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Модификация образа жизни, обучение и самоконтроль – важные компоненты лечения сахарного диабета и улучшения качества жизни пациентов
Модификация образа жизни, обучение и самоконтроль – важные компоненты лечения сахарного диабета и улучшения качества жизни пациентов
Волкова Е.А., Ворохобина Н.В., Малыгина О.Ф. Модификация образа жизни, обучение и самоконтроль – важные компоненты лечения сахарного диабета и улучшения качества жизни пациентов. Consilium Medicum. 2015; 1: 54–62. DOI: 10.26442/2075-1753_2015.1.54-62
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Аннотация
В статье рассматриваются проблемы модификации образа жизни пациентов с сахарным диабетом (СД), связь СД типа 2 и сердечно-сосудистых заболеваний , причины неудовлетворительной комплаентности многих пациентов с диабетом в отношении изменений образа жизни и рекомендуемого медикаментозного лечения. Обсуждается роль медицинских работников в лечении больных, значение структурированных обучающих программ по лечению СД типа 2. Подчеркиваются необходимость образования пациентов в школах больных СД, важное значение самоконтроля и индивидуального подхода специалистов к каждому пациенту с целью улучшения качества его жизни.
Ключевые слова: сахарный диабет, образ жизни, структурированные программы , факторы риска, сердечно-сосудистые заболевания, индивидуализация лечения, диетотерапия, физическая активность, самоконтроль.
Ключевые слова: сахарный диабет, образ жизни, структурированные программы , факторы риска, сердечно-сосудистые заболевания, индивидуализация лечения, диетотерапия, физическая активность, самоконтроль.
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The article deals with the problem of lifestyle modification in patients with diabetes mellitus, the connection between type 2 diabetes and cardiovascular disease, the causes of unsatisfactory noncompliance many patients with diabetes with regard to lifestyle changes and recommended medical treatment. The role of health professionals in the treatment of patients, the value of structured training programs for the treatment of type 2 diabetes patients is emphasized the need for education in schools diabetic patients, the importance of self-control and an individual approach to each patient specialists to improve the quality of life.
Key words: diabetes mellitus, lifestyle, structured programs, risk factors, cardiovascular disease, individualization of treatment, diet, physical activity, self-control.
Key words: diabetes mellitus, lifestyle, structured programs, risk factors, cardiovascular disease, individualization of treatment, diet, physical activity, self-control.
Полный текст
Список литературы
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17. Persson L, Hjalmarson A. Smoking cessation in patients with diabetes mellitus: results from a controlled study of an intervention programme in primary healthcare in Sweden. Scand J Prim Health Care 2006; 24 (2): 75–80.
18. Lloyd C, Hill J, Wallace C. The Psychology of Type 2 Diabetes. www.medscape.org/viewarticle/824061?src=wnl_cme_revw
19. Thomas DE, Elliott EJ, Naughton GA. Exercise for type 2 diabetes mellitus (Cochrane Review). In: The Cochrane Library, Issue 3, 2006. London: John Wiley & Sons Ltd.
20. Hill-Briggs F, Gemmell L. Problem solving in diabetes selfmanagement and control: a systematic review of the literature. Diabetes Educ 2007; 33 (6): 1032–50.
21. Cefalu WT. Diabetes Care to date: «the hits just keep on coming!» Diabetes Care 2013; 36: 1801–3.
22. Мartin S et al. ROSSO study. Diabetologia 2006; 49: 271–8.
23. Гарбузова М.А. Сахарный диабет и риски развития диабетической нефропатии. Справ. поликлин. врача. 2014; 3: 16–20. / Garbuzova M.A. Sakharnyi diabet i riski razvitiia diabeticheskoi nefropatii. Sprav. poliklin. vracha. 2014; 3: 16–20. [in Russian]
24. Черникова Н.А. Роль самостоятельного мониторирования гликемии в комплексном управлении сахарным диабетом типа 2. Consilium Medicum. 2014; 16 (1): 68–72. / Chernikova N.A. Rol' samostoiatel'nogo monitorirovaniia glikemii v kompleksnom upravlenii sakharnym diabetom tipa 2. Consilium Medicum. 2014; 16 (1): 68–72. [in Russian]
25. Редькин Ю.А., Богомолов В.В., Древаль А.В. Влияние различных факторов на эффективность самоконтроля при сахарном диабете. Consilium Medicum. 2011; 12: 54–7. / Red'kin Iu.A., Bogomolov V.V., Dreval' A.V. Vliianie razlichnykh faktorov na effektivnost' samokontrolia pri sakharnom diabete. Consilium Medicum. 2011; 12: 54–7. [in Russian]
26. Raine CH 3rd. Self-monitored blood glucose: a common pitfall. Endocr Pract 2003; 9 (9): 137–9.
27. Kristensen GB, Nerhus K, Thue G, Sandberg S. Standardized evaluation of instruments for self-monitoring of blood glucose by patients and a technologist. Clin Chem 2004; 50: 1068–71.
