Postprandial hyperglycemia is an independent risk factor for cardiovascular disease (CVD). Bolus insulins aim to mimic the physiological action of endogenous insulin secreted in response to food intake to control peaks of postprandial glycemia (PPG). Ultrafast insulin aspart is insulin with a high rate of absorption into the bloodstream that is designed to mimic the physiological prandial release of insulin more accurately than currently available short-acting or ultra-short-acting insulin preparations. The high bioavailability of ultrafast insulin aspart was achieved through the addition of two excipients — nicotinamide and L-arginine. At the same time, L-arginine ensures the stability of the drug, and nicotinamide is responsible for the accelerated absorption of insulin after subcutaneous administration. The results of clinical studies showed that subcutaneous injection of ultra-fast-acting insulin aspart provided an earlier onset of action and a greater effect of lowering blood glucose levels compared with ultra-short-acting aspart. The use of ultrafast insulin aspart both with subcutaneous injections and with CSII provided better control of PPG compared to the analogue of ultra-short-acting aspart. Moreover, the use of ultra-fast-acting insulin aspart 20 minutes after the start of a meal was not inferior to the ultra-short-acting aspart administered before meals in terms of HbA1c control. This emphasizes the possibility of using ultra-fast insulin aspart both before and after meals, without impairing glycemic control.

Diabetes mellitus (DM) is the biggest noncontagious epidemic in human history. This review is addressing an urgent challenge of modern healthcare - the treatment of type 2 diabetes mellitus (DM2). Key attention is paid to the prevention of the development and progression of type 2 diabetes complications and the need to manage risk factors for cardiovascular diseases (CVD), which are the leading cause of high mortality rates in people with type 2 diabetes. The clinical trials (CT) of recent decades contributed to the build-up of a solid evidence base on the effect of various antihyperglycemic drugs on the development of diabetic complications and outcomes in patients with T2DM. Also, the emergence of innovative classes of antihyperglycemic drugs have significantly expanded the potential of T2DM therapy. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a class of glucose-lowering drugs that affect many pathogenetic mechanisms of T2DM and have a high safety profile. Creation of extended-release forms of GLP-1 RAs is an important step in the treatment of T2DM. Dulaglutide (Trulicity) has become the first GLP-1 RA for the treatment of T2DM (2016) authorized in Russia that can be used once weekly without regard to timing of food ingestion, which contributes to high compliance with treatment. The evidence base on the efficacy and safety of dulaglutide is continuously expanding. The authors paid attention to the issues of cardiovascular safety of the administration of dulaglutide, discussed the main results of REWIND study, and brought up a problem about the expediency of an earlier initiation of primary prevention of cardiovascular events in patients with type 2 diabetes. The results of the REWIND study made it possible to recommend the inclusion of GLP-1 RAs into the therapy of patients with type 2 diabetes and cardiovascular risk factors with a view to get additional advantages in terms of life prognosis.

Introduction. To control carbohydrate metabolism disorders (CMD), which are closely related to the effect on the prognosis of cardiovascular diseases (CVD), their early, pathogenetically substantiated and prognosis-oriented therapy is required with a view to positive metabolic memory. The choice of drugs is based on the analysis of the formation of pre-nosological CMD - variants of prediabetes. The indices of the homeostatic model HOMA and the TyG family are most often used to assess the main links in the pathogenesis of CMD, IR and the secretory capacity of β-cells.

Objective: to assess the basic pathogenetic links in prenosological CMD in comparison with type 2 diabetes mellitus (DM2) using a cohort of postmenopausal women: parameters of IR and secretory capacity of β-cells according to the TyG and HOMA-2 indices. Materials and methods. The examined 94 postmenopausal women 58.0 (53.0; 63.0) years old were divided into groups by history and HbA1c levels (%). Group 1 consisted of patients with T2DM (7.20: 6.60; 7.98) with a duration of 4.0 (2.0; 7.0) years; women with two-fold fasting normoglycemia without a history of CMD were classified according to their HbA1c levels into group 2 (prediabetes) and 3 (without CMD) twice: according to WHO criteria - 6.15 (6.03; 6.30) and 5.45 (5.20; 5.80); and ADA - 6.00 (5.80; 6.23) and 5.35 (5.05; 5.40), respectively. The indices TyG, HOMA2-IR, HOMA2-%S, and HOMA2-%B were determined (based on C-peptide calculations).

