No abstract

Background: the problem of diseases of the thyroid gland (TG) remains relevant. The clinical picture and prevalence of diseases, as a rule, is analysed depending on the nosological form and severity of endocrinopathy. However, the estimated cases of morbidity syndrome on the basis of modern systemic diseases, the alleged reasonable appointment of endocrinopathies with places — the outcome of the syndromic/functional situation of thyroid disease, are divided into suspected either hypo- or hyperthyroidism.Objective: analysis of publications on the birth of diseases in hypo- and hyperthyroidism with the earliest possible search depth (publications since 1835), aimed at identifying current problems and relevant characteristics.Material and method: according to the key features “hypothyroidism”, “hyperthyroidism”, “mental disorders”, “depression”, “anxiety”, “psychosis”, literary sources in the MEDLINE/PubMed Scopus, Google Scientist databases were significant and studied.Conclusion: as a result of the analysis of the literature, it was revealed that the number of studies of the prevalence of diseases among the population in thyroid diseases compared to other somatic diseases is small, and many questions about the relationship between mantal diseases and diseases of thyroid glands that are currently unresolved. The thyroid gland is limited to affective and anxiety symptoms/syndromes, and genetic belonging to certain categories (nosogenic, somatogenic, endoform) is not qualified. At the same time, a number of significant aspects of the problem are discussed: “common symptoms” of mental affiliation and thyroidopathy, duplicating/ imitating each other; psychopathological prodromes and “masks” of thyroid diseases; stress induction, such as in Graves’ disease; psychopathological disorders, such as non-psychotic and psychotic registries, with analysis of the characteristics of limb features for the use of the thyroid gland.

Introduction. In type 2 diabetes mellitus, an inevitable decrease in the secretion of  β-cells of the pancreas occurs, which requires the  initiation of  insulin therapy. Currently, there have been no studies evaluating the  features of  insulin therapy in patients with diabetes type 2 and morbid obesity.Objective. To compare the effectiveness of different insulin therapy regimens in patients with type 2 diabetes mellitus and morbid obesity. Materials and methods. 140  patients with diabetes type  2 and morbid obesity were included in  a 24-week prospective, non-blinded, randomized clinical study. The patients were divided into 4  groups: 1  – received basic-bolus insulin therapy in combination with metformin (n = 40); 2 – used prandial insulin in combination with metformin (n = 40); 3 – basal insulin in combination with empagliflozin and metformin (n = 30); 4 – received prandial insulin in combination with empagliflozin and metformin (n = 30). Initially, after 12 and 24 weeks, the level of HbA1c, fasting plasma glucose and during the day, body weight, daily insulin doses, frequency of hypoglycemia, and albumin in daily urine were assessed.Results. After 24 weeks of treatment, there was no statistically significant difference in the achieved HbA1c level between the groups (p = 0.65); in groups 3 and 4, there was a statistically significant decrease in body weight, daily doses of insulin and frequency of hypoglycemia compared to the first and second treatment groups (p = 0.029, p < 0.001 and p < 0,001, respectively); also registered a decrease in albumin in daily urine by 27% during the study period compared with the first and second treatment groups (p = 0.044).Conclusions. Administration of iSGLT-2 in combination with both basal and prandial insulin in patients with diabetes type 2 and morbid obesity has advantages over the basic-bolus regimen and the regimen of multiple prandial injections, despite the comparable efficacy.

The article provides a review of the current literature about time-restricted eating (TRE) as a new tool for the treatment of obesity and comorbid conditions. The search for new nutritional strategies in obesity, one of which is TRE, is due to the weak adherence of patients to hypocaloric diets in the long term, as well as the available data on the importance of ­desynchronization of food intake with natural circadian rhythms in the development and progression of obesity and cardio-­metabolic complications. The article describes the main mechanisms that regulate the circadian rhythms of food intake and nutrient absorption, substantiates the importance of adhering to a physiological diet for maintaining metabolic health. The main part of the review is devoted to reviewing the currently available researches on the effectiveness of various strategies of intermittent energy restriction for weight loss and the correction of metabolic parameters. Potential mechanisms of  the ­effect of TRE on health are discussed, including those mediated by an unintentional decrease in caloric intake and changes in eating behavior, and differences in the effectiveness of early and late TRE. The article contains a detailed discussion of the potential problems and contradictions associated with the use of time-restricted eating in clinical practice, namely: the limitations and inconsistencies of the available clinical trials, the lack of data on long-term efficacy and safety, social and psychological limitations that impede the widespread use of TRE.