Основные аспекты регулярного самоконтроля уровня гликемии у пациентов с сахарным диабетом

Петунина Н.А., Гончарова Е.В., Панасенко О.И. Основные аспекты регулярного самоконтроля уровня гликемии у пациентов с сахарным диабетом. CardioСоматика. 2018; 9 (1): 61–66. DOI: 10.26442/2221-7185_2018.1.61-66

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Petunina N.A., Goncharova E.V., Panasenko O.I. Major aspects for constant self-monitoring of the level of glycemia in patients with diabetes. Cardiosomatics. 2018; 9 (1): 61–66. DOI: 10.26442/2221-7185_2018.1.61-66

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Аннотация

Статья посвящена роли самоконтроля уровня гликемии в достижении целей лечения у пациентов с сахарным диабетом. Показана зависимость между компенсацией углеводного обмена и уровнем мотивации обученного пациента по контролю гликемии, обоснована необходимость регулярного самоконтроля гликемии пациентом. Приведены основные методы и средства, используемые для самоконтроля гликемии и дана их характеристика. Обоснована значимость обучения пациентов методам самоконтроля как меры профилактики возникновения осложнений сахарного диабета. Приведены сравнительные данные по распространенности осложнений у пациентов, как не использующих самоконтроль, так и проводящих его. Обучение пациентов правильному контролю гликемии с помощью портативных глюкометров – важный и неотъемлемый компонент терапии сахарного диабета.

Ключевые слова: cахарный диабет, самоконтроль, гликированный гемоглобин.

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The article is devoted to the role of self-monitoring of the level of glycemia in achieving the goals of treatment in patients with diabetes mellitus. The dependence between the compensation of carbohydrate metabolism and the level of motivation of the trained patient for the control of glycemia is shown, the necessity of regular self-monitoring of glycemia by the patient is grounded. The main methods and means used for self-monitoring of glycemia are given and their characteristics are given. The importance of teaching patients to self-control methods as a measure of preventing the occurrence of complications of diabetes mellitus is substantiated. Comparative data on the prevalence of complications in patients, both not using self-monitoring, and conducting it, are given. Teaching patients proper glycemic control with portable glucometers is an important and indispensable component of diabetes therapy.

Key words: diabetes mellitus, self-control, glycated hemoglobin.