2. Dedov I.I. Sakharnyi diabet: razvitie tekhnologii v diagnostike, lechenii i profilaktike. Sakharnyi diabet. 2010; 3: 6–13. [in Russian]
3. Endokrinologiia. Rukovodstvo dlia vrachei. V 2 t. T. 2 Glava 1. Zabolevaniia ostrovkovogo apparata podzheludochnoi zhelezy. Pod red. S.B.Shustova. SPb.: SpetsLit, 2011; s. 45. [in Russian]
4. Alberti G, Zimmet P, Shaw J et al. Type 2 diabetes in the young: the evolving epidemic: the international diabetes federation consensus workshop. Diabetes Care 2004; 27: 1798–811.
5. Wilmot E, Idris I. Early Onset Type 2 Diabetes: Risk Factors, Clinical Impact and Management. Ther Adv Chronic Dis 2014; 5 (6): 234–44.
6. Twenty-First Century Behavioral Medicine: A Context for Empowering Clinicians and Patients With Diabetes: A consensus report. Diabetes Care 2013; 36: 463–70.
7. Podachnina C.V. Samokontrol' kak metod lecheniia sakharnogo diabeta. Sprav. poliklin. vracha. 2014; 6: 8–10. [in Russian]
8. Protasov K.V. Mnogofaktornyi podkhod k snizheniiu serdechno-sosudistogo riska: vozmozhnosti kombinirovannoi terapii amlodipinom i atorvostatinom. Consilium Medicum. 2014; 16 (5): 94–9. [in Russian]
9. Algoritmy spetsializirovannoi meditsinskoi pomoshchi bol'nym sakharnym diabetom. Pod red. I.I.Dedova, M.V.Shestakovoi. 7-e izd. M., 2015. Sakharnyi diabet. 2015; 18(1S): 1–112. DOI: 10.14341/DM20151S1-112. [in Russian]
10. Vandivier RW. Learning to act on secondhand tobacco smoke exposure to limit risk for coronary heart disease. JAMA Intern Med 2014; doi: 10.1001/JAMAINTERNMED.2014.4046.
11. Rigotti NA, Park ER, Streck J et al. An intervention to address secondhand tobacco smoke exposure among nonsmokers hospitalized with coronary heart disease. Am J Cardiol 2014; 114: 1040–5.
12. Management of diabetes. A national clinical guideline. 2010. http://www.sign.ac.uk
13. Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. Br Med J 2004; 328 (7455): 1519.
14. Ejerblad E, Fored CM, Lindblad P et al. Association between smoking and chronic renal failure in a nationwide population-based case-control study. J Am Soc Nephrol 2004; 15 (8): 2178–85.
15. Karamanos B, Porta M, Songini M et al. Different risk factors of microangiopathy in patients with type I diabetes mellitus of short versus long duration. The EURODIAB IDDM Complications Study. Diabetologia 2000; 43 (3): 348–55.
16. Stratton IM, Kohner EM, Aldington SJ et al. UKPDS 50: risk factors for incidence and progression of retinopathy in Type II diabetes over 6 years from diagnosis. Diabetologia 2001; 44 (2): 156–63.
17. Persson L, Hjalmarson A. Smoking cessation in patients with diabetes mellitus: results from a controlled study of an intervention programme in primary healthcare in Sweden. Scand J Prim Health Care 2006; 24 (2): 75–80.
18. Lloyd C, Hill J, Wallace C. The Psychology of Type 2 Diabetes. www.medscape.org/viewarticle/824061?src=wnl_cme_revw
19. Thomas DE, Elliott EJ, Naughton GA. Exercise for type 2 diabetes mellitus (Cochrane Review). In: The Cochrane Library, Issue 3, 2006. London: John Wiley & Sons Ltd.
20. Hill-Briggs F, Gemmell L. Problem solving in diabetes selfmanagement and control: a systematic review of the literature. Diabetes Educ 2007; 33 (6): 1032–50.
21. Cefalu WT. Diabetes Care to date: «the hits just keep on coming!» Diabetes Care 2013; 36: 1801–3.
22. Мartin S et al. ROSSO study. Diabetologia 2006; 49: 271–8.