Results and discussion. The performed analysis confirms the contribution of IR/insulin sensitivity to the progression of CMD with the participation of the phenomenon of lipoglucotoxicity at the prenosological stage of their formation, starting with HbA1c ≥ 5.7% levels. The inadequate secretory response of β-cells reflects an early decline in their functional abilities even at the stage of prediabetes. This limits the effectiveness of the classical stepwise scheme for intensifying glucose-lowering therapy with a T2DM duration of less than 10 years.

Conclusions. Along with the timely diagnosis of dysglycemia, to control the cardiometabolic risk, it is advisable to use drug combinations early in terms of their effect on the key links in the pathogenesis of CMD: insulin resistance and β-cell dysfunction. Pioglitazone has been substantiated as an insulin sensitizer, which has a proven effect on the regression of early CMD and a decrease in the risk of cardiovascular events. In order to eliminate incretin dysfunction, which is closely related to the adequacy of the secretory capabilities of β-cells to the needs of impaired glucose homeostasis, a rational combination with an inhibitor of dipeptidyl peptidase-4.

Introduction. In recent years, there has been an increase in the prevalence and incidence diabetes type 1. The high-quality glycemic control is critical in reducing the risk of developing and progression of vascular complications and adverse outcomes of diabetes. Self-monitoring blood glucose (SMBG) and professional continuous glucose monitoring (PCGM) provide the data set which must be interpreted using multiple indicators of glycemic control. A number of researchers have demonstrated the relationship between the time in range (TIR) and the risk of developing both micro- and macrovascular complications of diabetes. Considering the insufficient amount of data on TIR differences depending on the glucose level assessment method and the significant potential of using this indicator for the stratification of the risk of both micro- and macrovascular complications of diabetes, the study of TIR differences based on the data of PCGM and SMBG is relevant at present.

Aims. To estimate the time range according to professional continuous glucose monitoring and self-monitoring of blood glucose levels in the patients with diabetes type 1 among the adult population to improve the control of the disease course.

Materials and methods. An interventional open-label multicenter study in the patients with diabetes type 1 was conducted. The patients with diabetes type 1 aged 18 and older, with the disease duration of more than 1 year receiving the therapy with analog insulin was enrolled into the study. The calculation of the indicators of the time spent in the ranges of glycemia was carried out on the basis of the data of PCGM and SMBG.

Results and discussion. We examined 218 patients who met the inclusion criteria and did not have exclusion criteria. The presented differences in the indicators of time in ranges indicate the comparability of the SMBG and PCGM methods.

Conclusions. When assessing the indicators of time in the ranges of glycemia obtained on the basis of the data of PCGM and SMBG, clear correlations and linear dependence were demonstrated, which indicates the comparability of these parameters regardless of the measurement method.

Elderly patients with diabetes type 2 represent complex and heterogeneous group with different diabetes complications and comorbidity, polypharmacy, functional and cognitive state. Each of those factors should be taken into account to choose the best glycemic targets as well as the most tailored treatment so that it is necessary for endocrinologist to perform geriatric assessment. The most favorable antidiabetic drugs for elderly are safe in terms of hypoglycemia and cardiovascular risks, can be used irrespective of kidney function, do not affect weight or bone mineral density, and are available in fixed combinations with other drugs. Dipeptidyl pepti-dase-4 (DPP-4) inhibitors meet all these requirements with low adverse events rate. Interdisciplinary approach, close interaction with patient and his relatives and considerations for both intensification and deprescribing are keys to successful treatment in this patient subgroup. Cardiovascular events are the most common cause of death and hypoglycemia is highly unfavorable in elderly because it can lead to falls, life-threatening arrhythmias, and cognitive impairment. So deprescribing in elderly with diabetes should be primarily aimed at minimizing of cardiovascular events and severe hypoglycemia risks. For this purpose, it is considered to the reject use of sulfonylureas, glinides, insulins in favor of safer ones (metformin, GLP-1 receptor agonists, SGLT-2 inhibitors, DPP-4 inhibitors).

