BACKGROUND. The clinical and epidemiological characteristics of diabetes mellitus (DM) and the quality of its therapy are the key prognostic dominant that determines the organizational aspects of the diabetic service. The continuous dynamic   monitoring of DM has been carried out in the Russian Federation (RF) since 1996 through the activities of the Federal Register of Diabetes Mellitus (FDR).AIMS. The aim of our study was to analyze the epidemiological characteristics of DM in the RF (prevalence, morbidity, mortality), the prevalence diabetic of complications, the state of carbohydrate metabolism (level of HbA1c) and the dynamics of the structure of glucose-lowering therapy (GLT) according to the FDR.MATERIALS AND METHODS. The database of FRD (https://www.diaregistry.ru/), 85 regions of the RF. The data are presented as of 01.01.2023 and in dynamics for the period 2010–2022.RESULTS. The total number of DM patients in the RF as of 01.01.2023 was 4 962 762 (3.31% of the population), including: Type 1 (T1) — 5.58% (277.1 ths), T2 — 92.33% (4.58 million), other DM types —2.08% (103 ths). The dynamics of prevalence over the 13-year period (2010→2022) was 146.0→191.0/100 ths people with T1, and 2036.2→3158.8/100 ths people with T2; morbidity in T1 12.3→8.2/100 ths population, in T2 260.1→191.4/100 ths population; мortality: T1 2.1→2.4/100 ths population, T2 41.2→86.1/100 ths of the population. The main cause of death was cardiovascular: in T1 38.6% cases, in T2 — 50.9%. Life expectancy (average age of death of patients): T1 was 52.7 years, the dynamics in males 50.9 → 50.7 years, females 62.1→56.0 years; in T2 — 74.2 years, males 69.5→70.4 years, females 74.2→76.1 years. The dynamic of DM duration from onset to the death: in T1 15.4→19.9 years; in T2 11→11.4 10.2→11.8 years. The proportion of patients with laboratory-measured HbA1c <7% in the dynamics of 2010–2022: with DM1 24.4%→29%, with DM2 41.5%→42.2%, with HbA1c ≥9.0%: with DM1 29, 4% → 20.4%, with DM2 13.8 → 9.0%.The incidence of diabetic complications as of 01.01.2023 in T1 and T2 patients: neuropathy 41.3% and 23.7%, nephropathy (CKD) 22.8% and 19.1%, retinopathy 28.9% and 12.3%, respectively. The structure GLT in T2 patients as of 01.01.2023: monotherapy — 41.6%; combination of 2 GLM — 30.0%, 3 GLM — 5.8%, insulin therapy in 18.3%.CONCLUSIONS. The information-analytical system FDR is a key tool for systematizing the most important epidemiological and clinical characteristics of DM based on data from real clinical practice, which allows optimizing the algorithm of patient management and improving the quality of care for diabetes.

BACKGROUND: The increasing prevalence of gestational diabetes mellitus (GDM), the high probability of unfavorable pregnancy outcomes for the mother and the fetus, as well as a number of long-term consequences in GDM are a serious medical and social problem and require the need for its prevention by correcting risk factors, timely diagnosis and effective treatment.AIM: Analysis of risk factors for the development of gestational diabetes mellitus (GDM), the relationship between GDM, the course and outcomes of pregnancy.MATERIALS AND METHODS: Retrospective analysis of 79 case histories of patients with confirmed GDM in the period from 2015 to 2017.RESULTS: In the structure of risk factors for mother and fetus, age over 30 years (73.1%), burdened heredity for type 2 diabetes mellitus (T2DM) (30.8%), mother’s pre-pregnancy body mass index (BMI) (overweight / obesity (26.9%)) had the greatest impact. Among the complications of pregnancy, the most common was the caesarean section (47.4%). The incidence of other complications (macrosomia (9%), premature birth (7.7%), congenital malformations of the fetus (5.1%), preeclampsia (5.1%) was lower than the average frequency of these complications in GDM, described in the literature. Nevertheless, it is 1.5–2 times higher than the average population indicators. In the course of statistical analysis of the data it was revealed, that the higher the mother’s pre-pregnancy BMI, the lower the Apgar score for the first minute in the newborn.CONCLUSION: Women with GDM require intensive monitoring of the course of pregnancy and timely hospitalization for planned delivery, and the provision of competent obstetric benefits.

The concept of women’s long-term health and longevity implies maintaining the quality of life, including a discussion of the role of hormone replacement therapy within the ‘therapeutic window’. Aging is a complex multi-step process. It is believed that women begin to experience the effects of aging at the age of 40. The processes of age-related changes in the body are being actively studied these days and include markers, models, systems, but there is no unified concept yet. In recent decades, there has been an increase in life expectancy for women, hence there are more women in menopause, and an increase in the incidence of age-related diseases can be expected. With the onset of menopause and age-related changes, women may experience metabolic disorders, cardiovascular diseases, endothelial dysfunction, disorders of both the central and peripheral nervous systems, musculoskeletal disrders and mental health problems. Over past decades, attention has been paid to cellular markers of aging, and the telomere theory has been most developed. It is associated with shortening of telomeres – the end regions of chromosomes. Many studies in recent years have examined the mechanisms influencing the length of these regions, the activity of the telomerase enzyme, and the processes of reproductive aging associated with this theory. In the 20th and 21st centuries, the possible effect of exogenously administered estrogen on telomere length as part of hormone replacement therapy has been under active consideration. Key words: insulin resistance, menopause, telomeres, telomerase, type 2 diabetes, aging, hormone replacement therapy

Multiple endocrine neoplasia type 1 syndrome (MEN1) is a rare inherited disorder that can include combinations of more than 20 endocrine and non-endocrine tumors. Unfortunately, none of the described MEN1 mutations has been associated with a peculiar clinical phenotype, even within members of the same family, thus a genotype-to-phenotype correlation does not exist. MEN1 syndrome is the most common cause of hereditary primary hyperparathyroidism (PHPT), the disease penetrance of which exceeds 50% by the age of 20 and reaches 95% by the age of 40. At the same time, PHPT with hyperplasia or adenomas of the parathyroid glands (PTG) is the most distinctive manifestation of the MEN1 syndrome. One of the main symptoms of PHPT, both in sporadic and hereditary forms of the disease, is bone damage. At the time of diagnosis in PHPT/MEN1, the bone mineral density is generally lower in comparison with the sporadic form of PHPT. This may be due to excessive secretion of parathyroid hormone during the period of peak bone mass, concomitant components of the syndrome, extended surgical treatment, and the direct effect of a mutation in the menin gene on bone remodeling. This clinical case describes a young patient with severe bone complications of PHPT and uncertain rare MEN1 mutation. PHPT was diagnosed five years later from the first onset of bone complications and repeated orthopedic operations. There was the «hungry bones» syndrome after successful surgery of PHPT, which was managed with vitamin D and calcium carbonate supplementation and there is a positive dynamic in increased bone mineral density in the main skeleton after 6 months.