Эффективная терапия сахарного диабета невозможна без активного участия пациента. Причем важно, чтобы больные были соответствующим образом обучены постоянному контролю своего заболевания и имели в своем распоряжении современные, отвечающие международным стандартам и простые в управлении глюкометры. Изменения в национальных рекомендациях последнего пересмотра отражают важность самоконтроля в управлении заболеванием. В данной статье отражены существующие на сегодняшний день требования к приборам для контроля гликемии.
Ключевые слова: сахарный диабет, самоконтроль, контроль гликемии, гипогликемия, гипергликемия, глюкометр.
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The effective therapy of diabetes mellitus is impossible without active participation of the patient. And it is very important for the patients to be appropriately trained to control the disease and they should have at their disposal modern glucometers, which are in compliance with international standards and easy in management. Changes of the last version of national recommendations indicate the importance of self-monitoring in the disease control. This article reflects the current accuracy requirements for devices for analyzing blood glucose data.
1. International Diabetes Federation. IDF Diabetes Atlas, 6th edn. Brussels, Belgium: International Diabetes Federation, 2013. http://www.idf.org/diabetesatlas
2. Дедов И.И. и др. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Вып. 7. Сахарный диабет. 2015. / Dedov I.I. i dr. Algoritmy spetsializirovannoi meditsinskoi pomoshchi bol'nym sakharnym diabetom. Vyp. 7. Sakharnyi diabet. 2015. [in Russian]
3. American Diabetes Association et al. Standards of medical care in diabetes – 2014. Diabetes Care. 2014; 37 (Suppl. 1.); S14–S80.
4. Muhlhauser I, Berger M. Patient education – evaluation of a complex intervention. Diabetologia 2002; 45: 1723–33.
5. Анциферов М.Б., Котешкова О.М. Управление сахарным диабетом: организация и значение самоконтроля. Трудный пациент. 2009; 7 (10). / Antsiferov M.B., Koteshkova O.M. Upravlenie sakharnym diabetom: organizatsiia i znachenie samokontrolia. Trudnyi patsient. 2009; 7 (10). [in Russian]
6. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulpho-nylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837–53.
7. Clar C, Barnard K, Cummins E et al. Self-monitoring of blood glucose in type 2 diabetes: systematic review. Health Technol Assess 2010; 14 (12): 1–140.
8. Barnett AH, Krentz AJ, Strojek K et al. The efficacy of self-monitoring of blood glucose in the management of patients with type 2 diabetes treated with a gliclazide modified release-based regimen. A multicentre, randomized, parallel-group, 6-month evaluation (DINAMIC 1 study). Diabetes Obes Metab 2008; 10: 1239–47.
9. Дедов И.И. и др. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Вып. 6. Сахарный диабет. 2013. / Dedov I.I. i dr. Algoritmy spetsializirovannoi meditsinskoi pomoshchi bol'nym sakharnym diabetom. Vyp. 6. Sakharnyi diabet. 2013. [in Russian]
10. Evans JM, Newton RW, Ruta DA et al. Frequency of blood glucose monitoring in relation to glycaemic control: observational study with diabetes da-tabase. BMJ 1999; 319: 83–6.
11. Polonsky WH et al. Structured Self-Monitoring of Blood Glucose Significantly Reduces A1C Levels in Poorly Controlled, Noninsulin-Treated Type 2 Diabetes Results from the Structured Testing Program study. Diabetes Care 2011; 34 (2): 262–7.
12. Дедова И.И., Фадеева В.В. Обучение больных сахарным диабетом. 1999. / Dedova I.I., Fadeeva V.V. Obuchenie bol'nykh sakharnym diabetom. 1999. [in Russian]
13. Майоров А.Ю. и др. Обучение больных диабетом: синтез доказательной медицины и психологического подхода. Сахарный диабет. 2011; 1. / Maiorov A.Iu. i dr. Obuchenie bol'nykh diabetom: sintez dokazatel'noi meditsiny i psikhologicheskogo podkhoda. Sakharnyi diabet. 2011; 1. [in Russian]
14. ISO E. N. 15197: 2013. Vitro diagnostic test systems–Requirements for blood-glucose monitor-ing systems for self-testing in managing diabetes mellitus. Geneve, 2013.
15. Freckmann G et al. System accuracy evaluation of 43 blood glucose monitoring systems for self-monitoring of blood glucose according to DIN EN ISO 15197. J Diabet Scien Technol 2012; 6 (5): 1060–75.