Introduction. Long-lasting ulcerative defects in patients with diabetic foot syndrome (DFS) are prone to reinfection, persistence of primary and hospital-acquired infection, and the infectious process is often caused by multidrug-resistant organisms (MDRO).

Aim of the study: to compare the prevalence and specific characteristics of the severe diabetic foot infection pathogens during the inpatient and outpatient stages of treatment.

Materials and methods. We included 62 type 2 diabetic inpatients (group 1) with severe foot infection and 102 diabetic foot outpatients (group 2) with postoperative wounds, who had been operated on and discharged from the hospital, in to the study.

Cultures were obtained after surgery interventions immediately and on 14 days of hospitalization in group 1 of patients and in group 2 of patients with clinical signs of infection. Microbe species and resistant of pathogens to antibiotic were assessed.

Results and discussion. Severe infection connected with polymicrobe pathogens in both groups of patients. However, the prevalence of Gram-positive and Gram-negative bacilli was different. The most frequently isolated pathogens were Gram-positive bacteria in the wound samples of group 1 of patients with acute infection obtained after surgery interventions immediately. In the wound cultures of group 1 on 14 day of hospitalization and group 2 the prevalence of Gram-positive and Gram-negative bacilli was the same. It should be noted that there is still a high total frequency of isolation of non-fermenting Gram-negative bacilli among Gram-negative pathogens in complicated diabetic foot infection both at the inpatient and outpatient stages of treatment.

Conclusion. The great finding of the study is the identification of a parallel of the same prevalence of Gram-positive and Gramnegative pathogens in a prolonged infection at the inpatient and outpatient stages of treatment. The role of Enterobacterales increased with duration of infection. The prevalence of multidrug resistant Enterobacterales makes this group of microorganisms as important as Staphylococcaceae in the complicated course of the infectious process. Polyvalent microbial spectrum of pathogens significantly reduces the effectiveness of treatment.

Introduction. Diabetes mellitus, cardiovascular diseases and osteoporosis are linked by common pathophysiological mechanisms.

Objective. To evaluate the effect of alendronate bisphosphonate on cardiovascular outcomes in comorbid patients with ischemic heart disease (CHD) associated with type 2 diabetes mellitus (type 2 diabetes) and osteoporosis during a two-year follow-up.

Materials and methods. A total of 112 women with comorbid pathology including osteoporosis, coronary artery disease, and type 2 diabetes were examined. The patients' condition was assessed at baseline and prospectively for 24 months with a combined endpoint assessment, including: mortality, readmission for cardiovascular diseases, the development of myocardial infarction (MI), stroke, atrial fibrillation. Women were divided into groups: group 1 (n = 59) included patients who received basic therapy for IHD and type 2 diabetes, group 2 (n = 53) included patients who, in addition to basic therapy for coronary artery disease and diabetes Type 2 was prescribed alendronic acid preparation.

Results and discussion. According to the results of two-year follow-up, the patients were divided into two subgroups: patients with a favorable (n = 61) and unfavorable course of coronary artery disease (n = 51). At the same time, during prospective observation, the following was assessed: the frequency of hospitalizations for cardiovascular diseases, the dynamics of the functional class (FC) of exertional angina, the development of MI, stroke, atrial fibrillation, and mortality. A significant association of alendronate therapy with a favorable course of ischemic heart disease (OR = 0.26; 95% CI = 0.18-0.57; p = 0.008), a decrease in the risk of MI (OR = 0.32; 95% CI = 0.11-0.87; p = 0.018) and worsening of FC of exertional angina (OR = 0.4; 95% CI = 0.17-0.91; p = 0.014).

