Type 2 diabetes mellitus (T2DM) is one of the most common diseases in the world accounting for about 85--90% of the total number of people with diabetes. More than 80% of these patients are overweight or obese, and lead sedentary lifestyles. If earlier T2DM was considered "a disease of the elderly", now half of patients suffering from the disease are people of working age. Reduced working ability as well as financial burden of prevention and treatment of late complications of DM are a significant problem for the healthcare system and society as a whole. At the same time, T2DM therapy involving effective medicines which are convenient and have minimum side effects could markedly reduce treatment costs.

Despite the emergence of new antidiabetic drugs, diabetes type 2 treatment remains a relevant issue. In order to standardize and optimize medical care to patients with diabetes, global and national algorithms for type 2 diabetes treatment were developed. [1, 2] The current algorithms focus on an individual approach, safety and effectiveness of treatment. A balance should be maintained between achieving optimal glycemic control and safety of therapy.

Type 2 diabetes mellitus (T2DM) is a high risk factor for the development of macrovascular complications. Several large studies have demonstrated the fundamental role of early extensive blood glucose control in the prevention of these complications. An aggressive approach in achieving normoglycemia in patients with T2DM and existing macrovascular complications could lead to an increase in cardiovascular outcomes, which has a clear association with hypoglycemic conditions. Insulin therapy (IT) remains one of the most effective pharmacological treatments for diabetes provided adequate and timely prescription. The advent of long-acting insulin analogues helped not only to reduce the incidence of hypoglycemia as one of the most clinically relevant adverse events of IT, but also marked certain prospects in the prevention of type 2 diabetes in people with prediabetes.

Treatment of diabetes mellitus type 2 (T2DM) is a serious challenge which forces to search for new approaches in order to improve the results of pharmacotherapy. Recent advances in diabetology pertain to incretin-directed therapies. Along with traditional defects (insulin resistance, β-cell dysfunction), a significant contribution to the development and progression of the disease is made by a reduction of "incretin effect" (Fig. 1). The concept of reduced "incretin effect" served as the basis for the development and introduction into clinical practice of the innovative medications the action of which is based on the "incretin effect" - glucagon-like peptide-1 (GLP-1) and gastric inhibitory polypeptide (GIP). [12, 17].

Diabetes mellitus (DM) is a serious medical and social problem. The prevalence of diabetes has been steadily increasing in all countries, where 95% are patients with type 2 diabetes. According to the International Diabetes Federation, in 2014, the number of patients with type 2 diabetes was 387 million, or every 12th inhabitant of the planet. By 2035, the number of patients with type 2 diabetes could increase to 592 million people [1]. Global trends in diabetes incidence rates are also observed in Russia. According to the national register, there are 8 million diabetic patients in Russia, or approximately 5% of the total population, whereas 90% of them are patients with type 2 diabetes. By 2025, the number of patients is expected to increase to 13 million people. The number of registered patients is usually 2-3 times less than the real number. [2, 3] The greatest input in the number of diabetic patients is made by the increase in the number of type 2 diabetes patients in older age groups.

In the context of cardiac safety, the article discusses the prospects and benefits of a representatives of the DPP-4 inhibitors class - alogliptin (Vipidiya) for the management of hyperglycemia in patients with diabetes type 2 (T2DM).

The review tells about the specific diagnosis and treatment of dyslipidemia in patients with diabetes type 2 aimed at preventing serious cardiovascular complications.

The recent literature demonstrates an increase in the risk of new cases of diabetes in patients receiving statins. The review examines recent studies devoted to the problem, and possible mechanisms of disorders of glucose metabolism against a background of statin therapy. Target levels of atherogenic lipids in patients with diabetes and metabolic syndrome are analyzed.

The article tells about generalized Russian experience in the treatment of patients with diabetes and heart failure. The role of medicines affecting various links in the pathogenesis of diabetes mellitus in patients with concomitant cardiovascular diseases is deminstrated. The role of taurine as the optimum addition to glucose-lowering therapy in this group of patients is emphasized.

Oxidative stress is the pathogenetic basis for the progression of T2DM. It is important to evaluate antioxidant properties of testosterone medications used for the management of male hypogonadism (a comorbidity of T2DM). Aim: to evaluate antioxidant properties of testosterone hormone replacement therapy (THRT) in patients with type 2 diabetes. Material and methods: the randomized (1:1) clinical trial included 108 patients with type 2 diabetes, visceral obesity and hypogonadism. The treatment group received THRT for 12 months. The changes in metabolic (glycemic and non-glycemic) parameters and activity of antioxidant protection enzymes - superoxide dismutase (SOD) and glutathione peroxiase, (GPO), were evaluated. The ΔOxS index was suggested to characterize the changes in oxidative stress. Results: THRT was associated with improved metabolic and antioxidant status. Increased SOD and GPO activity against a background of THRT was 32.4 ± 5.6 U/l and 580 ± 68 U/ml, respectively (p < 0.05). ΔOxS was characterized by positive changes only in the treatment group, indicating a decrease in oxidative stress during THRT. Conclusions: in patients with visceral obesity and T2DM, THRT contributed to improvement in metabolic parameters and elimination of oxidative stress and glucose-lypo-toxicity, and that could potentially reduce the risk of progression of type 2 diabetes and its complications.

