Aim. This study aims to analyse the rhythm and levels of incretins and neuropeptides secretion in patients with Cushing disease (CD) and acromegaly, and thus specify the pathogenesis of carbohydrate metabolism disturbances.

Matherials and methods. In this study, 42 patients (mean age, 37.5 years) with CD and acromegaly were enrolled. All patients were newly diagnosed with CD and acromegaly, and none had a history of previous drug therapy, radiotherapy or pituitary surgery. All patients underwent OGTT, during which glucose, glucagon, GLP-1, GLP-2, GIP and ghrelin were evaluated at 0, 30 and 120 min, respectively.

Results. During OGTT, glucose levels were not significantly different between the groups. The relevance of pre-diabetes was higher in patients with CD. In these patients, while glucagon levels were substantially higher at all cut-off points than those in controls (р = 0.001), GIP secretion was slightly lower. The acromegaly group was characterised by an inverse rhythm of GIP secretion with no peak level at 30 min. In addition, GLP-1 levels were significantly higher in patients with CD (р = 0.047). Similarly, GLP-2 levels were also significantly higher in patients with CD than in those with acromegaly and controls (p = 0.001). Finally, ghrelin levels were significantly higher in patients with CD (р = 0.013) and acromegaly (р = 0.023).

Conclusion. More pleiotropic actions of glucocorticoids can explain the higher relevance of carbohydrate metabolism disturbances in patients with CD. This can also be explained by higher levels of glucagon secretion, which do not depend on the type of carbohydrate metabolism disorder and are stimulated by a direct action of glucocorticoids on the glucagon receptor. GIP and GLP-1 secretion in patients with CD and acromegaly are characterised by the inverse rhythm with no peak levels, implying that these hormones do not play a crucial role in the development of carbohydrate disturbances in these patients. In contrast, GLP-2 and ghrelin seem to influence and potentially regulate glucose homeostasis in patients with CD and acromegaly.

Relevance. Recently, drainage surgery has gained prevalence in the treatment of neovascular glaucoma. Unfortunately, studies have reported that their effectiveness does not exceed 70%–80%. During the postoperative period, the attending physician’s major concern is the normalisation of high IOP.

Aim. To evaluate the effectiveness of contact transscleral diode laser cyclocoagulation drainage after neovascular glaucoma surgery, which did not lead to the normalisation of elevated intraocular pressure.

Materials and methods. This study enrolled eight patients in the ophthalmic branch of the Endocrinology Research Center. All patients previously underwent a drainage operation for uncompensated secondary neovascular glaucoma with a history of diabetic retinopathy. During the postoperative period, because intraocular pressure failed to stabilise, we performed contact transscleral diode laser cyclocoagulation as per the original methodology.

Results. After the execution of contact transscleral diode laser cyclocoagulation, intraocular pressure was compensated in all patients, and any complication was noted for up to 6 months.

Conclusion. Contact transscleral diode laser cyclocoagulation can be used to normalise abnormal IOP after drainage surgery for the treatment of neovascular glaucoma in patients with diabetes mellitus.

Diabetes mellitus is the third most dangerous disease of our time preceded by cardiovascular diseases and oncologic pathology.

According to the International Diabetes Federation (January 1, 2016), worldwide approximately 415 million people aged 20–79 years suffer from diabetes.

The most significant manifestations of diabetes mellitus are lesions of the retina and blood vessels, which manifest as diabetic retinopathy and macular oedema, which lead to the inevitable loss of vision and disability in patients of working age. The existence of multile diagnostic methods and a broad classification provide an evidence of the complex nature of the pathological process of the macular zone in diabetes mellitus. However, to date, a single, generalised and accepted classification does not exist. Difficulties in the treatment of diabetic maculopathy are attributed to various forms of retinal lesions and ambiguities in the approach used to choose the disease management.

It determines the importance of the development of diagnostic methods for the further correction of the standard treatment approach. New directions of surgical treatment allow relying on the best results of diabetic maculopathy treatment.

