Section 1: Understanding of Diabetes: Modern View
- 1 Epidemiology and prevalence of diabetes:
- Global trends in the prevalence of diabetes 1 and 2 types.
- The influence of geographical, ethnic and socio-economic factors.
- Predictable changes in prevalence in the future.
- Statistics on Russia and other countries.
- 2 Classification of diabetes: updated system:
- Type 1 diabetes: autoimmune destruction of pancreatic β cells.
- Type 2 diabetes: insulin resistance and violation of insulin secretion.
- Gestational diabetes: diabetes that occurs during pregnancy.
- Other specific types of diabetes: Mody (Maturity-Oneset Diabetes of the Young), Lada (Lattoimmune Diabetes in Adults), diabetes caused by drugs or other diseases.
- Advantages and disadvantages of the existing classification.
- 3 Pathophysiology of diabetes: molecular mechanisms:
- The role of insulin in the regulation of glucose metabolism.
- Molecular mechanisms of insulin resistance.
- Violation of the secretion of insulin β-cells of the pancreas.
- The role of other hormones (glucagon, amilin, increetins) in the pathogenesis of diabetes.
- The influence of genetic factors and environmental factors.
- The role of chronic inflammation in the development of insulin resistance and type 2 diabetes.
- Glucozotoxicity and lipotoxicity: mechanisms for damage to β-cells and other organs.
- 4 Diabetes diagnostics: modern criteria and methods:
- Diabetes diagnosis criteria: glucose level in plasma on an empty stomach, glucose level after load, the level of glycated hemoglobin (HBA1C).
- Advantages and disadvantages of various diagnostic methods.
- Diabetes diagnostics algorithms 1 and 2 types.
- Diagnosis of gestational diabetes.
- Identification of persons with a high risk of development of diabetes (pre -Abet).
- Continuous glucose monitoring (CGM): Principles of work, advantages and disadvantages.
- New diagnostic methods: metabolism analysis, genetic testing.
- 5 Diabetes complications: from microsyuded to macro -vascular:
- Micro -vascular complications: retinopathy, nephropathy, neuropathy.
- Macro -vascular complications: coronary heart disease, stroke, peripheral arterial diseases.
- Other complications: diabetic foot, gastroparesis, erectile dysfunction.
- Mechanisms for the development of diabetes complications.
- Risk factors for the development of complications.
- The role of glycemic control in the prevention of complications.
- Modern approaches to the prevention and treatment of complications of diabetes.
Section 2: Traditional approaches to the treatment of diabetes: update and optimization
- 6 Dietotherapy: The basis for the treatment of diabetes:
- An individual approach to diet therapy.
- The role of carbohydrates, fats and proteins in a diet in diabetes.
- Glycemic index and glycemic load of products.
- Mediterranean diet, dash diet and other diets recommended for diabetes.
- The role of dietary fibers.
- Sweeteners and their use in diabetes.
- Modern recommendations for nutrition for diabetes 1 and 2 types.
- Personalized dietary plans based on continuous glucose monitoring.
- 7 Physical activity: an indispensable component of treatment:
- The effect of physical activity on blood glucose and insulin resistance.
- Recommendations on the type and intensity of physical activity.
- An individual approach to physical activity planning.
- Advantages of aerobic and anaerobic exercises.
- The role of physical activity in the prevention of diabetes complications.
- Monitoring of glucose levels during physical activity.
- Recommendations for patients with diabetes complications.
- 8 Medicine therapy: Modern drugs and strategies:
- Insulin therapy: types of insulin, insulin therapy schemes, pompom insulin therapy.
- Long -action basal insulins: Glargin, Detemir, Degludek.
- Bolosal insulins of short and ultra -short action: Lizpr, Aspart, Glulizin, human insulin.
- Mixed insulins.
- The modes of multiple injections of insulin (MDI) and constant subcutaneous insulin infusion (CSII).
- Insulin pumps: advantages, disadvantages and modern models.
- Inhalation insulin.
- Metformin: mechanism of action, indications, contraindications, side effects.
- Derivatives of sulfonylings: mechanism of action, indications, contraindications, side effects.
- Glinides (meglitinides): mechanism of action, indications, contraindications, side effects.
- Thiazolidindo (grocery and ginger): mechanism of action, indications, contraindications, side effects.
- Dipeptidylpeptidase-4 (DPP-4) inhibitors: mechanism of action, readings, contraindications, side effects.
