (95% CI: 3-8). Type 2 diabetes mellitus was previously diagnosed in 45 patients (12%, 95% CI: 9-16), there were no cases of first diagnosed diabetes mellitus. Individuals with impaired carbohydrate metabolism had a statistically significantly higher body mass index and lower values of osteocalcin (27,2 [24,2; 30,4] kg/m2 vs 32,7 [28,1; 39,4 kg/m2 and 48,1 [34; 76,3] ng/mL vs 33,1 [20,8; 51,8] ng/mL, respectively, for all parameters p<0,001). Among patients with type 2 diabetes mellitus, 36 people (80%) took hypoglycemic therapy, 14 of which received metformin monotherapy and 8 received two-component therapy, including metformin. 5 people were on insulin therapy. Diabetic nephropathy was diagnosed in 36,4% of patients, 15,4% had signs of diabetic retinopathy, symptoms of diabetic distal neuropathy were observed in 61,9% of patients with PHPT. Fasting glucose and glycated hemoglobin were negatively correlated with bone metabolism, and also expectedly depended on the glomerular filtration rate.Conclusion. Among patients with PHPT, type 2 diabetes mellitus is more common than in the general population. The likely reason of this may be insulin resistance, that can be caused by the effects of bone metabolites, primarily osteocalcin. In most cases, metformin makes it possible to achieve compensation for diabetes mellitus in PHPT.","PeriodicalId":274852,"journal":{"name":"FOCUS. Endocrinology","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131910255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-10DOI: 10.15829/1560-4071-2023-13
E. V. Kiseleva, E. Pigarova, N. Mokrysheva
Obesity is currently an important medical and social problem due to the multiple associated conditions that worsen the health of the population. Thus, there is a need for the development of accurate and non-invasive methods of body composition assessment for the purposes of diagnosing and monitoring the treatment of this disease. According to the estimates of the World Obesity Federation, by 2025 the prevalence of this disease will reach 21% in women, and 18% in men. This literature review is dedicated to the subject of various methods for assessing the degree of obesity, as well as determining the composition of the body in the context of historical achievements and a critical assessment of new technologies.
{"title":"The evolution of body composition assessment: from body mass index to body composition profiling","authors":"E. V. Kiseleva, E. Pigarova, N. Mokrysheva","doi":"10.15829/1560-4071-2023-13","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-13","url":null,"abstract":"Obesity is currently an important medical and social problem due to the multiple associated conditions that worsen the health of the population. Thus, there is a need for the development of accurate and non-invasive methods of body composition assessment for the purposes of diagnosing and monitoring the treatment of this disease. According to the estimates of the World Obesity Federation, by 2025 the prevalence of this disease will reach 21% in women, and 18% in men. This literature review is dedicated to the subject of various methods for assessing the degree of obesity, as well as determining the composition of the body in the context of historical achievements and a critical assessment of new technologies.","PeriodicalId":274852,"journal":{"name":"FOCUS. Endocrinology","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133453721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-10DOI: 10.15829/2713-0177-2023-27
E. V. Kovaleva, A. K. Eremkina, N. Mokrysheva
Hypoparathyroidism is a relatively rare endocrine disorder caused by the absence production of parathyroid hormone, leading to the classical biochemical features such as hypocalcaemia and hyperphosphataemia.The data from Europe, the USA and Asian countries shows that the long course of chronic postsurgical and non-surgical hypoparathyroidism can lead to many complications from different organs and systems. Hypoparathyroidism increases the risk of kidney disease, including kidney failure, neuropsychiatric disorders and infections. The frequency and degree of disease complications depend on its etiology. Non-surgical hypoparathyroidism is associated with an increased risks of cataracts, cardiovascular diseases and vertebral fractures; however, the pathogenesis of these disorders is not fully understood. Various parameters of mineral homeostasis were discussed in the context of identified complications. For example, persistent hypercalciuria and intake of large doses of calcium and vitamin D supplements were associated with the structural pathology of the kidneys (nephrolithiasis, nephrocalcinosis).This review covers the issue of the clinical manifestations and complications of chronic hypoparathyroidism, as well as predictors of their development.