23. Garbuzova M.A. Sakharnyi diabet i riski razvitiia diabeticheskoi nefropatii. Sprav. poliklin. vracha. 2014; 3: 16–20. [in Russian]
24. Chernikova N.A. Rol' samostoiatel'nogo monitorirovaniia glikemii v kompleksnom upravlenii sakharnym diabetom tipa 2. Consilium Medicum. 2014; 16 (1): 68–72. [in Russian]
25. Red'kin Iu.A., Bogomolov V.V., Dreval' A.V. Vliianie razlichnykh faktorov na effektivnost' samokontrolia pri sakharnom diabete. Consilium Medicum. 2011; 12: 54–7. [in Russian]
26. Raine CH 3rd. Self-monitored blood glucose: a common pitfall. Endocr Pract 2003; 9 (9): 137–9.
27. Kristensen GB, Nerhus K, Thue G, Sandberg S. Standardized evaluation of instruments for self-monitoring of blood glucose by patients and a technologist. Clin Chem 2004; 50: 1068–71.
2. Дедов И.И. Сахарный диабет: развитие технологий в диагностике, лечении и профилактике. Сахарный диабет. 2010; 3: 6–13. / Dedov I.I. Sakharnyi diabet: razvitie tekhnologii v diagnostike, lechenii i profilaktike. Sakharnyi diabet. 2010; 3: 6–13. [in Russian]
3. Эндокринология. Руководство для врачей. В 2 т. Т. 2 Глава 1. Заболевания островкового аппарата поджелудочной железы. Под ред. С.Б.Шустова. СПб.: СпецЛит, 2011; с. 45. / Endokrinologiia. Rukovodstvo dlia vrachei. V 2 t. T. 2 Glava 1. Zabolevaniia ostrovkovogo apparata podzheludochnoi zhelezy. Pod red. S.B.Shustova. SPb.: SpetsLit, 2011; s. 45. [in Russian]
4. Alberti G, Zimmet P, Shaw J et al. Type 2 diabetes in the young: the evolving epidemic: the international diabetes federation consensus workshop. Diabetes Care 2004; 27: 1798–811.
5. Wilmot E, Idris I. Early Onset Type 2 Diabetes: Risk Factors, Clinical Impact and Management. Ther Adv Chronic Dis 2014; 5 (6): 234–44.
6. Twenty-First Century Behavioral Medicine: A Context for Empowering Clinicians and Patients With Diabetes: A consensus report. Diabetes Care 2013; 36: 463–70.
7. Подачнина C.В. Самоконтроль как метод лечения сахарного диабета. Справ. поликлин. врача. 2014; 6: 8–10. / Podachnina C.V. Samokontrol' kak metod lecheniia sakharnogo diabeta. Sprav. poliklin. vracha. 2014; 6: 8–10. [in Russian]
8. Протасов К.В. Многофакторный подход к снижению сердечно-сосудистого риска: возможности комбинированной терапии амлодипином и аторвостатином. Consilium Medicum. 2014; 16 (5): 94–9. / Protasov K.V. Mnogofaktornyi podkhod k snizheniiu serdechno-sosudistogo riska: vozmozhnosti kombinirovannoi terapii amlodipinom i atorvostatinom. Consilium Medicum. 2014; 16 (5): 94–9. [in Russian]
9. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Под ред. И.И.Дедова, М.В.Шестаковой. 7-е изд. М., 2015. Сахарный диабет. 2015; 18 (1S): 1–112. DOI: 10.14341/DM20151S1-112. / Algoritmy spetsializirovannoi meditsinskoi pomoshchi bol'nym sakharnym diabetom. Pod red. I.I.Dedova, M.V.Shestakovoi. 7-e izd. M., 2015. Sakharnyi diabet. 2015; 18(1S): 1–112. DOI: 10.14341/DM20151S1-112. [in Russian]
10. Vandivier RW. Learning to act on secondhand tobacco smoke exposure to limit risk for coronary heart disease. JAMA Intern Med 2014; doi: 10.1001/JAMAINTERNMED.2014.4046.
11. Rigotti NA, Park ER, Streck J et al. An intervention to address secondhand tobacco smoke exposure among nonsmokers hospitalized with coronary heart disease. Am J Cardiol 2014; 114: 1040–5.
12. Management of diabetes. A national clinical guideline. 2010. http://www.sign.ac.uk
13. Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. Br Med J 2004; 328 (7455): 1519.
14. Ejerblad E, Fored CM, Lindblad P et al. Association between smoking and chronic renal failure in a nationwide population-based case-control study. J Am Soc Nephrol 2004; 15 (8): 2178–85.
