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Мотивация пациентов в достижении эффективности самоконтроля гликемии при сахарном диабете: проблемы и их решения
Мотивация пациентов в достижении эффективности самоконтроля гликемии при сахарном диабете: проблемы и их решения
Марченкова Л.А., Макарова Е.В. Мотивация пациентов в достижении эффективности самоконтроля гликемии при сахарном диабете: проблемы и их решения. Consilium Medicum. 2017; 19 (4): 32–35.
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Аннотация
Самоконтроль гликемии всегда был и остается важным аспектом лечения сахарного диабета. Несмотря на то что правила самоконтроля просты и доступны, лишь небольшой процент больных соблюдают рекомендации эндокринолога в предписанном объеме. В обзоре литературы представлены современные принципы проведения самоконтроля и формирования положительного отношения к нему пациентов, приводятся клинические и психологические причины, мешающие регулярному эффективному измерению сахара крови. Полноценная осведомленность о своем заболевании, знание техники измерения гликемии и умение скорректировать неблагополучное состояние придают пациенту с сахарным диабетом уверенность и помогают ему достичь хороших результатов лечения. Одним из важных факторов повышения мотивации пациента к эффективному самоконтролю является использование современных, точных и комфортных в использовании глюкометров.
Ключевые слова: сахарный диабет типа 2, самоконтроль гликемии, комплаенс, модель болезни, локус контроля болезни.
Key words: diabetes mellitus type 2, blood glucose self-monitoring, compliance, disease model, locus of disease control.
Ключевые слова: сахарный диабет типа 2, самоконтроль гликемии, комплаенс, модель болезни, локус контроля болезни.
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Key words: diabetes mellitus type 2, blood glucose self-monitoring, compliance, disease model, locus of disease control.
Полный текст
Список литературы
1. Towfigh A, Romanova M, Weinreb JE et al. Self-monitoring of blood glucose levels in patients with type 2 diabetes mellitus not taking insulin: a meta-analysis. Am J Manag Care 2008; 14: 468–75.
2. Duran A, Martin P, Runkle I et al. Benefits of self-monitoring blood glucose in the management of newonset type 2 diabetes mellitus: the St Carlos Study, a prospective randomized clinic-based interventional study with parallel groups. J Diabetes 2010; 2: 203–11.
3. Kleefstra N, Hortensius J, Logtenberg SJ et al. Self-monitoring of blood glucose in tablet-treated type 2 diabetic patients (ZODIAC). Neth J Med 2010; 68: 311–6.
4. Дедов И.И., Шестакова М.В. Эпидемиология сахарного диабета и микрососудистых осложнений. Сахарный диабет. 2010; 3: 17–22. / Dedov I.I., Shestakova M.V. Epidemiologiia sakharnogo diabeta i mikrososudistykh oslozhnenii. Sakharnyi diabet. 2010; 3: 17–22. [in Russian]
5. Holman RR, Paul SK, Bethel MA et al. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med 2008, 359 (15): 1577–89. DOI: 10.1056/NEJMoa0806470
6. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Под ред. И.И.Дедова, М.В.Шестаковой, А.Ю.Майорова. 8-й вып. М.: УП ПРИНТ, 2017; с. 12, 27. / Algoritmy spetsializirovannoi meditsinskoi pomoshchi bol'nym sakharnym diabetom. Pod red. I.I.Dedova, M.V.Shestakovoi, A.Iu.Maiorova. 8-i vyp. M.: UP PRINT, 2017; s. 12, 27. [in Russian]
7. Старостина Е.Г., Галстян Г.Р., Дедов И.И. Роль поведения, связанного с диабетом, в эффективности программы лечения и обучения при сахарном диабете I типа. Проблемы эндокринологии. 1994; 5: 39–40. / Starostina E.G., Galstian G.R., Dedov I.I. Rol' povedeniia, sviazannogo s diabetom, v effektivnosti programmy lecheniia i obucheniia pri sakharnom diabete I tipa. Problemy endokrinologii. 1994; 5: 39–40. [in Russian]
8. Рунова Г.Е. Самоконтроль гликемии при сахарном диабете: медицинские и психологические аспекты. Consilium Medicum. 2016; 18 (5): 98–102. / Runova G.E. Samokontrol' glikemii pri sakharnom diabete: meditsinskie i psikhologicheskie aspekty. Consilium Medicum. 2016; 18 (5): 98–102. [in Russian]
9. Glasgow RE, Anderson RM. In diabetes care, moving from compliance to adherence is not enough: something entirely different is needed. Diabetes Care 1999; 22 (12): 2090–2.
