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Patients with types I and II diabetes mellitus without the clinical signs of nephroangiopathy were subjected to a comprehensive study of renal function. Using the method for determination of endogenous creatinine clearance (140 patients), radionuclide methods (in 350 patients) and beta-2-microtest (in 130 patients) the impairment of renal filtration function was established in 30.8, 67.6 and in 52% of the patients, respectively. In 16.3% of the patients, there was an impairment of the proximal part of the canaliculi. The determination of proteinuria selectivity in polyacrylamide gel revealed latent proteinuria in 70% of the patients and enabled one to specify the spectrum of uroproteins. The informative value of the methods suggested was supported by the results of morphologic studies of biopsy specimens of the kidneys and skin. The importance of the specification of the preclinical stage of diabetic nephroangiopathy was determined by the possibility of the reverse development of the pathological alterations at the given stage. The authors describe the experience gained with the correction of functional disorders by means of programmed administration of insulin using the apparatus Biostator, application of diamicron and angioprotectors.

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The paper is concerned with the assessment of glipizide action in 32 patients aged 34 to 68 suffering from diabetes mellitus with decompensation of metabolic processes. Good tolerance of the drug, its positive hypoglycemic action enhanced by its combined use with acetylsalicylic acid were noted. No convincing proofs of glipizide influence on microcirculatory indices were obtained. In comparing its hemorheological action with other sulfanilurea drugs of the 2nd generation a similar effect of glipizide with manilin as monotherapy was revealed, on the one hand, and, on the other hand, similar action of glipizide with acetylsalicylic acid and diamicron was noted.

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A total of 43 patients aged 16-62 with moderately severe and severe type I diabetes mellitus of 2-27 years duration were observed. The patients were admitted to hospital with decompensation of metabolic processes. In order to achieve compensation monocomponent insulins were administered in an individual dose depending on the levels of glycemia and glucosuria and a scheme of drug administration (2 times continuously, i.v. using the Biostator apparatus). The duration of therapy was 4 months. A hypoglycemic effect in relation to immunological and hemorheological indices was assessed. A hypoglycemic effect was noted in all the patients. A positive effect of high-purity insulins on immunological and hemorheological indices was revealed. These insulins can be used for prevention of diabetic angiopathies.

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Altogether 100 patients with insulin-dependent diabetes mellitus of a labile course were treated using the Biostator unit (artificial pancreas). The control group (20 persons) was treated with divided doses of insulin within a day. A study was made of glycemia, the range of its deviations, daily glucosuria, diuresis, the basal level of C-peptide and glucagon in the study and control groups prior to and after treatment. Statistically significant improvement of the values in the study group was observed, that, in the authors' opinion, can be attributed to the improvement of insulin-glucagon ratio at the expense fo an increase in the basal secretion of C-peptide as a result of the use of the artificial pancreas.

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The authors present for the first time their results concerned with the determination of selective proteinurea by disc electrophoresis in polyacrylamide gel in patients with insulin-dependent and insulin-independent diabetes mellitus with and without the clinical signs of kidney affection. A study was made of the uroproteinograms of these patients before and after the correction of carbohydrate metabolism by means of programmed insulin administration. A conclusion was made of a possibility to use the above method for early detection of diabetic nephropathies. Programmed insulin administration using the Biostator apparatus was shown to improve tubuloglomerular functions, that was expressed in the lowering of proteinurea and in some cases in the improving of the qualitative composition of uroproteins.

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The clinicofunctional characteristics of the kidneys were estimated, biopsy of the kidney and skin with an immunohistochemical study was performed and some immunity values considered in 17 patients with type I diabetes mellitus. The study was performed with respect to the degree of expression of the clinical signs of nephropathy including the preclinical stage, too. Three types of morphological changes in the kidney and skin were singled out. Initial tubuloglomerular disorders occurred at the preclinical stage of nephroangiopathy. The nature of changes in the skin coincided mostly with changes in the kidney lagging behind in some cases. The results confirmed the leading role of metabolic derangements in the genesis of microangiopathies and a necessity of a good compensation of diabetes for its prevention. The immunohistochemical and immunological findings did not make it possible to exclude the immune mechanisms in the development of diabetic nephroangiopathy.

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