Предотвращение развития гипогликемии: современные возможности

Доскина Е.В., Танхилевич Б.М. Предотвращение развития гипогликемии: современные возможности. CardioСоматика. 2019; 10 (3): 65–70. DOI: 10.26442/22217185.2019.3.190501

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Doskina E.V., Tankhilevich B.M. Hypoglycemia Prevention: Current Opportunities. Cardiosomatics. 2019; 10 (3): 65–70. DOI: 10.26442/22217185.2019.3.190501

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Аннотация

В России, так же как и во всем мире, отмечается постоянное увеличение распространенности сахарного диабета (СД). Российская Федерация входит в топ 10 стран с самым высоким числом взрослого населения, больного СД. Частота развития гипогликемических состояний остается крайне высокой, несмотря на доступные методы самоконтроля гликемии и большое разнообразие сахароснижающих препаратов. Так, по данным таких исследований, как URPDS, ACCJRD, VADT, ADVANCE, частота гипогликемических состояний составляла от 0,7 до 16% в зависимости от вида терапии. Независимо от тяжести гипогликемии они приводят к снижению качества жизни больных, увеличению массы тела, развитию когнитивного дефицита и/или деменции, судорожного синдрома, сердечно-сосудистых катастроф, увеличивают частоту госпитализаций и затраты на лечение СД, а также способствуют увеличению риска травматизма. Важным инструментом в управлении СД является самоконтроль гликемии. Современные глюкометры должны отвечать потребностям пациента – быть информативными, точными, удобными в использовании. Для своевременного выявления гипогликемии большое значение имеет точность глюкометра.

Ключевые слова: сахарный диабет, гипогликемия, самоконтроль, глюкометр, глюкометр Контур Плюс Уан.

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In Russia, as well as throughout the world, there is a constant increase in the prevalence of diabetes mellitus. The Russian Federation is in the top 10 countries with the highest number of adults with diabetes. The incidence of hypoglycemic conditions remains extremely high, despite the available methods of self-control of glycemia and a wide variety of sugar-lowering drugs. So, according to studies such as URPDS, ACCJRD, VADT, ADVANCE, the frequency of hypoglycemic conditions ranged from 0.7 to 16%, depending on the type of therapy. Regardless of the severity of hypoglycemia, they lead to a decrease in the quality of life of patients, weight gain, the development of cognitive deficits and/or dementia, convulsive syndrome, cardiovascular catastrophes, increase the frequency of hospitalizations and the costs of treating diabetes, and also increase the risk of injury. The main tool in managing diabetes is self-monitoring of glycemia. Modern blood glucose meters must meet the needs of the patient – to be informative, accurate, convenient to use. For the timely detection of hypoglycemia, the accuracy of the glucometer is of great importance.

Key words: diabetes mellitus, hypoglycemia, self-monitoring, glucometer, glucose meter Contour Plus One.