- Glucagono-like peptide-1 (GPP-1) receptors: mechanism of action, readings, contraindications, side effects.
- Exenatide, luraglutide, semaglutide, dulaglutide.
- Advantages of weight loss and cardiovascular risks.
- Inhibitors of sodium-glucose coter carrier 2 (SGLT2): mechanism of action, readings, contraindications, side effects.
- Dapagriflozin, émpagriflozin, kanagriflozin.
- Advantages in reducing cardiovascular and renal risks.
- Combined therapy: rational combinations of drugs.
- An individual approach to the choice of drug therapy.
- Type 2 diabetes treatment algorithms.
- New oral drugs and injection forms.
- Insulin therapy: types of insulin, insulin therapy schemes, pompom insulin therapy.
- 9 Self -control glucose: the key to successful treatment:
- The importance of self -control of the level of glucose in the blood.
- Self -control methods: glucometers, continuous glucose monitoring systems (CGM).
- Interpretation of the results of self -control.
- Adaptation of treatment based on the results of self -control.
- Patient training is self -control.
- Telemedicine and self -control.
- 10 Patient training: Expanding opportunities:
- The importance of teaching patients with diabetes treatment.
- Patient training programs.
- The role of nurses and other specialists in patient training.
- The use of modern technologies (websites, mobile applications) for teaching patients.
- Training of relatives and close patients.
- Psychological support of patients.
Section 3: Innovative approaches to the treatment of diabetes: Revolution in therapy
- 11 Artificial pancreas: automated glucose control:
- The principles of artificial pancreas.
- Components of artificial pancreas: glucose sensor, insulin pump, control algorithm.
- Various types of artificial pancreas: a closed circuit, a hybrid closed circuit.
- Advantages and disadvantages of artificial pancreas.
- Clinical tests of artificial pancreas.
- Prospects for the use of artificial pancreas in patients with type 1 diabetes.
- The use of artificial pancreas in patients with type 2 diabetes.
- Commercially available systems of artificial pancreas.
- 12 Cell therapy: restoration of β cells:
- Transplantation of β-cells of the pancreas: sources of β-cells, transplantation methods, immunosuppression.
- Induction of regeneration of β-cells: the use of growth factors, kinase inhibitors, gene therapy.
- Stem cell transplantation: differentiation of stem cells to β-cells, immune compatibility.
- Immunotherapy of type 1 diabetes: prevention of autoimmune destruction of β-cells.
- Clinical tests of cell therapy.
- Advantages and disadvantages of cell therapy.
- Ethical aspects of cell therapy.
- Prospects for cell therapy in the treatment of type 1 diabetes.
- 13 Gene therapy: modification of genes associated with diabetes:
- General diabetes therapy of type 1: delivery of genes encoding insulin to liver or muscles.
- Genetic therapy of type 2 diabetes: modification of genes involved in the regulation of glucose and insulin resistance metabolism.
- The use of viral vectors for genes delivery.
- CRISPR/CAS9 technology for editing the genome.
- Clinical trials of genetic therapy.
- Advantages and disadvantages of genetic therapy.
- Ethical aspects of genetic therapy.
- Prospects for genetic therapy in the treatment of diabetes.
- 14 Type 1 diabetes immunotherapy: prevention of autoimmune attacks:
- The mechanisms of autoimmune destruction of β-cells in type 1 diabetes.
- Targets for immunotherapy: T cells, B cells, antigen-representative cells.
- Various approaches to immunotherapy: antibodies to immune cells, immunomodulators, cellular immunotherapy.
- Clinical tests of immunotherapy.
- Advantages and disadvantages of immunotherapy.
- Prospects for the use of immunotherapy to prevent the development of type 1 diabetes.
- 15 Microbiota and diabetes: new connection:
- The composition of the intestinal microbiots in patients with diabetes and healthy people.
- The effect of microbiota on glucose metabolism and insulin resistance.
- The mechanisms of the interaction of microbiota and the body of the owner.
- Modulation opportunities microbiota: diet, probiotics, prebiotics, transplantation of fecal microbiota.
- Clinical tests of modulation microbiota.
- The advantages and disadvantages of module microbiota.
- Prospects for the use of microbiotic modulation in the treatment of diabetes.
Section 4: auxiliary and alternative methods of treatment of diabetes
- 16 Traditional medicine and alternative methods:
- The use of medicinal plants and herbs in traditional medicine.
- Ayurveda, traditional Chinese medicine and other systems.
- Acupuncture, yoga and other methods.
