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Introduction: Antioxidants may have positive impact on diabetic polyneuropathy (DPN), presumably due to alleviation of oxidative stress. We aimed to evaluate the efficacy and safety of combination of antioxidants: succinic acid, inosine, nicotinamide, and riboflavin (SINR) in the treatment of DPN., Research Design and Methods: In a double-blind, placebo-controlled clinical trial, men and women aged 45-74 years with type 2 diabetes and symptomatic DPN, with initial Total Symptom Score (TSS) ˃5, were randomized into experimental (n=109) or placebo (n=107) group. Patients received study medication/placebo intravenously for 10 days, followed by oral administration for 75 days. Statistical significance was defined as a two-tailed p<0.05., Results: In SINR group, mean TSS change after 12 weeks was -2.65 (±1.46) vs -1.73 (±1.51) in the placebo group (p<0.0001; t-test). Reduction of symptoms in the SINR group was achieved regardless of hemoglobin A1c levels, but better results were observed in patients with initial TSS <7.5. The analysis of TSS subscores revealed statistically significant between-group differences by dynamics of the intensity of paresthesia and of numbness starting from day 11 (p=0.035 and p=0.001, respectively; mixed model); by day 57, statistically significant between-group differences were detected also by dynamics of burning intensity (p=0.005; mixed model). Study limitations are small effect size, moderate proportion of patients with severe DPN symptoms, subjective assessment of outcomes, exclusion of participants who received injectable glucose-lowering medications other than insulins, and patients with uncontrolled and type 1 diabetes., Conclusions: The combination of SINR effectively alleviates DPN symptoms in patients with type 2 diabetes., Trial Registration Number: ClinicalTrials.gov Registry (NCT04649203; Unique Protocol ID: CTF-III-DM-2019)., Competing Interests: Competing interests: TK was an employee of POLYSAN Scientific & Technological Pharmaceutical Company when this research was conducted. IAS was a scientific advisor for this study and was compensated by POLYSAN Scientific & Technological Pharmaceutical Company for his work on this research. YGS, AFV, NSO, and VPP were compensated by POLYSAN Scientific & Technological Pharmaceutical Company for their work on this research., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Diabetes mellitus represents a significant medico - social problem for health care around the world. The main reason for an invalidism and a mortality of patients with diabetes mellitus are the lesions of heart and vessels united in the concept "diabetic macroangiopathty". This complication is often taped already at the time of diagnosis of a diabetes mellitus and demands active treatment.

Aim: To assess the efficacy and safety of ipragliflozin as add-on therapy to metformin in Russian patients with type 2 diabetes mellitus., Methods: In this double-blind study conducted in 14 centers in Russia, 165 patients were randomized 2:1 to ipragliflozin (50 mg/day) or placebo for 24 weeks while continuing metformin. Patients who had HbA1c ≥ 7.0% (53 mmol/mol) at Week 12 received open-label ipragliflozin (50 mg/day) in addition to the blinded drug from Week 12-24., Results: Significant reductions in HbA1c and body weight from baseline to Week 12 in favor of ipragliflozin were observed (adjusted mean difference to placebo: -0.3% (-3 mmol/mol), P = 0.048 and -1.34 kg, P < 0.001, respectively). The incidence of AEs was similar in both groups. Uptitration to 100 mg/day ipragliflozin led to a further reduction in body weight (mean change from Week 12: -0.65 kg, P = 0.004) and an additional 13% (9/69) of patients achieving HbA1c < 7.0% (53 mmol/mol) at Week 24. Incidence of AEs was similar among patients receiving ipragliflozin 50 mg/day (23.7%) and 100 mg/day (24.6%)., Conclusion: Ipragliflozin 50 mg/day added to metformin significantly reduced HbA1c and body weight after 12 weeks and showed a safety profile comparable to placebo. Uptitration to 100 mg/day improved clinical outcomes with no additional safety concerns., (Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.)

Diabetes mellitus (DM) type 2 is the serious progressing chronic disease representing independent risk factor of development of cardiovascular complications. The mortality from cardiovascular diseases at the persons suffering from DM type 2 continues to grow around the world, despite constant augmentation of expenses on treatment and prophylaxis. In this article factors of cardiovascular risk at DM are analyzed and possible ways of their correction are surveyed.