Conclusion. Long-term (24 months) use of alendronate is an effective and safe method for the treatment of associated cardiovascular pathology, represented by coronary artery disease, type 2 diabetes and osteoporosis in postmenopausal women, reducing the risk of MI, worsening of FC of exertional angina. These results suggest a more aggressive prescription of alendronate for osteoporotic patients at very high cardiovascular risk.

Combined pathology is a real problem for rational pharmacotherapy due to multiple organ damage. The need to affect simultaneously several pathogenesis processes leads to polypharmacy that can appear to be less effective, toxic and unacceptable in some time. For comorbid patients with long - term ongoing type 2 diabetes mellitus (T2DM), the problem of drug interactions is as relevant as the selection of optimal hypoglycemic therapy. This review aims to identify opportunities to optimize drug therapy in comorbid pathology to increase the effectiveness of pharmacotherapy, improve the prognosis and outcomes of concomitant diseases, and slow the progression of one or a combination of diseases. One of the ways to individualize pharmacotherapy is to identify polymorphic genes that can account not only to the predisposition to the disease, but also to the formation of a pharmacological response, thus determining the effectiveness of drug therapy. A peptide hormone leptin along with its receptors in various tissues could be the milestone of unifying pathology that contributes both to the development of diseases - chronic obstructive pulmonary disease (COPD) and T2DM. This modality potentially forms the pharmacological response to prescribed drug therapy of such. Gene polymorphism determines the development of pathologies such as leptin and insulin resistance. These deteriorations are in turn likely to be the targets of many oral antidiabetic drugs. The review suggests potential associations and directions for research in the field of pharmacogenetics of drugs used for the treatment of comorbid patients. The duly identified mutations involved in the general pathogenesis of type 2 diabetes and COPD will account to the approach toward tailored medicine and contribute to proper control of both diseases.

Diabetes mellitus (DM) is a well known risk factor for osteoporosis and an increased risk of fractures. A lot of data has been published about the relationship between diabetes and bone health. DM type 1 and DM type 2 have different effects on bone mineral density (BMD). The central link in pathogenesis of bone fragility in patients with DM type 1 is a violation of the activity and gifferentiation of osteoblasts. On the contrary, hyperinsulinemia in DM type 2 activates the division and gifferentiation of osteoblasts and contributes to an increase in BMD. However, Higher BMD values in patients with DM type 2 are combined with slowdown in bone metabolism. As the result, high-quality bone remodeling does not occur. And bone strength decreases despite the high BMD. Despite the differences, DM type 1 and DM type 2 have common pathogenic pathways, that lead to increased bone fragility. For example, non-enzymatic glycation of bone matrix collagen and increase in concentration of sclerostin, which blocks the Wnt signaling pathway. In this review, we will analyze current data about epidemiology and pathogenesis of osteoporosis in DM and discuss the practical issues of the clinic, diagnosis, stratification of fracture risk and treatment. Special attention will be paid to the effects of glucose-lowering and anti-osteoporotic drugs on bone tissue.

Introduction. In Russian Federation, there are no comprehensive studies assessing the quality of life and risk factors for vitamin D deficiency and insufficiency, taking into account its status in different geographic latitudes.

Aim. To assess the quality of life and risk factors for vitamin D deficiency and insufficiency among the population living in the regions of the Russian Federation located at latitudes from 45 ° to 70 °.

Materials and methods. The first stage of the Russian multicenter non-interventional registry study using the “cross-sectional” method was carried out from March 2020 to May 2020.

Results and discussion. According to the results of the correlation analysis, qualitative and quantitative factors were identified, presumably being risk factors for vitamin D deficiency and deficiency. Qualitative risk factors include: education; alcohol consumption; being in direct sunlight for more than 30 minutes a day; visit to the solarium; using sunscreen; drinking coffee; taking medications (not vitamin-mineral complexes). Quantitative factors include: visits to specialists (total per year); smoking (duration, years); exercise for more than 30 minutes a day, once a week; being in direct sunlight for more than 30 minutes a day.