- The importance of consulting a doctor before using alternative methods.
- Scientific research of the effectiveness of alternative methods.
- Potential risks and side effects.
- 17 Psychological support and stress management:
- The effect of stress on the level of glucose in the blood.
- Stress management methods: meditation, relaxation, cognitive-behavioral therapy.
- Support groups for patients with diabetes.
- The role of a psychologist in the treatment of diabetes.
- 18 Telemedicine and remote monitoring:
- Advantages of telemedicine for patients with diabetes.
- Remote counseling, glucose level monitoring, patient training.
- The use of mobile applications and websites.
- Integration of telemedicine into the healthcare system.
- The effectiveness of telemedicine in improving glycemic control.
Section 5: Prevention of diabetes and prediabetes
- 19 Type 1 diabetes prevention: Modern research:
- Risk factors for the development of diabetes of type 1.
- Primary prevention studies: prevention of autoimmune destruction of β cells.
- Secondary prevention studies: slowdown in the progression of the autoimmune process.
- Using immunomodulators and other drugs.
- Genetic testing to identify persons with high risk.
- Dietary factors and their role in the prevention of type 1 diabetes.
- 20 Type 2 diabetes prevention: Life change change and medical prevention:
- Risk factors for the development of diabetes of type 2.
- Change in lifestyle: diet, physical activity, weight loss.
- Drug prevention: metformin, akarbose, thiazolidindo.
- Type 2 diabetes prevention programs.
- Assessment of the effectiveness of prevention programs.
- The role of the healthcare system in the prevention of type 2 diabetes.
- Strategies to reduce the prevalence of type 2 diabetes.
- 21 Pre -Abet: Early detection and intervention:
- Criteria for the diagnosis of pre -ibet.
- The value of the early detection of pre -ibet.
- Change in lifestyle with pre -Abet.
- Medication therapy for pre -ABET.
- Diabetes prevention programs in people with pre -Aibet.
- Long -term results of prevention programs.
- 22 Prevention Gestative Diabetes:
- Risk factors for the development of gestational diabetes.
- Screening for gestational diabetes.
- Diet therapy and physical activity in gestational diabetes.
- Insulin therapy for gestational diabetes.
- Prevention of type 2 diabetes after gestational diabetes.
Section 6: Future of treatment of diabetes: prospects and challenges
- 23 Personalized medicine in the treatment of diabetes:
- An individual approach to diagnosis and treatment of diabetes.
- Genetic testing to determine the risk of diabetes and the choice of optimal therapy.
- Pharmacogenomy: the effect of genetic factors on the effectiveness and safety of drugs.
- Analysis of metabolism and proteoma to detect diabetes biomarkers.
- The use of big data and artificial intelligence to develop personalized treatment strategies.
- 24 Nanotechnology in the treatment of diabetes:
- Nanosensers for continuous monitoring of glucose levels.
- Nanoparticles for the delivery of drugs to β-cells of the pancreas.
- Artificial β-based nanomaterials.
- Nanotherapy for the treatment of diabetes complications.
- 25 Artificial intelligence and big data in the treatment of diabetes:
- The use of artificial intelligence to analyze the data of continuous glucose monitoring.
- Development of algorithms for automatic dose correction of insulin.
- The use of large data to identify risk factors for the development of diabetes and develop prevention programs.
- Artificial intelligence for the diagnosis of diabetes and its complications.
- 26 Ethical and social aspects of new methods of treatment of diabetes:
- The availability of new treatment methods for all patients.
- Confidentiality of genetic information.
- Ethical issues related to genetic therapy and cell therapy.
- The influence of new technologies on the relationship between the doctor and the patient.
- 27 The role of the state and the healthcare system in the development of new methods of treatment of diabetes:
- Financing of scientific research.
- Regulation of new treatment methods.
- Integration of new technologies into the healthcare system.
- Education of medical workers with new treatment methods.
- Information of the population about new treatment methods.
Section 7: Complications of diabetes: advanced management and treatment methods
- 28 Diabetic retinopathy: modern approaches to treatment:
- Pathogenesis of diabetic retinopathy.
- Classification of diabetic retinopathy.
- Methods of diagnosis of diabetic retinopathy: ophthalmoscopy, fluorescent angiography, optical coherent tomography (OKT).
- Laser coagulation of the retina.
- Intravitreal injections of VEGF inhibitors (vascular endothelial growth factor).
- Ranumab, Afshebizumab, Bevatumab.