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Список литературы

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6. Mudenha ET, Aarella VG, Chandrasekaram S, Fernando DJ. Rising HbA1c in the presence of optimal glycaemic control as assessed by self-monitoring – iron deficiency anaemia. JRSM Open 2016; 7 (2). DOI: 10.1177/2054270415619321
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8. Майоров А.Ю. Самоконтроль метаболических параметров у больных сахарным диабетом на современном этапе. Фарматека. 2006; 17: 69–74. / Maiorov A.Yu. Samokontrol' metabolicheskikh parametrov u bol'nykh sakharnym diabetom na sovremennom etape. Farmateka. 2006; 17: 69–74. [in Russian]
9. Петунина Н.А., Гончарова Е.В., Терехова А.Л. Управление сахарным диабетом. Новая эпоха самоконтроля: выявление тенденций и закономерностей гликемии. Сахарный диабет. 2017; 20 (6): 441–8. / Petunina N.A., Goncharova E.V., Terekhova A.L. Upravlenie sakharnym diabetom. Novaia epokha samokontrolia: vyiavlenie tendentsii i zakonomernostei glikemii. Sakharnyi diabet. 2017; 20 (6): 441–8. [in Russian]
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12. Guerci B et al. Self-monitoring of blood glucose significantly improves metabolic control in patients with type 2 diabetes mellitus: the Auto-Surveillance Intervention Active (ASIA) study. Diabet Metab 2003; 29: 587–94.
13. Karter AJ et al. Longitudinal study of new and prevalent use of self-monitoring of blood glucose. Diabet Care 2006; 29: 1757–63.
14. Davidson PC, Hebblewhite HR, Bode BW et al. Statistically fitted curve for A1c as a function of the SMBG tests per day. Program and abstracts from the 64th Scientific Sessions of the American Diabetes Association. Orlando, Florida, June 4–8 2004. Abstract 430-P.
15. Martin S, Schneider B, Heinemann L et al. Self-monitoring of blood glucose in type 2 diabetes and long-term outcome: an epidemiological cohort study. Diabetologia 2006; 49 (2): 271–8.
16. Cox DJ, Gonder-Frederick L, Ritterband L et al. Prediction of severe hypoglycemia. Diabet Care 2007; 30: 1370–3.
17. Weber C et al. Self-Measurement of Blood Glucose in Patients with Type 2 Diabetes: A Health Economic Assessment. J Diabet Sci Technol 2007; 1 (Is. 5): 676–84.
18. Turner RC, Holman RR. The UK Prospective Diabetes Study. UK Prospective Diabetes Study Group. Ann Med 1996; 28 (5): 439–44. DOI: 10,1056/NEJMoa1006524
19. Бабенко А.Ю., Кононова Ю.А., Циберкин А.И., Ходзицкий М.К. Динамика развития методов контроля гликемии от инвазивных к неинвазивным. Актуальные перспективы. Сахарный диабет. 2016; 19 (5): 397–405. / Babenko A.Yu., Kononova Yu.A., Tsiberkin A.I., Khodzitskii M.K. Dinamika razvitiia metodov kontrolia glikemii ot invazivnykh k neinvazivnym. Aktual'nye perspektivy. Sakharnyi diabet. 2016; 19 (5): 397–405. [in Russian]
20. Попович Л.Д., Шестакова М.В., Потапчик Е.Г. и др. Выгодно ли государству обеспечивать больных сахарным диабетом, находящихся на инсулинотерапии, средствами для проведения самоконтроля уровня глюкозы крови по нормативным потребностям? Сахарный диабет. 2017; 20 (2): 108–18. / Popovich L.D., Shestakova M.V., Potapchik E.G. i dr. Vygodno li gosudarstvu obespechivat' bol'nykh sakharnym diabetom, nakhodiashchikhsia na insulinoterapii, sredstvami dlia provedeniia samokontrolia urovnia gliukozy krovi po normativnym potrebnostiam? Sakharnyi diabet. 2017; 20 (2): 108–18. [in Russian]
21. International Organization for Standardization (ISO). ISO 15197:2013. In vitro diagnostic test systems-requirement s for blood-glucose monitoring systems for self-testing in managing diabetes mellitus. Accessed April 8, 2016.
22. Caswell M et al. Accuracy and User Performance Evaluation of a Blood Glucose Monitoring System. Diabetes Technol Ther 2015; 3: 1–7.