Conclusion. A wide range of risk factors for vitamin D deficiency dictates the need for their further study to clarify the category of persons who are shown targeted biochemical screening with subsequent drug correction.

Bone metastases are a common complication of cancer. Patients with bone metastases may have experienced skeletal-related events, such as hypercalcemia, pathological fractures, pain syndrome of varying intensity, spinal cord compression with negative effects on the quality of life. Current diagnostic tools have some limitations, such as high cost and limited availability in the distant areas, as well as falls negative and falls positive results. In this aspect, non-invasive sensitive markers of bone metabolism might give additional valuable information. Bone remodeling markers (N-terminal propeptide of type 1 collagen, osteocalcin, C-terminal telopeptide of type 1 collagen, etc.) have been used for a long time to predict the effectiveness of osteoporosis treatment; as additional risk factors for treatment initiation in patients with osteoporosis, in diagnostic search for secondary forms of osteoporosis; and as predictors of fracture in population studies. This review summarizes the clinically relevant biochemical markers of bone remodeling and the available evidence for their use in the metastatic bone disease in particularly in the diagnosis and prognosis of bone metastases risk and skeletal complications, predicting clinical outcomes, bone disease progression and overall survival. It has been shown that a sufficient suppression of bone remodeling biochemical markers while on treatment with bisphosphonates is associated with an improvement in survival and a decrease in the risk of skeletal complications in patients with bone metastases. New data may become a rational basis for wider use of bone metabolism markers in oncological practice. However, it is necessary to standardize and validate the determination of bone markers and verification of cut-off diagnostic values for their introduction into the routine clinical practice of patients with malignancy.

Introduction. The special rehabilitation programs are often required for patients with osteoporosis (OP). So physicians working in the field of physical and rehabilitation medicine should be well-versed in this problem.

Aims. To study the awareness of doctors of rehabilitation medicine in the field of diagnosis and treatment of osteoporosis and their activity in providing medical care to patients with OP.

Materials and methods. A questionnaire survey of 157 doctors (M-34, F-123) of 8 medical specialties working in 27 specialized medical institutions on the profile of “medical rehabilitation” was carried out. The questionnaire for doctors consisted of 21 items of special questions.

Results and discussion. In the sample of rehabilitation doctors, 90.45% of the interviewed doctors believed that the problem of OP is relevant for their clinical activities, 100% of the respondents indicated that the presence of OP significantly affects the rehabilitation prognosis and 95.54% - on the degree of effectiveness of medical rehabilitation. According to the respondents, patients with OP make up on average 30.0% [20.0; 50.0] (0-90) of the total flow of patients. Endocrinologists (all surveyed doctors - 100%), obstetricians - gynecologists (66.67%) and therapists (60%) are mainly involved in the treatment of OP. Most often, specialists from rehabilitation institutions recommend zoledronic acid (23.57% of doctors indicated in this aspect), preparations of vitamin D (23.57%) and calcium (14.65%), various methods of physical therapy (14.65%) and parenteral form of ibandronic acid (12.74%).

Conclusions. The presence of OP significantly affects the rehabilitation prognosis and the effectiveness of medical rehabilitation. 23.57% of specialists in the field of rehabilitation medicine prescribe treatment for OP to patients, giving preference to parenteral bisphosphonates, vitamin D, calcium and physical exercises.

The main goals of treatment for many diseases are to improve the prognosis of diseases and to enhance the quality of life. Among the barriers that restrict achieving these goals we have to mention adherence to treatment. Patients with chronic diseases, including acromegaly, are at increased risk of poor adherence to treatment. The duration of supervision of patients with acromegaly in most cases exceeds 25-30 years, which makes the issue of adherence to treatment extremely important.