- Surgical treatment: vitrectomy.
- New treatment methods: gene therapy, cell therapy.
- Prevention of diabetic retinopathy: monitoring the level of glucose in the blood, blood pressure and lipids.
- 29 Diabetic nephropathy: advanced methods of treatment and prevention:
- Pathogenesis of diabetic nephropathy.
- Stages of diabetic nephropathy.
- Methods of diagnosis of diabetic nephropathy: urine analysis for microalbuminuria, determining the speed of glomerular filtration (SCF), kidney biopsy.
- ACE inhibitors (angiotenzinzinoping enzyme) and Angiotensin II receptor blockers (sconces).
- SGLT2 inhibitors: kidney protection in diabetes.
- Control of blood pressure.
- Diet therapy: restriction of protein and salt consumption.
- Placement of renal therapy: hemodialysis, peritoneal dialysis, kidney transplantation.
- New treatment methods: antifibrose drugs, cell therapy.
- Prevention of diabetic nephropathy: monitoring the level of glucose in the blood, blood pressure and lipids, early detection and treatment.
- 30 Diabetic neuropathy: modern approaches to treatment:
- Pathogenesis of diabetic neuropathy.
- Classification of diabetic neuropathy: peripheral, autonomous, focal.
- Symptoms of diabetic neuropathy: pain, numbness, tingling, weakness, digestive disorders, orthostatic hypotension, erectile dysfunction.
- Methods of diagnosis of diabetic neuropathy: neurological examination, electroneuromyography (ENMG), quantitative sensory testing (KST).
- Monitoring the level of glucose in the blood.
- Medicines for the treatment of pain neuropathy: antidepressants (amitriptyin, dulcesetin), anticonvulsants (Gabapentin, Pregabalin), opioid analgesics (tramadol).
- Local treatment of pain neuropathy: capsaicin, lidocaine.
- Treatment of autonomous neuropathy: diet correction, drugs for the treatment of gastroparesis, orthostatic hypotension and erectile dysfunction.
- New treatment methods: gene therapy, cell therapy.
- Physiotherapy and rehabilitation.
- 31 Diabetic foot: an integrated approach to treatment and prevention:
- Risk factors for the development of diabetic foot: neuropathy, angiopathy, foot deformation, injury, infection.
- Classification of lesions of the diabetic foot: neuropathic ulcer, ischemic ulcer, neuroichemic ulcer.
- Diabetic foot diagnostic methods: examination of the foot, sensitivity assessment, determination of pulsation of arteries, ankle-breed index (LPI), transcetic oxymmetry (TSRO2), angiography.
- Care for the feet: regular inspection, washing, moisturizing, circumcision of nails, wearing suitable shoes.
- Unloading of the affected limb: the use of orthosis, crutches, wheelchair.
- Surgical treatment: removal of necrotic tissues, abscess drainage, revascularization (angioplasty, shunting).
- Antibiotic therapy for infections.
- Local treatment of ulcers: cleaning wounds, using modern wound coatings, healing stimulation.
- Reconstructive operations to correct the deformation of the foot.
- Prevention of diabetic foot: patient training, regular examination of the feet, wearing suitable shoes, control of blood glucose, and smoking refusal.
- 32 Cardiovascular diseases in diabetes: Modern strategies for treatment and prevention:
- Increased risk of cardiovascular diseases in patients with diabetes.
- Pathogenesis of cardiovascular diseases in diabetes.
- Risk factors for cardiovascular diseases: dyslipidemia, arterial hypertension, obesity, smoking, family history.
- Screening for cardiovascular diseases: electrocardiogram (ECG), echocardiography, stress test, coronary angiography.
- Change in lifestyle: diet, physical activity, rejection of smoking.
- Drug therapy: anti-agents (aspirin, clopidogrel), statins, ACE inhibitors, angiotensin II receptors, beta-blockers, SGLT2 inhibitors, GPP-1 agonists.
- Myocardium revascularization: angioplasty, shunting.
- Treatment of heart failure.
- Prevention of cardiovascular diseases: monitoring the level of glucose in the blood, blood pressure and lipids, refusal of smoking, a healthy lifestyle.
Section 8: Special groups of patients with diabetes
- 33 Diabetes in children and adolescents: unique problems and solutions:
- Features of the diagnosis and treatment of diabetes in children and adolescents.
- Type 1 diabetes in children and adolescents: insulin therapy, pompom insulin therapy, self -control of the level of blood glucose, diet, physical activity, psychological support.