{"title":"Chronic hypoparathyroidism: clinical manifestations, complications and impact on the quality of life","authors":"E. V. Kovaleva, A. K. Eremkina, N. Mokrysheva","doi":"10.15829/2713-0177-2023-27","DOIUrl":"https://doi.org/10.15829/2713-0177-2023-27","url":null,"abstract":"Hypoparathyroidism is a relatively rare endocrine disorder caused by the absence production of parathyroid hormone, leading to the classical biochemical features such as hypocalcaemia and hyperphosphataemia.The data from Europe, the USA and Asian countries shows that the long course of chronic postsurgical and non-surgical hypoparathyroidism can lead to many complications from different organs and systems. Hypoparathyroidism increases the risk of kidney disease, including kidney failure, neuropsychiatric disorders and infections. The frequency and degree of disease complications depend on its etiology. Non-surgical hypoparathyroidism is associated with an increased risks of cataracts, cardiovascular diseases and vertebral fractures; however, the pathogenesis of these disorders is not fully understood. Various parameters of mineral homeostasis were discussed in the context of identified complications. For example, persistent hypercalciuria and intake of large doses of calcium and vitamin D supplements were associated with the structural pathology of the kidneys (nephrolithiasis, nephrocalcinosis).This review covers the issue of the clinical manifestations and complications of chronic hypoparathyroidism, as well as predictors of their development.","PeriodicalId":274852,"journal":{"name":"FOCUS. Endocrinology","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127695276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-10DOI: 10.15829/1560-4071-2023-15
T. Demidova, A. Kochina
The management of diabetes in the elderly requires careful consideration of concomitant geriatric syndromes and chronic diseases that increase the risk of complications, including severe hypoglycemia. An individualized approach to the treatment of elderly patients includes the establishment of less strict goals of glycemic control, blood pressure control, taking into account impaired self-care abilities, cognitive abilities and loss of vision. The goals of diabetes treatment in the elderly are considered to maintain the quality of life and minimize symptomatic hyperglycemia, the risk of hypoglycemia and side effects of medications. In this regard, the concept of deprescribing in the treatment of elderly patients is gaining more and more popularity.
{"title":"Pecularities of treatment of elderly patients with type 2 diabetes mellitus","authors":"T. Demidova, A. Kochina","doi":"10.15829/1560-4071-2023-15","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-15","url":null,"abstract":"The management of diabetes in the elderly requires careful consideration of concomitant geriatric syndromes and chronic diseases that increase the risk of complications, including severe hypoglycemia. An individualized approach to the treatment of elderly patients includes the establishment of less strict goals of glycemic control, blood pressure control, taking into account impaired self-care abilities, cognitive abilities and loss of vision. The goals of diabetes treatment in the elderly are considered to maintain the quality of life and minimize symptomatic hyperglycemia, the risk of hypoglycemia and side effects of medications. In this regard, the concept of deprescribing in the treatment of elderly patients is gaining more and more popularity.","PeriodicalId":274852,"journal":{"name":"FOCUS. Endocrinology","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125279881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-10DOI: 10.15829/2713-0177-2023-11
M. V. Yaroslavtseva, Y. A. El-Taravi, O. Bondarenko, A. Povaliaeva, E. Pigarova
Patients with multiple complications of diabetes mellitus often have significant deviations in the parameters of calcium-phosphorus and bone metabolism. The multifactorial nature of the pathogenesis of such disorders makes it difficult to manage patients with a long and complicated course of diabetes mellitus. This article describes a clinical case of a patient with a long history of type 1 diabetes mellitus, kidney transplantation as a result of terminal renal failure, and diabetic neuroosteoarthropathy. The features of vitamin D metabolism, the importance of timely diagnosis of phosphorus-calcium disorders and the features of patient therapy are discussed.
{"title":"Vitamin D metabolism in patient with type 1 diabetes, chronic kidney disease, and charcot foot: a case report","authors":"M. V. Yaroslavtseva, Y. A. El-Taravi, O. Bondarenko, A. Povaliaeva, E. Pigarova","doi":"10.15829/2713-0177-2023-11","DOIUrl":"https://doi.org/10.15829/2713-0177-2023-11","url":null,"abstract":"Patients with multiple complications of diabetes mellitus often have significant deviations in the parameters of calcium-phosphorus and bone metabolism. The multifactorial nature of the pathogenesis of such disorders makes it difficult to manage patients with a long and complicated course of diabetes mellitus. This article describes a clinical case of a patient with a long history of type 1 diabetes mellitus, kidney transplantation as a result of terminal renal failure, and diabetic neuroosteoarthropathy. The features of vitamin D metabolism, the importance of timely diagnosis of phosphorus-calcium disorders and the features of patient therapy are discussed.","PeriodicalId":274852,"journal":{"name":"FOCUS. Endocrinology","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116572051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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