На сьогодні все більше значення надається дослідженню проблеми екзокринної панкреатичної недостатності, що спостерігається в значної кількості хворих на цукровий діабет (ЦД) 1-го і 2-го типу і може потенційно впливати на компенсацію ЦД. Механізм зниження зовнішньої секреції підшлункової залози при ЦД пов’язаний із дисбалансом інгібуючих і стимулю­ючих панкреатичну секрецію гормонів, із фіброзом залози в результаті діабетичної ангіопатії. При ЦД 2-го типу в патогенезі зовнішньосекреторної панкреатичної недостатності беруть участь механізми, що є наслідком метаболічного синдрому. Замісну ферментну терапію слід розглядати як один із перспективних методів лікування хворих на ЦД.

Dear Sir, Ion-exchange chromatrography is commonly used for determining haemoglobin A1 (HbA0 [1][2][3]. Micro-scale assays are attractive [3], but present practical difficulties such as adjustment of the phosphate buffer to the correct pH. This step can be avoided by precise weighing of the phosphates on an analytical balance. We weigh out 3.2746 g of Na2HPO4 precisely, while keeping the rest of the buffer components as originally described [3]. In our experience this modification leads to a stable and reproducible pH of bufferA; pH 6.740 with red• water and pH 6.725-6.735 with monodistilled water. Routinely we use monodistilled water and equilibrate the resins to the pH value of buffer A, i. e. to 6.730. The ionic strength of the buffer prepared in this way is always 0.11, i.e. in the best range for the ion-exchange technique we use. We have used not only Bio-Rex 70 (200-400 mesh; BioRad Laboratories, Richmond, California, USA) but have also compared it with Amberlite CG 50 (100-200 mesh; Fluka, Buchs, Switzerland) and found that using the latter shortens the chromatographic procedure from 2 h to 40 rain. We found that performing the chromatography at a constant temperature of 22 ~ in a water bath increased the reproducibility of the results. Amberlite CG 50 columns showed an intra-assay coefficient of variation of 1.8% and an interassay coefficient of variation of 3.9%, compared with 3% and 4% respectively as shown by Welch and Boucher [3].We chromatographed 15 haemolysates simultaneously on Amberlite CG 50, on Bio-Rex 70 columns and with electro-focussing on an LKB: 1804-103 PAG Plate (pH 5.5-8.5) (LKB, Bromma, Sweden).Mean results for HbAI with Amberlite CG 50 were 13.35% and with Bio-Rex 70 13.48% (p > 0.10, r = 0.9966). The mean HbAlc with isoelectric focussing was 10.46% and the correlation coefficient between HbAlo determined by isoelectric focussing and HbA1 by chromatography were 0.8857 for Amberlite CG 50 and 0.8664 for BioRex 70.Our method has the convenience of repeated re-use of the same resin. After each assay, the resins are regenerated. They are washed once with an excess of 0.5 N NaOH to a pH > 10 and rinsed several times with distilled water to a pH of approximately 9. This is followed by washing in 0.5 N HC1 to a pH of approximately 1 and then in distilled water to approximately pH 4. The resin is then washed twice with buffer A (five volumes). To reach the pH of buffer A (6.730), it is necessary to adjust the titrate of the buffer six times with 0.5 N NaOH to a pH of approximately 6.740-6.750. (The first washing with buffer A results in a pH of the resin below 6.700, after the second and third washes the pH reaches 6.710, and after the last wash it is approximately 6.730.) The resin has then to be washed three to four times with buffer A to allow the eluates to reach the ionic strength of buffer A. The equilibration of the resin is controlled with a pHM64-meter (Radiometer, Copenhagen, Denmark). The resin is then ready for use.Thirty healthy subjects examined with our method (mean age 36 yea...

This review article presents the results of research in recent years on the evaluation of the motor-evacuation function of the stomach in patients with diabetes mellitus. The data on the pathogenesis, clinic, differential diagnosis and the principles and current trends in the treatment of diabetic gastroparesis. Diabetic gastroparesis is a component of autonomic neuropathy, resulting from prolonged, poorly controlled type 1 and type 2 diabetes. Gastroparesis manifested by a significant decrease in the quality of life of patients with diabetes mellitus. Diagnostic examination of DG first eliminates obstruction and other causes, including drugs that can mimic the delay / violation of gastric emptying. A balanced diet, a healthy lifestyle, symptomatic treatment and glycemic control are the main components of the treatment of DG.

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