10. Старостина Е.Г., Володина М.Н. Роль комплаентности в ведении больных диабетом. РМЖ. 2015; 8: 477. / Starostina E.G., Volodina M.N. Rol' komplaentnosti v vedenii bol'nykh diabetom. RMZh. 2015; 8: 477. [in Russian]
11. Ciechanowski P, Katon WJ. The interpersonal experience of health care through the eyes of patients with diabetes. Soc Sci Med 2006; 63: 3067–79. DOI: 10.1016/j.socscimed.2006.08.002
12. Peyrot M, Rubin RR, Lauritzen T et al. Psychosocial problems and barriers to improved diabetes management: results of the Cross-National Diabetes Attitudes, Wishes and Needs (DAWN) Study. Diabet Med 2005; 22 (10): 1379–85.
13. Gonzalez JS, Peyrot M, McCarl LA et al. Depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care 2008; 31 (12): 2398–403. DOI: 10.2337/dc08-1341
14. Farmer AJ, Wade AN, French DP et al. Blood Glucose monitoring in type 2 diabetes: a randomised controlled trial. Health Technol Assess 2009; 13 (15): 29–40.
15. Hortensius J, Kars MC, Wierenga WS. Perspectives of patients with type 1 or insulin-treated type 2 diabetes on self-monitoring of blood glucose: a qualitative study. BMC Public Health 2012; 12: 167. DOI: 10.1186/1471-2458-12-167
16. Fisher WA, Kohut T, Schachner H, Stenger P. Understanding Self-monitoring of blood glucose among individuals with type 1 and type 2 diabetes. An information-motivation-behavioral skills analysis. Diabetes Educ 2011; 37: 85–94. DOI: 10.1177/0145721710391479
17. Wagner EH, Austin BT, Davis C et al. Improving chronic illness care: translating evidence into action. Heal Aff 2001; 20 (6): 64–78. DOI: 10.1377/hlthaff.20.6.64
18. Dunn SM. Psychological issues in diabetes management: (I) Blood glucose monitoring and learned helplessness. Practical Diabetes 1987; 4: 108–10. DOI: 10.1002/pdi.1960040304
19. International Organization for Standardization. ISO 15197: 2013 (E): In Vitro Diagnostic Test Systems-Requirements for Blood-Glucose Monitoring Systems for Self-Testing in Managing Diabetes Mellitus. Geneva: International Organization for Standardization, 2013.
20. Caswell M, Frank J, Viggiani MT et al. Accuracy and User Performance Evaluation of a Blood Glucose Monitoring System. Diabetes Technol Ther 2015; 17 (3). DOI: 10.1089/dia.2014.0129
2. Duran A, Martin P, Runkle I et al. Benefits of self-monitoring blood glucose in the management of newonset type 2 diabetes mellitus: the St Carlos Study, a prospective randomized clinic-based interventional study with parallel groups. J Diabetes 2010; 2: 203–11.
3. Kleefstra N, Hortensius J, Logtenberg SJ et al. Self-monitoring of blood glucose in tablet-treated type 2 diabetic patients (ZODIAC). Neth J Med 2010; 68: 311–6.