One of the main goals of the acromegaly treatment is to achieve the target values of STH and IGF-1, which ensures the regression of most clinical symptoms and restoration of life expectancy. For this purpose, a significant proportion of patients with acromegaly receive somatostatin analog treatment - as a second line of treatment after non-radical neurosurgical intervention, or as the first line of treatment if neurosurgical intervention could not be performed for any reason. Adherence to treatment is influenced by socio-economic factors, the characteristics of the drug, and the characteristics of the patient. Recent studies have shown that the easy administration of lanreotide provides better treatment adherence than octreotide. Factors that can reduce adherence to the treatment of acromegaly are old age, mental disorders, subjective opinion about the low quality of life, the need to visit medical institutions to administer the drug. On the contrary, the ability to perform subcutaneous injections (on their own or with the help of relatives) without visiting medical facilities, providing accessible information about the disease and the need for its treatment significantly increases adherence to treatment. It is necessary to continue research on the factors and methods of increasing adherence to drug treatment of acromegaly.

Pheochromocytoma/paraganglioma is a neuroendocrine tumor of chromaffin and nonchromaffin cells of the autonomic nervous system, in most cases localized in the medullary layer of the adrenal gland. Its development is often associated with genetic predisposition. More than 30% of adult patients have genetically determined PCC/PG. In the last decade, many genes predisposing to the manifestation of PCC/PG have been found: RET, VHL, NF1, SDHB, SDHC, SDHD, SDHA, SDHAF2, TMEM127, MAH, KIF1BP, PHD2, EGLN1, FH, H-RAS, IDH, SLC25A11, MDH2. Mutation of the oncosuppressor genes TMEM127 and EGLN1, which regulate the level of factors induced by HIF hypoxia, is extremely rare in patients with PCC/PG, and has not been described at all in combination with pancreatic tumor. To date, data on the clinical manifestations of these gene mutations are limited. Accumulating clinical data on patients with identified genetic alterations is important for predicting the course of the disease, clarifying the malignant potential and stratifying the risk of developing comorbid pathology. We present the clinical case of a 62-year-old patient with PCC/PG and pancreatic tumor in whom a previously undescribed combination of TMEM127 c.99G > A (p.S33S) and EGLN1 c.515C > T (p.A172V) gene variants was found.

Introduction. One of the objectives of weight loss in obesity is to prevent metabolic disorders associated with it. An important component in the maintenance of the achieved results is a change of eating behavior.

Goal: to study the effect of liraglutide 3.0 mg on the dynamics of metabolic parameters and eating behavior in patients with obesity. Materials and methods. The study enrolled 42 obese patients in whom anthropometric parameters, metabolic parameters, and eating behavior were assessed with Dutch Eating Behavior Questionnaire (DEBQ). Patients were divided into 2 groups, one of which received liraglutide 3.0 mg with lifestyle modification for 3 months. The other group was recommended to receive only lifestyle modification. The participants were re-examined after 3 months.

Results and discussion. in the liraglutide group in addition to a significant decrease in body weight, BMI and waist circumference, there was a statistical trend toward lower glucose, insulin and HOMA-IR levels. When comparing the dynamics of parameters between the groups, Д body weight, BMI and glucose in the liraglutide group were significantly superior. In reassessment of eating behavior after 3 months of treatment, no statistically significant differences were found with the initial severity of restrictive, emotional, and/or external types in both groups and, despite a more pronounced decrease in body weight in the liraglutide group, between them.

Conclusions: Three months of isolated lifestyle modification and/or its combination with liraglutide 3.0 mg is not sufficient to make a lasting change in eating behavior. However, considering that obesity is a chronic and relapsing disease, the need for eating behavior correction remains relevant to prevent disease recurrence. This substantiates the need for more long-term intervention in obesity, including drug therapy.

Riedel's thyroiditis is a rare disease characterized by chronic fibrosis. Clinical performance of this disease is dense stony goiter, which can poorly be displaced during palpation. The overgrowth of the goiter can lead to the development of compression syndrome. To diagnose we need to made fine needle biopsy and made the final diagnose according to its results or according to the morphological description of the postoperative material. An important step in the diagnosis of Riedel's thyroiditis is the determination of serum IgG and IgG4 to exclude an IgG4-associated disease. Treatment of this disease includes drug therapy, which is based on glucocorticosteroids administration or surgical treatment when develops compression syndrome. This article presents a clinical case of a patient with Riedel's thyroiditis; the main complaints were associated with the growth of goiter and the development of compression syndrome. In this regard, patient underwent surgery on the thyroid gland, and after this we get final diagnose. Due to feeling unwell, drug therapy with glucocorticosteroids was prescribed, against the background of which we noted a positive trend.