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Список литературы

1. Атлас диабета IDF (7-е изд.). 2015. https://www.idf.org/e-library/epidemiology-research/diabetes-atlas
[Atlas diabeta IDF (7-e izd.). 2015. https://www.idf.org/e-library/epidemiology-research/diabetes-atlas (in Russian).]
2. UK Prospective Diabetes Study Group (UKPDS). Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes. Lancet 1998, 352 (9131): 837–53.
3. Cavalot F, Pagliarino A, Valle M et al. Postprandial blood glucose predicts cardiovascular events and all-cause mortality in type 2 diabetes in a 14-year follow-up: lessons from the San Luigi Gonzaga Diabetes Study. Diabetes Care 2011; 34: 2237–43.
4. Coutinho M, Gerstein HC, Wang Y, Yusuf S. The relationship between glucose and incident cardiovascular events. A meta-regression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. Diabetes Care 1999; 22: 233–40.
5. Guerci B, Drouin P, Grange V et al. Self-monitoring of blood glucose significantly improvesтmetabolic control in patients with type 2 diabetes mellitus: the Auto-Surveillance Intervention Active (ASIA) study. Diabet Metab 2003; 29: 587–94.
6. Jansen JP. Self-monitoring of glucose in type 2 diabetes mellitus: a Bayesian meta-analysis of direct and indirect comparisons. Curr Med Res Opin 2006; 22: 671–81.
7. 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: 271–8.
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[Maiorov A.Iu., Mel'nikova O.G., Filippov Iu.I. Samokontrol' glikemii – neot"emlemyi komponent lecheniia sakharnogo diabeta. Med. sovet. 2013, 1: 90–7 (in Russian).]
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12. Action to Control Cardiovascular Risk in Diabetes Study Group. Rationale and design for the blood pressure intervention. Am J Cardiol 2007; 99 (Suppl.): 44–55.
13. Клинические рекомендации «Алгоритмы специализированной медицинской помощи больным сахарным диабетом». Под ред. И.И.Дедова, М.В.Шестаковой, А.Ю.Майорова. 9-й вып. М., 2019.
[Clinical recommendations "Algorithms of specialized medical care for patients with diabetes mellitus". Pod red. I.I.Dedova, M.V.Shestakovoi, A.Iu.Maiorova. 9-i vyp. Moscow, 2019 (in Russian).]
14. Desouza CV, Bolli GB, Fonseca V. Hypoglycemia, diabetes, and cardiovascular events. Diabet Care 2010; 33: 1389–94.
15. Cryer PE. Severe hypoglycemia predicts mortality in diabetes. Diabet Care 2012; 35: 1814–6.
16. Zoungas S, Patel A, Chalmers J et al. Heller Severe hypoglycemia and risks of vascular events and death. N Engl J Med 2010; 363: 1410–8.
17. Holstein A, Patzer OM, Machalke K et al. Substantial increase in incidence of severe hypoglycemia between 1997–2000 and 2007–2010. A German longitudinal population-based study. Diabet Care 2012; 35 (5): 972–5.
18. Bremer JP, Jauch-Chara K, Hallschmid M et al. Hypoglycemia unawareness in older compared with middle-aged patients with type 2 diabetes. Diabet Care 2009; 32: 1513–7.
19. Brierley EJ, Broughton DL, James OF, Alberti KG. Reduced awareness of hypoglycaemia in the elderly despite an intact counter-regulatory response. QJM 1995; 88: 439–45.
20. Desouza CV, Bolli GB, Fonseca V. Hypoglycemia, diabetes, and cardiovascular events. Diabet Care 2010; 33: 1389–94.
21. Veterans Affairs Diabetes Trial Study Group. Ethnicity, race, and clinically significant macular edema. Diabetes Res Clin Pract 2009; 86 (2): 104–10.
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23. Dunne N et al. Accuracy Evaluation of CONTOUR PLUS Compared With Four Blood Glucose Monitoring Systems, Diabetes Ther 2015; 6: 377–88.

