[Changes of gustatory perception in elderly patients with type II sugar diabetes. Surgical section].

In 73 elderly patients with type II sugar diabetes there were found changes of gustatory perception of sweet that were most pronounced on primary stage of the disease and that can be considered as manifestation of diabetic neuropathy of oral cavity organs and tissues.

[The histo- and ultrastructural characteristics of the myocardium and vascular wall in patients with type 2 diabetes mellitus].

The histo- and ultrastructural characteristics ofmyocardial and vascular lesions were studied in 27 patients (15 males and 12 females) with type 2 diabetes mellitus (DM), coronary heart disease (CHD), and atherosclerosis obliterans of lower extremity vessels. The lifetime endomyocardial biopsy specimens, intraoperative leg arterial biopsy specimens taken from intact tissues during leg amputation and поп-infarction areas of the left ventricular myocardium, autoptically taken from 32 patients who had died from complications due to atherosclerosis were examined. Myocardial ultrastructural derangement in type 2 DM was found to primarily affect the structures responsible for the energy and plastic metabolism in the cardiomyocytes. Moreover, the most pronounced functional changes were associated with cardiac diastolic function. The morphological pattern of damage to endotheliocytes, working cells of the myocardium and the ultrastructural organization of microvessels in patients with type 2 DM are directly related to the severity of hormone metabolic disorders, hyperinsulinemia and hyperglycemia in particular. The changes found in the microcirculatory system in type 2 DM were pronounced to the extent that the presence of coronary artery stenoses aggravated the typical changes in the architectonics and cardiomyocytic functions no longer.

[Evaluation of glucose utilization in patients with insulin-independent diabetes mellitus by using breathing test]. / Kharakteristika utilizatsii gliukozy s pomoshch'iu 13C-neinvazibvnogo dykhatel'nogo testa pri insulinnezavisimom sakharnom diabete.

Commonly used clinical and biochemical parameters, such as the content of glucose, insulin, somatotropic hormone, triglycerides, lactate, pyruvate, and free fatty acids (FFA) in blood of practically healthy subjects and in patients with insulin-independent diabetes mellitus (IIDM), were compared with the parameters obtained by mass-spectrometric analysis of 13CO2 in expired air after 13C-glucose loading. It was shown that, as opposed to healthy subjects, the content of blood glucose and free fatty acids in patients with IIDM increased, the level of glucose dropped in progression upon short-term fasting, and the concentration of lactate changed both upon fasting and after the administration of small test doses of glucose. The use of the 13C-glucose breathing test (13C-GBT), which presupposes the loading of safe small doses of glucose enriched in 13C-isotope permitted one to reveal a number of novel quantitative diagnostic criteria for the evaluation of glucose metabolism in patients with IIDM: a decrease in the rate of 13C withdrawal as a constituent of expired carbon dioxide after the administration of 13C-glucose; a reduction in the amount of exogenous glucose metabolized to carbon dioxide; and increased oxidation of endogenous substrates participating in carbon dioxide formation. Small glucose loads proposed by the authors in 13C-GBT are safe for patients with diabetes mellitus and have no effect on the level of blood glucose in healthy persons. The parameters determined by noninvasive 13C-GBT are more sensitive for diagnosis than commonly used biochemical characteristics of blood in patients with IIDM. The diagnostic criteria obtained allow the prediction of the maximum prohibited glucose loading for every patient.

[Intersensory correlations in diabetic neuropathy during adaptation to intervalic normobaric hypoxia]. / Mezhsensornye vzaimootnosheniia pri diabeticheskoi neiropatii v protsesse adaptatsii k interval'noi normobaricheskoi gipoksii.

The state of vibration sensitivity and of gustatory perception as well as the influence of interval hypoxic training on these indices were estimated in 21 patients with insulin-independent diabetes mellitus (IIDM) without neuropathic manifestations, in 21 analogous patients with neuropathic manifestations and in 16 individuals with neuropathies of nondiabetic genesis. The improvement of indices studied was observed in patients with neuropathies. Interval hypoxic training may be recommended for the treatment of distal neuropathies including the patients with IIDM in the state of compensation.

[Taste perception in children with diabetes mellitus]. / Osobennosti vkusovogo vocpriiatiia u detei pri sakharnom diabete.

Gustatory perception was studied in 10 children aged 8 to 15 suffering from medium-severe diabetes mellitus by the functional mobility method. Glycemia values and the level of mobilization of gustatory lingual papillae were high when the patients were admitted; the characteristic reverse proportional relationship between these values, observed in healthy children, was absent. A course of therapy resulted in reduction of glycemia level, but the level of mobilization of gustatory papillae on an empty stomach was unchanged, the gastro-lingual reflex did not recover. The defected dissociation between glycemia values and the level of mobilization of the gustatory receptor system may be an extra for the diagnosis of diabetes severity and treatment efficacy.