Type 2 diabetes and obesity are two enormous epidemic diseases of the 21st century. Because obesity is a primary risk factor for type 2 diabetes development, patients with diabetes are frequently obese. This comorbidity makes it challenging for these patients to not only compensate diabetes but also bring their weight back to normal. Several anti-diabetic drugs cause weight gain, which augments insulin resistance, and thus demands anti-diabetic treatment intensification. For the treatment, it is crucial to find an anti-diabetic treatment drug that is efficient but does not cause weight gain. In the last few decades, new anti-diabetic drugs with minimal or decrementing effects on the body weight have been introduced. New molecules appearing in the anti-obesity treatment are capable of not only reducing weight but also compensating diabetes. This study focuses on the current anti-obesity and anti-diabetic treatment and optimal combinations for treating comorbid patients.

This review includes results of scientific and clinical use of laser Doppler flowmetry (LDF) in patients with diabetes mellitus. LDF is a non-invasive method for the quantitative evaluation of microcirculation, which can assess microcirculatory rhythms and conduct functional tests with various impacts, allowing the exploration of regulatory mechanisms of microcirculation.

LDF reveals specific diabetes changes in the regulatory function of microcirculation. Microcirculation disturbances, which are traditionally associated with the pathogenesis of complications, also occur in patients with early disorders of carbohydrate metabolism and may precede the manifestation of diabetes. However, this method is still not applied in clinical practice. In this review, we analysed factors limiting the implementation of LDF in practical medicine and suggest ways to improve its clinical significance.

Glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RAs) are a class of antidiabetic drugs developed over the past 15 years. GLP-1, a gastrointestinal peptide hormone that contributes to the postprandial “incretin effect”, stimulates glucose-dependent insulin secretion. The incretin effect is greatly diminished in type 2 diabetes, but can be restored by GLP-1RAs. These drugs also exert other GLP-1 effects, including reducing glucagon secretion, delaying gastric emptying, reducing food intake, improving cardiac ventricular function, and lowering blood pressure. Short-acting GLP-1RAs are administered once daily (lixisenatide) or twice daily (exenatide); long-acting GLP 1RAs are administered once daily (liraglutide) or once weekly (slow-release exenatide, dulaglutide, albiglutide). All GLP-1RAs significantly reduce glycated hemoglobin (HbA1c) in patients with type 2 diabetes whose glycemic control is inadequate with oral antidiabetic drugs. Compared with other antidiabetic medications, GLP-1RAs provide better glycemic control with the additional benefit of weight loss. Within this class, long-acting GLP-1RAs are more efficacious than short-acting GLP-1RAs, with similar or lower risk of hypoglycemia and lower incidence of gastrointestinal adverse effects. Head-to-head trials and a network meta-analysis suggest that once daily liraglutide is the most effective GLP-1RA in reducing HbA1c. Dulaglutide is the only once-weekly GLP 1RA demonstrated to be noninferior to liraglutide. The once-weekly GLP-1RAs offer additional advantages to patients, including fewer injections and easy-to-use, single-dose pen devices. Despite the relatively recent development of GLP-1RAs, international diabetes guidelines recognize the benefits of this class of drugs and recommend them as a treatment option for patients with type 2 diabetes.

Aim. Present study aimed to evaluate the efficiency of microalgal metabolites as ligands for anti-diabetic target proteins viz., glucokinase, fructose-1, 6-bisphosphatase, glycogen synthase kinase, cytochrome P450, multi drug resistant protein, and peroxisome proliferator-activated receptor-γ(PPARγ) via computational approach.

Matherials and methods. Three-dimensional structures of microalgal metabolites were retrieved from PubChem database and were energy minimized. The active site of target protein was predicted through PDB sum. Molecular docking was performed with microalgae metabolites by using Hex 8.0 and DockThor server.

Results. Hex docking revealed that the binding interaction of fucoxanthin was higher with fructose 1.6 bis-phosphatase (-298.31), human multidrug resistant protein 1 (-369.67), and PPARγ (-404.18). DockThor docking indicated that zeaxanthin with glucokinase produced higher total energy (111.23 kcal/mol) and interaction energy (-2.99 kcal/mol). Lutein with fructose 1.6 bis phosphatase, human multidrug resistant protein, glycogen synthase kinase, PPARγ and cytochrome p450 produced higher total energy and interaction energy.

Conclusion. Further studies will assess the anti-diabetic effect of carotenoids of microalgae especially lutein, zeaxanthin and fucoxanthin.