Introduction. Androgen deprivation, used to treat prostate cancer, leads to metabolic disorders, including glucose metabolism disorders. The timing of development and the characteristics of these changes have not been sufficiently studied. The expansion of the possibilities for assessing glycemia makes it possible to obtain changes in glucose.

Objective. To study the dynamics of the effect of long-term androgen-deprivation therapy with gonadotropin-releasing hormone agonists (GnRH agonists) on the parameters of glucose metabolism and ambulatory glucose profile in patients with locally advanced prostate cancer (La PCa).

Materials and methods. The study included 99 patients with La PCa receiving androgendeprivation therapy (ADT) with (GnRH agonists) for at least 12 months. The study of fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) levels was performed at baseline, after 3, 6 and 12 months of ADT, and constant self-monitoring of glycemia was recommended using portable glucometers. Flash glucose monitoring systems (FreeStyle Libre) were installed in ten patients with a detected increase in glycemia on the background of ADT, allowing them to obtain data on the ambulatory glucose profile (AGP).

Results and discussion. Long-term ADT in patients with La PCa, regardless of baseline age, BMI, WC, was accompanied by an early, progressive deterioration in parameters of glucose metabolism. The proportion of patients with prediabetic FPG values after 12 months becames 66% according ADA criteria. We found that 12-month ADT changes the AGP: an increase area under the curve and postprandial glycemic levels, an increase in blood glucose variability with an increase in the CONGA index to 6.817 (p < 0.001).

Conclusion. ADT by GnRH agonists in patients with La PCa is accompanied by a predisposition to early disorders of glucose metabolism with a high risk of rapid development of prediabetes regardless of baseline age, BMI, and WC. The AGP of patients is characterized by an increase in the total glycemic load, and glycemic variability.

Introduction. According to various authors, uncompensated gestational diabetes mellitus (GDM) is accompanied by the development of many complications affecting the mother and fetus. However, published data on the prevalence of GDM and its complications in real clinical practice in our country are insufficient.

Aim. To estimate the prevalence of GDM among pregnant women in the South-Eastern Administrative District of Moscow, to analyze the main risk factors, the features of the course and pregnancy outcomes in women with GDM.

Materials and Methods. Retrospective analysis of primary records of 510 pregnant women who were diagnosed with GDM during 2019. A comparative analysis of pregnancy complications and outcomes depending on the age of diagnosis of GDM was performed.

Results and Discussion. During 2019, 510 pregnant women out of 5,000 women observed were diagnosed with GSD. The mean age of the women was 31.9 ± 4.8 (95% CI 31.5-32.3). Most frequently, 224 pregnant women (43.9%) were diagnosed in the 1st trimester of pregnancy, 31.8% (162) in the 2nd trimester, and 18.6% (95) in the 3rd trimester. Mean venous plasma glucose values were 5.43 [5.25; 5.7] mmol/L, and glycated hemoglobin was 5.19 ± 0.4% (95% CI 5.15-5.24). Diet therapy was predominantly sufficient to achieve GSD compensation - 84.3%. Complications of pregnancy were observed in 123 women (24.1%). Unfavorable pregnancy outcomes were recorded in 153 women with GSD out of 213 women analyzed (71.8%). There was no statistically significant difference in pregnancy outcomes depending on the age of diagnosis of GDM.

Conclusions. The prevalence of GDM in the South-Eastern Administrative District of Moscow was 10.2%, which is consistent with the data of various epidemiological studies in other regions. The development of adverse pregnancy outcomes remains at a high level. Therefore, it is advisable to conduct further research aimed at assessing the main factors influencing the course and outcomes of pregnancy.