16. Редькин Ю.А., Богомолов В.В.. Влияние различных факторов на эффективность самоконтроля при сахарном диабете. Consilium Medicum. 2011; 12: 54–8.
17. Чижов С.А. Новые модели глюкометров: на что обратить внимание? 2009. / Chizhov S.A. Novye modeli gliukometrov: na chto obratit' vnimanie? 2009. [in Russian]
18. Дедов И.И. и др. Терапевтическое обучение больных сахарным диабетом. М.: Реафарм, 2004. / Dedov I.I. i dr. Terapevticheskoe obuchenie bol'nykh sakharnym diabetom. M.: Reafarm, 2004. [in Russian]
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1. International Diabetes Federation. IDF Diabetes Atlas, 6th edn. Brussels, Belgium: International Diabetes Federation, 2013. http://www.idf.org/diabetesatlas
2. Dedov I.I. i dr. Algoritmy spetsializirovannoi meditsinskoi pomoshchi bol'nym sakharnym diabetom. Vyp. 7. Sakharnyi diabet. 2015. [in Russian]
3. American Diabetes Association et al. Standards of medical care in diabetes – 2014. Diabetes Care. 2014; 37 (Suppl. 1.); S14–S80.
4. Muhlhauser I, Berger M. Patient education – evaluation of a complex intervention. Diabetologia 2002; 45: 1723–33.
5. Antsiferov M.B., Koteshkova O.M. Upravlenie sakharnym diabetom: organizatsiia i znachenie samokontrolia. Trudnyi patsient. 2009; 7 (10). [in Russian]
6. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulpho-nylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837–53.
7. Clar C, Barnard K, Cummins E et al. Self-monitoring of blood glucose in type 2 diabetes: systematic review. Health Technol Assess 2010; 14 (12): 1–140.
8. Barnett AH, Krentz AJ, Strojek K et al. The efficacy of self-monitoring of blood glucose in the management of patients with type 2 diabetes treated with a gliclazide modified release-based regimen. A multicentre, randomized, parallel-group, 6-month evaluation (DINAMIC 1 study). Diabetes Obes Metab 2008; 10: 1239–47.
9. Dedov I.I. i dr. Algoritmy spetsializirovannoi meditsinskoi pomoshchi bol'nym sakharnym diabetom. Vyp. 6. Sakharnyi diabet. 2013. [in Russian]
10. Evans JM, Newton RW, Ruta DA et al. Frequency of blood glucose monitoring in relation to glycaemic control: observational study with diabetes da-tabase. BMJ 1999; 319: 83–6.
11. Polonsky WH et al. Structured Self-Monitoring of Blood Glucose Significantly Reduces A1C Levels in Poorly Controlled, Noninsulin-Treated Type 2 Diabetes Results from the Structured Testing Program study. Diabetes Care 2011; 34 (2): 262–7.
12. Dedova I.I., Fadeeva V.V. Obuchenie bol'nykh sakharnym diabetom. 1999. [in Russian]
13. Maiorov A.Iu. i dr. Obuchenie bol'nykh diabetom: sintez dokazatel'noi meditsiny i psikhologicheskogo podkhoda. Sakharnyi diabet. 2011; 1. [in Russian]
14. ISO E. N. 15197: 2013. Vitro diagnostic test systems–Requirements for blood-glucose monitor-ing systems for self-testing in managing diabetes mellitus. Geneve, 2013.
15. Freckmann G et al. System accuracy evaluation of 43 blood glucose monitoring systems for self-monitoring of blood glucose according to DIN EN ISO 15197. J Diabet Scien Technol 2012; 6 (5): 1060–75.
16. Редькин Ю.А., Богомолов В.В.. Влияние различных факторов на эффективность самоконтроля при сахарном диабете. Consilium Medicum. 2011; 12: 54–8.
17. Chizhov S.A. Novye modeli gliukometrov: na chto obratit' vnimanie? 2009. [in Russian]
18. Dedov I.I. i dr. Terapevticheskoe obuchenie bol'nykh sakharnym diabetom. M.: Reafarm, 2004. [in Russian]
ГБОУ ВПО Волгоградский государственный медицинский университет Минздрава России. 400131, Россия, Волгоград, пл. Павших борцов, д. 1
*solarheart7@gmail.com
Volgograd State Medical University of the Ministry of Health of the Russian Federation. 400131, Russian Federation, Volgograd, pl. Pavshikh bortsov, d. 1
*solarheart7@gmail.com