Thanks to the approaches of precision medicine, great strides have been made in the diagnosis and treatment of diabetes mellitus, taking into account the individual characteristics of each patient or subgroups for monogenic subtypes of diabetes and newborn diabetes. For monogenic diabetes, molecular genetics can identify discrete etiological subtypes, the manifestation of which has profound implications for treatment, and predict the further development of concomitant clinical signs that allow early prophylaxis or supportive therapy. In contrast, second-type diabetes mellitus has a polygenic nature, which makes it difficult to define discrete clinical subtypes. The implementation of the approaches of precision medicine in the diagnosis and treatment of diabetes mellitus will allow a targeted selection of drug therapy. This review shows the successful use of precision medicine in monogenic diabetes and the possibilities of this approach to solving problems in diabetes of the second type.

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A scientific and practical symposium Essential phospholipids in the treatment of diabetes mellitus and dyslipidemia organized by RON-PULENK RORER (Cologne, Germany) was held at the State Central Scientific Medical Library of the Ministry of Health of Russia. The basic concept of the development of dyslipidemia (DLP) and the working classification of this metabolic state were presented in a report by Yu. A. Knyazev (Moscow). In the message K. Gundermann et al. (Cologne, Germany) the mechanism of action of essential phospholipids (EPL) at the molecular level, the level of insulin receptor and postreceptor interactions in cytomembranes, as well as in lipolytic and cholinesterizing enzyme systems was described. The feasibility of using EPL preparations for the prevention of diabetic angiopathies (AP) by transplanting pancreatic incretory cell cultures, with conservative and surgical treatment of AP with the aim of stabilizing or even reversing the development of atherosclerotic vascular lesions, was substantiated in a report by A. A. Chirkin et al. (Vitebsk, Belarus). The results of the study of intravascular microcirculation in patients with diabetes with clinical signs of AP made it possible to evaluate lipostabil (a drug containing EPL and prescribed together with hypoglycemic agents) as an effective tool in the plasma-cell type of microcirculatory disorders in patients with diabetes aged 19 to 68 years (I. M Kakhnovsky et al., Moscow). Under the influence of lipostabil forte, an increase in insulin sensitivity is possible (L. L. Vakhrusheva et al., Moscow), which underlies a decrease in the need for exogenous insulin and a tendency to normalize indicators of carbohydrate and fat metabolism, the level of counterinsulin hormones. 6 months after the start of lipostabil forte administration, an inhibition of AP progression was noted against the background of an adequate dose of insulin.