Chronic kidney disease (CKD) in patients with diabetes mellitus (DM) remains a global medical and social problem of the 21st century and the leading cause of end-stage renal disease (ESRD). Kidney damage in diabetes is multifactorial, and diagnosis is often delayed, since structural changes in the glomeruli of the kidneys are detected before the appearance of significant albuminuria (AU) and a decrease in glomerular filtration rate. In this regard, the search for new, early informative biomarkers for the diagnosis of CKD in patients with DM is extremely relevant.

Target: To establish the significance of biomarkers of podocyte dysfunction and fibro and angiogenesis excreted in the urine for early diagnosis and assessment of the risk of progression of kidney damage in patients with DM. Materials and Methods: in 74 patients with type 1 and type 2 diabetes (30 and 44, respectively), podocyte proteins and markers of fibro and angiogenesis were determined in the urine by enzyme immunoassay.

Results: in patients with diabetes, compared to healthy people, there is increased urinary excretion of podocyte damage markers - nephrin, podocin, and fibroaniogenesis markers – type IV collagen, TGFβ-1, VEGF. Concentrations of nephrin in urine >7.18 ng/U/Cr urine and collagen >12.88 ng/U/Cr urine reliably indicate kidney damage. In patients with diabetes in the absence of traditional signs of CKD, diagnostically significant concentrations of nephrin were detected in 22% of cases, and collagen in 16.6%.

Conclusion: determination of nephrin and/or type IV collagen in urine can be used both for early diagnosis and for monitoring kidney damage in diabetes.

A patient with diabetes mellitus often sees a neurologist. The article addresses the questions: why does such a patient go to a neurologist and with what complaints, what does a neurologist see and how can he help a patient with diabetes? The authors of the article pay attention to the clinical diversity of neurological manifestations of diabetes mellitus, including insomnia. Identification of sleep disorders and subsequent correction can become the cornerstone not only in effective control of diabetes mellitus, but also in improving the patient’s quality of life.

Glucagon-like peptide-1 receptor agonists (arGPP-1) have proven their advantages in persistent reduction of glycemia and HbA1c and achieving targeted control in patients with type 2 diabetes mellitus (DM2) as monotherapy or in combination with other medications. These drugs are also highly effective in reducing body weight for both patients with and without DM2.

The research results indicate the potential of arGPP-1 in reducing cardiovascular events, especially in patients with pre-existing atherosclerotic diseases. Although with a low risk of cardiovascular disease, such effects may be less obvious.

The presence of side effects, especially from the gastrointestinal tract (GI tract), the high cost and low availability of drugs may be a limitation for their use. In addition, the advantages in relation to the possible prevention of late complications of DM2 within the group are heterogeneous, if the patient has risk factors, drugs with proven effects on cardiovascular and renal outcomes may have advantages. Thus, in some cases, patients may need to change the drug within this class. At the same time, it is important to make a smooth transition between drugs to optimize the treatment of diabetes mellitus and minimize side effects.

Most of the physiological functions of the body, including hormone secretion, differ during sleep and wakefulness. Circadian rhythm and homeostatic sleep pressure are the determining factors in falling asleep and maintaining sleep. Fluctuations in hormone levels are largely determined by circadian rhythms. The central biological clock located in the suprachiasmatic nucleus of the hypothalamus is synchronized with external signals, and largely determines the daily rhythms of hormone secretion. Many hormones can affect respiratory function during sleep, exacerbating sleep apnea when their secretion is excessive or deficient. Sleep disorders can occur in a number of neuroendocrine diseases, worsening the quality of life of patients and, in some cases, contributing to the development of life-threatening complications. Screening for sleep disorders, in particular the active detection of sleep apnea in acromegaly, hypothyroidism and hypercorticism, can significantly reduce the risk of complications with timely treatment.

Stroke is a serious and disabling disease with a high mortality rate that is becoming increasingly common worldwide, posing a serious threat to the health and quality of life of patients. Type 2 diabetes plays a special role in increasing the risk of stroke, which not only increases the risk of developing a stroke, but also negatively affects the outcome and the possibility of recurrent strokes.

In order to prevent stroke, systematic action is necessary, including the correction of risk factors and the use of effective medications. One such drug is pioglitazone. Many studies support its effectiveness in reducing the risk of cardiovascular events, including stroke, for both secondary and primary prevention.

Pioglitazone may be particularly beneficial for patients at high risk of cardiovascular disease and those with a history of ischemic brain damage. Despite the known side effects, its benefits in preventing stroke outweigh the possible disadvantages.

This review provides important aspects of the role of type 2 diabetes mellitus in increasing the risk of stroke and discusses the prospects for the use of pioglitazone as a drug therapy affecting stroke risk and prognosis.