- Type 2 diabetes in children and adolescents: risk factors, lifestyle changes, metformin, insulin therapy.
- Gestational diabetes in adolescents: Features of pregnancy.
- The transition from children’s to adult healthcare.
- Psychosocial aspects of diabetes in children and adolescents: stigmatization, depression, anxiety.
- The role of the family in the treatment of diabetes in children and adolescents.
- Using modern technologies: continuous glucose monitoring, insulin pumps with a closed contour.
- Prevention of diabetes complications.
- 34 Diabetes in the elderly: special approaches to treatment:
- Features of diagnosis and treatment of diabetes in the elderly.
- The goals of glycemic control in the elderly: reducing the risk of hypoglycemia, improving the quality of life.
- The choice of drugs in the elderly: accounting for concomitant diseases and drug interactions.
- Diet therapy and physical activity in older people: individual approach, accounting of physical restrictions.
- Assessment of cognitive functions and functional status.
- Prevention of falls and injuries.
- Treatment of diabetes complications.
- The role of home departure and social support.
- Palliative assistance in the terminal stages of diabetes.
- 35 Diabetes and pregnancy: Optimal management for the health of the mother and child:
- Pregnancy planning in women with diabetes.
- Proofing preparation: control of the level of glucose in the blood, blood pressure and lipids, rejection of smoking and alcohol, intake of folic acid.
- Pregnancy in type 1 diabetes: insulin therapy, self -control of the level of glucose in the blood, diet, physical activity, monitoring of the condition of the fetus.
- Pregnancy in type 2 diabetes: metformin, insulin therapy, self -control of the level of glucose in the blood, diet, physical activity, monitoring of the condition of the fetus.
- Gestational diabetes: diagnosis, diet therapy, physical activity, insulin therapy, monitoring of the condition of the fetus.
- Childbirth in women with diabetes: the choice of the method of delivery, monitoring the level of glucose in the blood during childbirth, monitoring the state of the newborn.
- The postpartum period: control of the level of glucose in the blood, return to the previous therapy, breastfeeding, prevention of type 2 diabetes.
- Complications of pregnancy in diabetes: preeclampsia, premature birth, fetal macrosomia, shoulder dystos, neonatal hypoglycemia.
- 36 Diabetes and mental disorders: an integrated approach to treatment:
- The increased prevalence of mental disorders in patients with diabetes: depression, anxiety, eating disorders.
- The influence of mental disorders on the control of the level of glucose in the blood and commitment to treatment.
- Methods of diagnosing mental disorders in patients with diabetes: screening, clinical interview.
- Treatment of depression and anxiety: psychotherapy, antidepressants, anxiolytics.
- Treatment of eating disorders: psychotherapy, diet therapy, drug therapy.
- Psychological support and training of patients.
- An integrated approach to the treatment of diabetes and mental disorders: cooperation between an endocrinologist, psychiatrist and psychologist.
- 37 Diabetes and HIV infection: joint management:
- Increased prevalence of diabetes in patients with HIV infection.
- The effect of antiretroviral therapy on glucose metabolism.
- Features of diagnosis and treatment of diabetes in patients with HIV infection.
- Drug interactions between drugs for the treatment of diabetes and HIV infection.
- Prevention of diabetes in patients with HIV infection: change in lifestyle, screening for diabetes.
- Joint conducting patients with diabetes and HIV infection: cooperation between an endocrinologist and infectious disease specialist.
Section 9: Research and the Future of Diabetology
- 38 New targets for the treatment of diabetes:
- The study of new molecular targets for the development of drugs.
- The role of inflammation in the pathogenesis of diabetes.
- The effect of intestinal microbiots on glucose metabolism.
- The study of genetic factors affecting the development of diabetes.
- Development of new drugs to improve insulin secretion, increase insulin sensitivity and reduce blood glucose.
- 39 Clinical tests of new methods of diabetes:
- Review of current clinical tests of new methods of treatment of diabetes.
- Testing of new drugs, devices and technologies.
- The results of clinical trials and their impact on clinical practice.
- Patients of patients in clinical trials: advantages and risks.
- 40 Trends and forecasts in the treatment of diabetes:
- The development of personalized medicine in the treatment of diabetes.
- The use of artificial intelligence and large data to improve glycemic control.
- Development of new insulin delivery methods.
- Cellular and genetic therapy of diabetes.
- Prevention of diabetes and its complications.
- Improving the quality of life of patients with diabetes.
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