Obesity is a serious medico-social and economic problem. Increased body mass index is associated with a rise in the general mortality rate and mortality due to cardiovascular diseases. In this article, modern views of the influence of obesity on the cardiovascular system are considered.

Subclinical hypothyroidism is a rather common disorder of the thyroid gland. Despite the fact that subclinical hypothyroidism has no clear-cut clinical picture, this condition is associated with changes in various organs and systems, moreover, it is a risk factor of cardiovascular diseases. The article summarizes the available data on subclinical hypothyroidism, principles of its diagnostics and treatment.

Osteoprotegerin (OPG) is a glycoprotein that is a representative of the tumor necrosis factor-α receptor superfamily. Information about the possible role of OPG in the development of cardiovascular diseases has begun to appear in the literature in recent years. This review discusses the role of increasing the level of OPG in the development and progression of atherosclerosis and as a consequence of coronary heart disease and chronic heart failure.

As of now, osteoporosis (OP) is one of the most important sociomedical problems because of its high prevalence and resultant disability, as well as significant mortality attributable to complications. The current strategy for providing care for patients of OP is its early diagnosis, by determining the high risk of fractures, and early pathogenetic treatment. The article gives an update on the epidemiology, risk factors, diagnosis, and treatment of OP.

The article presents data on the relationship between thyroid dysfunction and cardiovascular diseases. The role of dyslipidemia, adipokines (adiponectin, leptin, resistin), C-reactive protein, deficiency of vitamin D3 in the development of cardiovascular disease in hypothyroidism is discussed. The article describes characteristics of myocardial remodeling, its dysfunction and their correlation with risk factors of cardiovascular diseases in patients with hypothyroidism.

Aim: To investigate the relationship between resistin, adiponectin, leptin, and hormonal and metabolic parameters in patients with type 2 diabetes mellitus (T2DM) and in those with its concurrence with asthma., Material and Methods: Twenty-seven patients with T2DM and 26 patients with T2DM concurrent with asthma were examined. The examination data of 23 apparently healthy women served as a control. Anthropometric measurements, carbohydrate and lipid metabolic parameters, and leptin, resistin, adiponectin, interleukin (IL)-6 and IL-10 levels were studied., Results: Hyperleptinemia, hyperresistinemia, and lower adiponectin concentrations were found in the patients with T2DM and in those with its concurrence with asthma. These changes in the patients from these groups occurred in the presence of subclinical inflammation. Obvious insulin resistance (IR) accompanied by compensatory hyperinsulinemia was identified in the examined women. The detected atherogenic dyslipidemia appeared as increases in the levels of total cholesterol (C), triglycerides, low-density lipoprotein C, and atherogenic index and as a decrease in those of high-density lipoprotein C. The women with the concurrence of the diseases showed a positive correlation of the level of resistin with insulin and the HOMA index., Conclusion: The patients with T2DM and those with its concurrence with asthma exhibited obvious IR accompanied by compensatory hyperinsulinemia. Hyperresistinemia plays a role in the development of IR in the concurrence of these diseases. The patients with T2DM and those with its concurrence with asthma were found to have hyperleptinemia, hyperresistinemia, and a trend for decreasing adiponectin values in the presence of subclinical inflammation.

We measured the levels of osteoprotegerin, resistin, leptin, and adiponectin in patients with hypothyroidism differing in the thyroid status. The levels of osteoprotegerin, resistin, leptin were higher and those of adiponectin lower than normal. The patients suffered atherogenic dyslipidemia associated with enhanced insulin resistance and compensatory hyperinsulinemia. Leptin and adiponectin levels correlated with characteristics of lipid metabolism. It is concluded that leptin and adiponectin play a role in the development of dyslipidemia in hypothyroidism.

In patients with coronary heart disease (CHD) and periodically recorded impaired fasting glycemia, the Incidence of impaired glucose tolerance and type 2 diabetes mellitus was 61.6 and 17.8%, respectively. CHD patients with a history of carbohydrate metabolic disturbance were observed to have hyperinsulinemia on fasting and 2 hours after glucose load. In these patients, ambiguous changes were found in C-peptide 2 hours following glucose load. Changes were ascertained in the lipid spectrum.