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1. Atlas diabeta IDF (7-e izd.). 2015. https://www.idf.org/e-library/epidemiology-research/diabetes-atlas (in Russian).
2. UK Prospective Diabetes Study Group (UKPDS). Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes. Lancet 1998, 352 (9131): 837–53.
3. Cavalot F, Pagliarino A, Valle M et al. Postprandial blood glucose predicts cardiovascular events and all-cause mortality in type 2 diabetes in a 14-year follow-up: lessons from the San Luigi Gonzaga Diabetes Study. Diabetes Care 2011; 34: 2237–43.
4. Coutinho M, Gerstein HC, Wang Y, Yusuf S. The relationship between glucose and incident cardiovascular events. A meta-regression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. Diabetes Care 1999; 22: 233–40.
5. Guerci B, Drouin P, Grange V et al. Self-monitoring of blood glucose significantly improvesтmetabolic control in patients with type 2 diabetes mellitus: the Auto-Surveillance Intervention Active (ASIA) study. Diabet Metab 2003; 29: 587–94.
6. Jansen JP. Self-monitoring of glucose in type 2 diabetes mellitus: a Bayesian meta-analysis of direct and indirect comparisons. Curr Med Res Opin 2006; 22: 671–81.
7. 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: 271–8.
8. Muchmore DB, Springer J, Miller M. Self-monitoring of blood glucose in overweight type 2 diabetic patients. Acta Diabetol 1994; 31: 215–9.
9. Sarol JN, Nicodemus NA, Tan KM, Grava MB. Self-monitoring of blood glucose as part of a multi-component therapy among non-insulin requiring type 2 diabetes patients: a meta-analysis (1966–2004). Curr Med Res Opin 2005; 21: 173–84.
10. Maiorov A.Iu., Mel'nikova O.G., Filippov Iu.I. Samokontrol' glikemii – neot"emlemyi komponent lecheniia sakharnogo diabeta. Med. sovet. 2013, 1: 90–7 (in Russian).
11. Veterans Affairs Diabetes Trial Study Group. Ethnicity, race, and clinically significant macular edema. Diabetes Res Clin Pract 2009; 86 (2): 104–10.
12. Action to Control Cardiovascular Risk in Diabetes Study Group. Rationale and design for the blood pressure intervention. Am J Cardiol 2007; 99 (Suppl.): 44–55.
13. Clinical recommendations "Algorithms of specialized medical care for patients with diabetes mellitus". Pod red. I.I.Dedova, M.V.Shestakovoi, A.Iu.Maiorova. 9-i vyp. Moscow, 2019 (in Russian).
14. Desouza CV, Bolli GB, Fonseca V. Hypoglycemia, diabetes, and cardiovascular events. Diabet Care 2010; 33: 1389–94.
15. Cryer PE. Severe hypoglycemia predicts mortality in diabetes. Diabet Care 2012; 35: 1814–6.
16. Zoungas S, Patel A, Chalmers J et al. Heller Severe hypoglycemia and risks of vascular events and death. N Engl J Med 2010; 363: 1410–8.
17. Holstein A, Patzer OM, Machalke K et al. Substantial increase in incidence of severe hypoglycemia between 1997–2000 and 2007–2010. A German longitudinal population-based study. Diabet Care 2012; 35 (5): 972–5.
18. Bremer JP, Jauch-Chara K, Hallschmid M et al. Hypoglycemia unawareness in older compared with middle-aged patients with type 2 diabetes. Diabet Care 2009; 32: 1513–7.
19. Brierley EJ, Broughton DL, James OF, Alberti KG. Reduced awareness of hypoglycaemia in the elderly despite an intact counter-regulatory response. QJM 1995; 88: 439–45.
20. Desouza CV, Bolli GB, Fonseca V. Hypoglycemia, diabetes, and cardiovascular events. Diabet Care 2010; 33: 1389–94.
21. Veterans Affairs Diabetes Trial Study Group. Ethnicity, race, and clinically significant macular edema. Diabetes Res Clin Pract 2009; 86 (2): 104–10.
22. Contour Plus. User's manual. Bayer, 2013. (in Russian).
23. Dunne N et al. Accuracy Evaluation of CONTOUR PLUS Compared With Four Blood Glucose Monitoring Systems, Diabetes Ther 2015; 6: 377–88.

Авторы

Е.В. Доскина*1, Б.М. Танхилевич2

1 ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия;
2 ГБУЗ «Городская клиническая больница им. С.П. Боткина» Департамента здравоохранения г. Москвы
*Evd-evd2008@yandex.ru

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Elena V. Doskina*1, Boris M. Tankhilevich2

1 Russian Medical Academy of Continuous Professional Education, Moscow, Russia;
2 Botkin City Clinical Hospital
*Evd-evd2008@yandex.ru

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