Diabetes mellitus (DM) is associated with an increased risk of stroke and cognitive impairment. The problem of preventing cerebral disorders in diabetes has not been solved. The review presents current data on the place and role of sodium-glucose cotransporters (SGLTs) in the brain, whose receptors play an important role in ischemia-reperfusion injury of the brain and neurodegenerative changes. Modern studies on the cerebroprotective effects of hypoglycemic drugs – SGLT inhibitors – are presented and summarized.

Despite the successes achieved in diagnosis and treatment, HF, regardless of the phenotype, remains one of the significant problems in the health sector, due to the high incidence, frequency of hospitalization, disability and mortality. In turn, patients with both type 2 diabetes and prediabetes are a vulnerable group in terms of the development of CHF. CH-sFV therapy has been focused for several decades on the treatment of concomitant diseases such as type 2 diabetes, hypertension, coronary heart disease, obesity and, if necessary, initiation of diuretic therapy to improve the quality of life. However, to date, great progress has been made in the treatment of HF-sFV. All guidelines for the management of patients with HF, based on the results of large randomized trials, postulate that iNGLT2 types are the basic drugs for the treatment of patients with HF, regardless of PV. Algorithms of specialized medical care for patients with diabetes recommend the appointment of iNGLT type 2 in the presence or high risk of developing CHF and/or CKD, regardless of the HbA1c level, in patients with type 2 diabetes to reduce the risk of hospitalization for HF, cardiovascular events and reduce the risks of CKD progression.

Hyperprolactinemia is a condition characterized by persistently elevated blood prolactin level. The most prominent manifestations of it are reproductive dysfunction, as well as fat and carbohydrate metabolism disorders, including body weight gain, dyslipidemia, impaired glucose tolerance, and insulin resistance. We describe here a case of hyperprolactinemia in a young man and perform differential diagnosis of prolactinoma with craniopharyngioma. The article demonstrates that initiation of treatment with dopamine agonists allows us to make a correct diagnosis and to determine optimal tactic of management – either therapy or surgery.

The probability of pregnancy in women with acromegaly is relatively low, however modern therapy approaches make it possible to achieve disease compensation and improve reproductive function.

World expert’s experience in managing pregnancy in patients with acromegaly is currently insufficient. Pregnancy may be associated with an increased risk for both mother and fetus due to the possible growth of the tumor, the development of metabolic complications (diabetes mellitus, arterial hypertension).

This article describes a case of a successful pregnancy in a woman with active acromegaly occurring after somatostatin analogues and cabergoline treatment.

A patient aged 32 with complaints of primary infertility based on additional examination data (increased blood prolactin level, presence of pituitary gland formation according to magnetic resonance imaging of the brain) was diagnosed with prolactin-secreting pituitary microadenoma. At the same time, galactorrhea and menstrual disorders were not noted. Against the background of cabergoline treatment, a pregnancy occurred, which ended with the birth of a full-term healthy child. After delivery, the patient resumed dosing cabergoline 0.5 mg 1 once every two weeks, against the background of which a pronounced decrease in prolactin levels was observed, but there was a progression in the growth of pituitary adenoma (macroadenoma). No acromegaly traits were observed in the patient.

Against the background of withdrawal of cabergoline, the patient underwent a study of tropical pituitary hormones, which revealed an increase in the level of growth hormone and insulin-like growth factor-1. During the oral glucose tolerance test with 75 grams of glucose, the somatotropin-producing activity of the pituitary macroadenoma was confirmed. At the age of 43, the patient underwent transsphenoidal adenomectomy, after which she experienced persistent remission for past 6 years.

The purpose of this work is to focus the attention of practitioners on the manifestation of possible mixed hormonal activity of pituitary microadenomas.

Currently, there is a substantial body of research dedicated to exploring the impact of SARS-CoV-2 on the endocrine system. However, information regarding pathological changes in the hypothalamo-pituitary system in the context of COVID-19 remains limited. Hypophysitis is a general term encompassing various inflammatory conditions affecting the pituitary gland, leading to structural alterations in the hypothalamo-pituitary axis and various levels of hormonal deficiencies in the anterior and/or posterior pituitary.

This paper presents a clinical case of central diabetes insipidus resulting from neurohypophysitis, manifested two months after recovering from the novel coronavirus infection SARS-CoV-2 (COVID-19). Our study contributes to expanding knowledge about a rare but potentially consequential outcome of the novel coronavirus infection, which holds significance given the global prevalence of COVID-19. The unexpected consequences of SARS-CoV-2 infection contribute to maintaining caution among medical professionals and stimulate interest in scientific research.