Надано огляд літератури з питань терапії цукрового діабету 1-го і 2-го типу на основі інкретинового ефекту, про механізми дії, переваги й обмеження нового класу протидіабетичних препаратів — агоністів рецепторів глюкагоноподібного пептиду‑1 (ГПП‑1), про їх клінічне застосування в комбінації з інсуліном, що дозволяє нівелювати негативні ефекти останнього. Наводяться описи успішного клінічного застосування ліраглутиду в пацієнтів, що страждають на цукровий діабет 2-го типу, у випадках неефективно контрольованої глікемії натще, за відсутності компенсації глікемії високими дозами інсуліну й метформіну, а також при кардіоренальному синдромі.

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Obtaining a tattoo has become very popular and the number of persons having tattoos has increased, nowadays in Germany more than 25 % of young people have a tattoo with increasing tendency. In persisting ¹old" tattoos, as well as in dyes used cur− rentlly, we found metals (aluminium, copper, chromium, titani− um) and aromatic compounds, covalent nitrits and nitrats were detected, which can lead to negative skin reactions and may cau− se problems during elimination of the tattoo using laser therapy. Elementanalysis was done using enerydispersive X−ray−microa− nalysis (scanning electronmicroscopy), powder diffraction and infrared spectroscopy. Histologically we found a perivascular localisation of the dyes and a persiting prominent inflammatory response to the dyes which depends on the dye used. Activation of macrophages was most intensive to yellow tattoo pigments, probably caused by aluminium. Due to missing regulations same colours may con− tain different components. Unspecific inflammatory responses may be expected even after years and components found may cause problems during removal of tattoos using lasers. Originalarbeit 514Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimmung des Verlages.

Recent studies have demonstrated the importance of bone as an endocrine organ that produces biologically active substances, which regulate both local bone metabolism and metabolic functions throughout the body. In the process of bone remodeling (formation/destruction), the active cells secrete specific biomarkers that help detect osteometabolic dysfunction. Among bone hormones, osteocalcin plays an important role as a coordinator of bone modeling processes, energy homeostasis, metabolism of glucose, lipids and minerals. Osteocalcin is a structural protein of the bone matrix, which is synthesized by osteoblasts and enters the bloodstream in the process of bone resorption. The level of osteocalcin in the serum is used as a specific marker of bone formation. Osteocalcin promotes pancreatic β-cell proliferation and insulin secretion, and also affects the insulin sensitivity of peripheral tissues. The inverse association of glycemia with the level of osteocalcin was revealed. Patients with type 2 diabetes mellitus usually have normal or even slightly elevated bone mineral density compared to age-appropriate controls. Decreased bone quality and increased risk of fractures are associated with changes in bone microarchitecture and local humoral environment. An imbalance in osteoblast/osteoclast activity may be due to oxidative stress and the accumulation of glycosylation end products, which contributes to chronic inflammation and bone resorbtion in patients with diabetes. It is shown that the level of osteocalcin in the blood serum is significantly reduced compared to healthy controls, both in patients with type 1 diabetes mellitus and, especially, in type 2 diabetes mellitus. Given the importance of developing new approaches to the diagnosis and correction of metabolic disorders in diabetic patients, the study of the influence of bone hormones on hormonal and metabolic parameters and bone status, including the risk of fractures, remains relevant in modern diabetology.