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1. International Diabetes Federation. IDF Diabetes Atlas, 8th edn. Brussels, Belgium: International Diabetes Federation, 2017. http://www.diabetesatlas.org
2. Khamnueva L.Yu., Andreev L.S. Sakharnyi diabet. Epidemiologiia, etiologiia, patogenez, klinika, pozdnie oslozhneniia. Uchebnoe posobie. Irkutsk: IGMU, 2014. [in Russian]
3. Algoritmy spetsializirovannoi meditsinskoi pomoshchi bol'nym sakharnym diabetom. Pod red. I.I.Dedova, M.V.Shestakovoi, A.Yu.Maiorova. Vyp. 8. Sakharnyi diabet. 2017; 20 (1S): 1–112. DOI: 10.14341/DM20171S8 [in Russian]
4. Katz LB, Dirani RG, Li G et al. Automated Glycemic Pattern Analysis Can Improve Health Care Professional Efficiency and Accuracy. J Diabetes Sci Technol 2013; 7 (1): 163–6. DOI: 10,1177/193229681300700120
5. Raine CH, Schrock LE, Edelman SV et al. Significant insulin dose errors may occur if blood glucose results are obtained from miscoded meters. J Diabetes Sci Technol 2007; 1: 205–10.
6. Mudenha ET, Aarella VG, Chandrasekaram S, Fernando DJ. Rising HbA1c in the presence of optimal glycaemic control as assessed by self-monitoring – iron deficiency anaemia. JRSM Open 2016; 7 (2). DOI: 10.1177/2054270415619321
7. American Diabetes Association. Standards of medical care in diabetes – 2016. Glycemic targets. Diabetes Care 2016; 39 (Suppl. 1): 39–46. DOI: 10.2337/dc16-S008
8. Maiorov A.Yu. Samokontrol' metabolicheskikh parametrov u bol'nykh sakharnym diabetom na sovremennom etape. Farmateka. 2006; 17: 69–74. [in Russian]
9. Petunina N.A., Goncharova E.V., Terekhova A.L. Upravlenie sakharnym diabetom. Novaia epokha samokontrolia: vyiavlenie tendentsii i zakonomernostei glikemii. Sakharnyi diabet. 2017; 20 (6): 441–8. [in Russian]
10. Welschen LMC et al. Self-monitoring of blood glucose in patients with type 2 diabetes who are not using insulin: a systematic review. Diabet Care 2005; 28: 1510–7.
11. Sarol JNJr et al. Self-monitoring of blood glucose as part of a multi-component therapy among noninsulin requiring type 2 diabetes patients: a meta-analysis (1966–2004). Curr Med Res Opin 2005; 21: 173–83.
12. Guerci B et al. Self-monitoring of blood glucose significantly improves metabolic control in patients with type 2 diabetes mellitus: the Auto-Surveillance Intervention Active (ASIA) study. Diabet Metab 2003; 29: 587–94.
13. Karter AJ et al. Longitudinal study of new and prevalent use of self-monitoring of blood glucose. Diabet Care 2006; 29: 1757–63.
14. Davidson PC, Hebblewhite HR, Bode BW et al. Statistically fitted curve for A1c as a function of the SMBG tests per day. Program and abstracts from the 64th Scientific Sessions of the American Diabetes Association. Orlando, Florida, June 4–8 2004. Abstract 430-P.
15. Martin S, Schneider B, Heinemann L et al. Self-monitoring of blood glucose in type 2 diabetes and long-term outcome: an epidemiological cohort study. Diabetologia 2006; 49 (2): 271–8.
16. Cox DJ, Gonder-Frederick L, Ritterband L et al. Prediction of severe hypoglycemia. Diabet Care 2007; 30: 1370–3.
17. Weber C et al. Self-Measurement of Blood Glucose in Patients with Type 2 Diabetes: A Health Economic Assessment. J Diabet Sci Technol 2007; 1 (Is. 5): 676–84.
18. Turner RC, Holman RR. The UK Prospective Diabetes Study. UK Prospective Diabetes Study Group. Ann Med 1996; 28 (5): 439–44. DOI: 10,1056/NEJMoa1006524
19. Babenko A.Yu., Kononova Yu.A., Tsiberkin A.I., Khodzitskii M.K. Dinamika razvitiia metodov kontrolia glikemii ot invazivnykh k neinvazivnym. Aktual'nye perspektivy. Sakharnyi diabet. 2016; 19 (5): 397–405. [in Russian]
20. Popovich L.D., Shestakova M.V., Potapchik E.G. i dr. Vygodno li gosudarstvu obespechivat' bol'nykh sakharnym diabetom, nakhodiashchikhsia na insulinoterapii, sredstvami dlia provedeniia samokontrolia urovnia gliukozy krovi po normativnym potrebnostiam? Sakharnyi diabet. 2017; 20 (2): 108–18. [in Russian]
21. International Organization for Standardization (ISO). ISO 15197:2013. In vitro diagnostic test systems-requirement s for blood-glucose monitoring systems for self-testing in managing diabetes mellitus. Accessed April 8, 2016.
22. Caswell M et al. Accuracy and User Performance Evaluation of a Blood Glucose Monitoring System. Diabetes Technol Ther 2015; 3: 1–7.

Авторы

Н.А.Петунина*, Е.В.Гончарова, О.И.Панасенко

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*ksuyhap03@mail.ru

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N.A.Petunina*, E.V.Goncharova, O.I.Panasenko

I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
*ksuyhap03@mail.ru

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