2. ДИАГНОСТИКА ЗАБОЛЕВАНИЯ ИЛИ СОСТОЯНИЯ (ГРУППЫ ЗАБОЛЕВАНИЙ ИЛИ СОСТОЯНИЙ), МЕДИЦИНСКИЕ ПОКАЗАНИЯ И ПРОТИВОПОКАЗАНИЯ К ПРИМЕНЕНИЮ МЕТОДОВ ДИАГНОСТИКИ 2.1 ЖАЛОБЫ И АНАМНЕЗ 2.2 ФИЗИКАЛЬНОЕ ОБСЛЕДОВАНИЕ 2.3 ЛАБОРАТОРНЫЕ ДИАГНОСТИЧЕСКИЕ ИССЛЕДОВАНИЯ 2.4 ИНСТРУМЕНТАЛЬНЫЕ ДИАГНОСТИЧЕСКИЕ ИССЛЕДОВАНИЯ 2.5 ИНЫЕ ДИАГНОСТИЧЕСКИЕ ИССЛЕДОВАНИЯ 3. ЛЕЧЕНИЕ, ВКЛЮЧАЯ МЕДИКАМЕНТОЗНУЮ И НЕМЕДИКАМЕНТОЗНУЮ ТЕРАПИИ, ДИЕТОТЕРАПИЮ, ОБЕЗБОЛИВАНИЕ, МЕДИЦИНСКИЕ ПОКАЗАНИЯ И ПРОТИВОПОКАЗАНИЯ К ПРИМЕНЕНИЮ МЕТОДОВ ЛЕЧЕНИЯ 3.1 ТЕРАПЕВТИЧЕСКИЕ ЦЕЛИ 3.1.1 Показатели контроля углеводного обмена (индивидуальные цели лечения) 3.1.2 Целевые уровни показателей липидного обмена 3.1.3 Целевые уровни показателей артериального давления 3.2 КОНТРОЛЬ УРОВНЯ ГЛЮКОЗЫ 3.3 НЕМЕДИКАМЕНТОЗНЫЕ МЕТОДЫ ЛЕЧЕНИЯ 3.3.1 Рекомендации по питанию 3.3.2 Рекомендации по физической активности 3.4 МЕДИКАМЕНТОЗНАЯ ТЕРАПИЯ 3.4.1 Общие принципы медикаментозной терапии 3.4.2 Инсулинотерапия 3.5 ХИРУРГИЧЕСКОЕ ЛЕЧЕНИЕ

More than 100 genes associated with the risk of type 2 diabetes mellitus (T2DM) are now established. Most of them affect insulin secretion, adipogenesis and insulin resistance, but the exact molecular mechanisms determining their involvement in the pathogenesis of T2DM are not understood completely.

Aim.  To investigate the association of polymorphisms in TCF7L2 and PPARG2 genes with type 2 diabetes mellitus (T2DM) in Novosibirsk population. Materials and Methods. We examined 391 patients with T2DM and 556 individuals with normal glucose metabolism. Allelic identification was performed with TaqMan technique, implementing allele-specific real-time PCR. Results.  Analysis shows that allelic frequency distribution of rs1801282 variant of PPARG2 gene and rs7903146 variant of TCF7L2 differs significantly between the study and control groups (OR [CI 95%]=1.44 [1.12?1.85], p=0.005 and OR [CI 95%]=1.57 [1.17?2.10], p=0.003, respectively). T2DM patients with T/T genotype of rs7903146 variant of TCF7L2 gene had lower BMI (p=0.02). Observed combination of risk alleles reached 99%. Combined beta-cell dysfunction and insulin resistance genotypes were identified in 56% of tested subjects, isolated insulin resistance ? in 42.2% of subjects, and isolated beta-cell dysfunction ? in 0.8% of subjects. Conclusion.  Our data shows that carrier state of 12Pro rs1801284 variant of PPARG2 gene and T-allele rs7903146 variant of TCF7L2 gene are associated with T2DM in Novosibirsk population, increasing its risk 1.44 and 1.57 times, respectively. Combination of these polymorphisms was observed in 99% of patients with T2DM.

Aim. To determine the diagnostic value of urinary excretion of type IV collagen in patients with type 1 diabetes with different stages of nephropathy.Methods. Urinary type IV collagen was determined in 60 patients with type 1 diabetes (23 with normal albuminuria, 28 with microalbuminuriaand 9 with macroalbuminuria) by an enzyme immunoassay. 10 healthy individuals were acted as the control group. Renal biopsy was performedin 22 patients. Deposits of type IV collagen were revealed by 11 individuals by immunohistochemistry. Results. The urinary excretion of type IV collagen increased with severety of diabetic nephropathy, correlating with the urinary albumin/creatinineratio, serum creatinine and parameters of daytime and nighttime systolic and diastolic blood pressure. Patients with excessive accumulation of typeIV collagen in the glomeruli had significantly higher level of type IV collagen in the urine. Conclusion. The determination of urinary type IV collagen can be used for early detection of renal fibrosis in patients with type 1 diabetes.

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