The high prevalence of obesity is a serious medical and social problem conditioned by urbanization, reduced physical activity and availability of high-calorie food. All over the world, the prevalence of obesity has been steadily growing over the last few decades: body mass index increased by 0,4--0,5 over a decade globally [1-3]. Sample surveys conducted in Russia showed that at present, up to 30% of the working population of the country are overweight and 25% have obesity. That is why WHO defined obesity as the noninfectious epidemic of the XX-XXI centuries. [4--8].

Hypothyroidism is one of the most common endocrine diseases. The article tells about prevalence, etiology and clinical pattern of hypothyroidism. The principles of diagnosis of thyroid hormone deficiency and levothyroxine replacement therapy are discussed. Factors that affect the quality of hypothyroidism compensation, and major causes of the disease decompensation are also considered.

Summary: Natural iodine deficiency affects around 2 billion people worldwide. It is known that insufficient intake of iodine is especially dangerous at the stage of fetal development and early childhood. Changes caused by iodine deficiency in these periods of life bring about irreversible defects in the intellectual and physical development of children. A dramatic outcome of chronic iodine deficiency during fetal development and early childhood is mental disability. The urgency and procedure for iodine prophylaxis in pregnant and lactating women are defined by the World Health Organization (WHO) and the International Council for the Control of IDD (ICCIDD). Pregnant and lactating women are referred to the group of absolute risk for developing IDD. WHO recommends to administer potassium iodide to pregnant and breastfeeding women residing in the areas of iodine deficiency. The Order of the Russian Ministry of Health defined the list of essential drugs for women during pregnancy and the postpartum period which also includes potassium iodide medications. Russian guidelines for the level of iodine intake by pregnant and nursing women conform to the WHO recommendations. Federal standards of care for pregnant women stipulate prescription of potassium iodide medications.

One of the most common diseases of the thyroid gland is nodular goiter. The widespread use of modern diagnostic methods (ultrasound, computed tomography, magnetic resonance imaging) helps to identify a huge number of thyroid incidentalomas. This, in turn, requires clear and clinically substantiated guidelines for the diagnosis and treatment of nodular goiter. Such guidelines are being developed by both Russian and foreign endocrinologists, which are the same across the main provisions but have some differences as well. Advancements in diagnostic methods and accumulation of clinical experience result in a regular update of the recommendations. Examination of patients with nodular goiter focuses on ruling out malignant thyroid. Among nodular abnormalities, thyroid cancer is detected in 4,7--5,0% of cases.

Vildagliptin is an innovative, effective DPP-4 inhibitor to be used as mono- or combination therapy of type 2 diabetes. The drug consistently reduces the level of glycated hemoglobin and does not increase the risk of hypoglycemia and cardiovascular disease. Numerous clinical studies have demonstrated the efficacy and safety of vildagliptin and opened new prospects for its application.

The role of hyperglycemia as an independent predictor of adverse course and prognosis of acute coronary syndrome (ACS) in patients with diabetes mellitus (DM) and without it [1] can hardly be overestimated. This relationship is thoroughly covered in the literature [2-- 13], and the discussions on the subject are underway. A simple summation of risks results in higher than expected rates of morbidity and mortality from CAD in DM patients, demonstrating a direct effect of hyperglycemia on the atherosclerotic process [14--16]. It is worth noting that in patients without DM hyperglycemia is associated with worse clinical outcomes and higher mortality from all causes compared with patients suffering from diabetes mellitus [17--21]. Increased blood sugar levels at the time of admission are usually seen as a reaction to stress in acute condition, but in some cases may serve as a marker of an existing though not yet diagnosed type 2 diabetes or impaired glucose tolerance (IGT) [22]. According to observational studies, hyperglycemia occurs in 32--38% of patients in hospitals [23, 24], 41% of severe patients with acute coronary syndrome[25], 44% of patients with heart failure [25] and 80% of patients after coronary intervention [26, 27].

Inadequate nutrition prevents patients with type 2 diabetes (T2DM) from achieving target values of glycemic and non-glycemic parameters. Aim: to evaluate metabolic effects of the balanced diet including specialized nutrition (SN). Material and methods: the randomized clinical trial included 60 patients with type 2 diabetes treated with a double combination metformin + glibenclamide, who were divided into 2 groups. Patients in the treatment group received SN Glucerna SR which replaced the main meal; the comparison group of patients were on a natural low-calorie diet. Changes in glycemic and non-glycemic parameters were evaluated in 12 weeks. Results: SN improves glycemic control without correction of the background antidiabetic therapy. Thus, the treatment group demonstrated a decrease in HbA1c from 7.8 ± 1.6 to 6.7 ± 1.1%, fasting glycemia - from 7.5 ± 1.2 to 5.9 ± 0.6 mmol/l, postprandial glucose (PPG) - from 10.6 ± 1.0 to 7.5 ± 0.5 mmol /l, glycemic variability SD - from 2.0 ± 0.8 to 1.1 ± 0.6 mmol/l, and normalization of glycemic pattern (p < 0.05). SN contributed to improvement of the lipid profile (p < 0.05). Conclusions: SN in patients with type 2 diabetes and visceral obesity is associated with positive dynamics of metabolic parameters. Elimination of postprandial hyperglycemia induces a decrease in glycemic variability, minimizing the progression of type 2 diabetes.