15. Karamanos B, Porta M, Songini M et al. Different risk factors of microangiopathy in patients with type I diabetes mellitus of short versus long duration. The EURODIAB IDDM Complications Study. Diabetologia 2000; 43 (3): 348–55.
16. Stratton IM, Kohner EM, Aldington SJ et al. UKPDS 50: risk factors for incidence and progression of retinopathy in Type II diabetes over 6 years from diagnosis. Diabetologia 2001; 44 (2): 156–63.
17. Persson L, Hjalmarson A. Smoking cessation in patients with diabetes mellitus: results from a controlled study of an intervention programme in primary healthcare in Sweden. Scand J Prim Health Care 2006; 24 (2): 75–80.
18. Lloyd C, Hill J, Wallace C. The Psychology of Type 2 Diabetes. www.medscape.org/viewarticle/824061?src=wnl_cme_revw
19. Thomas DE, Elliott EJ, Naughton GA. Exercise for type 2 diabetes mellitus (Cochrane Review). In: The Cochrane Library, Issue 3, 2006. London: John Wiley & Sons Ltd.
20. Hill-Briggs F, Gemmell L. Problem solving in diabetes selfmanagement and control: a systematic review of the literature. Diabetes Educ 2007; 33 (6): 1032–50.
21. Cefalu WT. Diabetes Care to date: «the hits just keep on coming!» Diabetes Care 2013; 36: 1801–3.
22. Мartin S et al. ROSSO study. Diabetologia 2006; 49: 271–8.
23. Гарбузова М.А. Сахарный диабет и риски развития диабетической нефропатии. Справ. поликлин. врача. 2014; 3: 16–20. / Garbuzova M.A. Sakharnyi diabet i riski razvitiia diabeticheskoi nefropatii. Sprav. poliklin. vracha. 2014; 3: 16–20. [in Russian]
24. Черникова Н.А. Роль самостоятельного мониторирования гликемии в комплексном управлении сахарным диабетом типа 2. Consilium Medicum. 2014; 16 (1): 68–72. / Chernikova N.A. Rol' samostoiatel'nogo monitorirovaniia glikemii v kompleksnom upravlenii sakharnym diabetom tipa 2. Consilium Medicum. 2014; 16 (1): 68–72. [in Russian]
25. Редькин Ю.А., Богомолов В.В., Древаль А.В. Влияние различных факторов на эффективность самоконтроля при сахарном диабете. Consilium Medicum. 2011; 12: 54–7. / Red'kin Iu.A., Bogomolov V.V., Dreval' A.V. Vliianie razlichnykh faktorov na effektivnost' samokontrolia pri sakharnom diabete. Consilium Medicum. 2011; 12: 54–7. [in Russian]
26. Raine CH 3rd. Self-monitored blood glucose: a common pitfall. Endocr Pract 2003; 9 (9): 137–9.
27. Kristensen GB, Nerhus K, Thue G, Sandberg S. Standardized evaluation of instruments for self-monitoring of blood glucose by patients and a technologist. Clin Chem 2004; 50: 1068–71.
________________________________________________
2. Dedov I.I. Sakharnyi diabet: razvitie tekhnologii v diagnostike, lechenii i profilaktike. Sakharnyi diabet. 2010; 3: 6–13. [in Russian]
3. Endokrinologiia. Rukovodstvo dlia vrachei. V 2 t. T. 2 Glava 1. Zabolevaniia ostrovkovogo apparata podzheludochnoi zhelezy. Pod red. S.B.Shustova. SPb.: SpetsLit, 2011; s. 45. [in Russian]
4. Alberti G, Zimmet P, Shaw J et al. Type 2 diabetes in the young: the evolving epidemic: the international diabetes federation consensus workshop. Diabetes Care 2004; 27: 1798–811.
5. Wilmot E, Idris I. Early Onset Type 2 Diabetes: Risk Factors, Clinical Impact and Management. Ther Adv Chronic Dis 2014; 5 (6): 234–44.
6. Twenty-First Century Behavioral Medicine: A Context for Empowering Clinicians and Patients With Diabetes: A consensus report. Diabetes Care 2013; 36: 463–70.
7. Podachnina C.V. Samokontrol' kak metod lecheniia sakharnogo diabeta. Sprav. poliklin. vracha. 2014; 6: 8–10. [in Russian]
8. Protasov K.V. Mnogofaktornyi podkhod k snizheniiu serdechno-sosudistogo riska: vozmozhnosti kombinirovannoi terapii amlodipinom i atorvostatinom. Consilium Medicum. 2014; 16 (5): 94–9. [in Russian]
9. Algoritmy spetsializirovannoi meditsinskoi pomoshchi bol'nym sakharnym diabetom. Pod red. I.I.Dedova, M.V.Shestakovoi. 7-e izd. M., 2015. Sakharnyi diabet. 2015; 18(1S): 1–112. DOI: 10.14341/DM20151S1-112. [in Russian]
10. Vandivier RW. Learning to act on secondhand tobacco smoke exposure to limit risk for coronary heart disease. JAMA Intern Med 2014; doi: 10.1001/JAMAINTERNMED.2014.4046.
11. Rigotti NA, Park ER, Streck J et al. An intervention to address secondhand tobacco smoke exposure among nonsmokers hospitalized with coronary heart disease. Am J Cardiol 2014; 114: 1040–5.
12. Management of diabetes. A national clinical guideline. 2010. http://www.sign.ac.uk
13. Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. Br Med J 2004; 328 (7455): 1519.
14. Ejerblad E, Fored CM, Lindblad P et al. Association between smoking and chronic renal failure in a nationwide population-based case-control study. J Am Soc Nephrol 2004; 15 (8): 2178–85.
15. Karamanos B, Porta M, Songini M et al. Different risk factors of microangiopathy in patients with type I diabetes mellitus of short versus long duration. The EURODIAB IDDM Complications Study. Diabetologia 2000; 43 (3): 348–55.
16. Stratton IM, Kohner EM, Aldington SJ et al. UKPDS 50: risk factors for incidence and progression of retinopathy in Type II diabetes over 6 years from diagnosis. Diabetologia 2001; 44 (2): 156–63.
17. Persson L, Hjalmarson A. Smoking cessation in patients with diabetes mellitus: results from a controlled study of an intervention programme in primary healthcare in Sweden. Scand J Prim Health Care 2006; 24 (2): 75–80.
18. Lloyd C, Hill J, Wallace C. The Psychology of Type 2 Diabetes. www.medscape.org/viewarticle/824061?src=wnl_cme_revw
19. Thomas DE, Elliott EJ, Naughton GA. Exercise for type 2 diabetes mellitus (Cochrane Review). In: The Cochrane Library, Issue 3, 2006. London: John Wiley & Sons Ltd.
20. Hill-Briggs F, Gemmell L. Problem solving in diabetes selfmanagement and control: a systematic review of the literature. Diabetes Educ 2007; 33 (6): 1032–50.
21. Cefalu WT. Diabetes Care to date: «the hits just keep on coming!» Diabetes Care 2013; 36: 1801–3.
22. Мartin S et al. ROSSO study. Diabetologia 2006; 49: 271–8.
23. Garbuzova M.A. Sakharnyi diabet i riski razvitiia diabeticheskoi nefropatii. Sprav. poliklin. vracha. 2014; 3: 16–20. [in Russian]
24. Chernikova N.A. Rol' samostoiatel'nogo monitorirovaniia glikemii v kompleksnom upravlenii sakharnym diabetom tipa 2. Consilium Medicum. 2014; 16 (1): 68–72. [in Russian]
25. Red'kin Iu.A., Bogomolov V.V., Dreval' A.V. Vliianie razlichnykh faktorov na effektivnost' samokontrolia pri sakharnom diabete. Consilium Medicum. 2011; 12: 54–7. [in Russian]
26. Raine CH 3rd. Self-monitored blood glucose: a common pitfall. Endocr Pract 2003; 9 (9): 137–9.
27. Kristensen GB, Nerhus K, Thue G, Sandberg S. Standardized evaluation of instruments for self-monitoring of blood glucose by patients and a technologist. Clin Chem 2004; 50: 1068–71.
Авторы
Е.А.Волкова*, Н.В.Ворохобина, О.Ф.Малыгина
ГБОУ ВПО Северо-Западный государственный медицинский университет им. И.И.Мечникова Минздрава России. 191015, Россия, Санкт-Петербург, ул. Кирочная, д. 41
*velena555@yandex.ru
ГБОУ ВПО Северо-Западный государственный медицинский университет им. И.И.Мечникова Минздрава России. 191015, Россия, Санкт-Петербург, ул. Кирочная, д. 41
*velena555@yandex.ru
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E.A.Volkova*, N.V.Vorokhobina, O.F.Malygina
North-Western State Medical University named after I.I.Mechnikov of the Ministry of Health of the Russian Federation. 191015, Russian Federation, Saint-Petersburg, ul. Kirochnaia, d. 41
*velena555@yandex.ru
North-Western State Medical University named after I.I.Mechnikov of the Ministry of Health of the Russian Federation. 191015, Russian Federation, Saint-Petersburg, ul. Kirochnaia, d. 41
*velena555@yandex.ru
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