4. Dedov I.I., Shestakova M.V. Epidemiologiia sakharnogo diabeta i mikrososudistykh oslozhnenii. Sakharnyi diabet. 2010; 3: 17–22. [in Russian]
5. Holman RR, Paul SK, Bethel MA et al. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med 2008, 359 (15): 1577–89. DOI: 10.1056/NEJMoa0806470
6. Algoritmy spetsializirovannoi meditsinskoi pomoshchi bol'nym sakharnym diabetom. Pod red. I.I.Dedova, M.V.Shestakovoi, A.Iu.Maiorova. 8-i vyp. M.: UP PRINT, 2017; s. 12, 27. [in Russian]
7. Starostina E.G., Galstian G.R., Dedov I.I. Rol' povedeniia, sviazannogo s diabetom, v effektivnosti programmy lecheniia i obucheniia pri sakharnom diabete I tipa. Problemy endokrinologii. 1994; 5: 39–40. [in Russian]
8. Runova G.E. Samokontrol' glikemii pri sakharnom diabete: meditsinskie i psikhologicheskie aspekty. Consilium Medicum. 2016; 18 (5): 98–102. [in Russian]
9. Glasgow RE, Anderson RM. In diabetes care, moving from compliance to adherence is not enough: something entirely different is needed. Diabetes Care 1999; 22 (12): 2090–2.
10. Starostina E.G., Volodina M.N. Rol' komplaentnosti v vedenii bol'nykh diabetom. RMZh. 2015; 8: 477. [in Russian]
11. Ciechanowski P, Katon WJ. The interpersonal experience of health care through the eyes of patients with diabetes. Soc Sci Med 2006; 63: 3067–79. DOI: 10.1016/j.socscimed.2006.08.002
12. Peyrot M, Rubin RR, Lauritzen T et al. Psychosocial problems and barriers to improved diabetes management: results of the Cross-National Diabetes Attitudes, Wishes and Needs (DAWN) Study. Diabet Med 2005; 22 (10): 1379–85.
13. Gonzalez JS, Peyrot M, McCarl LA et al. Depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care 2008; 31 (12): 2398–403. DOI: 10.2337/dc08-1341
14. Farmer AJ, Wade AN, French DP et al. Blood Glucose monitoring in type 2 diabetes: a randomised controlled trial. Health Technol Assess 2009; 13 (15): 29–40.
15. Hortensius J, Kars MC, Wierenga WS. Perspectives of patients with type 1 or insulin-treated type 2 diabetes on self-monitoring of blood glucose: a qualitative study. BMC Public Health 2012; 12: 167. DOI: 10.1186/1471-2458-12-167
16. Fisher WA, Kohut T, Schachner H, Stenger P. Understanding Self-monitoring of blood glucose among individuals with type 1 and type 2 diabetes. An information-motivation-behavioral skills analysis. Diabetes Educ 2011; 37: 85–94. DOI: 10.1177/0145721710391479
17. Wagner EH, Austin BT, Davis C et al. Improving chronic illness care: translating evidence into action. Heal Aff 2001; 20 (6): 64–78. DOI: 10.1377/hlthaff.20.6.64
18. Dunn SM. Psychological issues in diabetes management: (I) Blood glucose monitoring and learned helplessness. Practical Diabetes 1987; 4: 108–10. DOI: 10.1002/pdi.1960040304
19. International Organization for Standardization. ISO 15197: 2013 (E): In Vitro Diagnostic Test Systems-Requirements for Blood-Glucose Monitoring Systems for Self-Testing in Managing Diabetes Mellitus. Geneva: International Organization for Standardization, 2013.
20. Caswell M, Frank J, Viggiani MT et al. Accuracy and User Performance Evaluation of a Blood Glucose Monitoring System. Diabetes Technol Ther 2015; 17 (3). DOI: 10.1089/dia.2014.0129
2. Duran A, Martin P, Runkle I et al. Benefits of self-monitoring blood glucose in the management of newonset type 2 diabetes mellitus: the St Carlos Study, a prospective randomized clinic-based interventional study with parallel groups. J Diabetes 2010; 2: 203–11.
3. Kleefstra N, Hortensius J, Logtenberg SJ et al. Self-monitoring of blood glucose in tablet-treated type 2 diabetic patients (ZODIAC). Neth J Med 2010; 68: 311–6.
4. Дедов И.И., Шестакова М.В. Эпидемиология сахарного диабета и микрососудистых осложнений. Сахарный диабет. 2010; 3: 17–22. / Dedov I.I., Shestakova M.V. Epidemiologiia sakharnogo diabeta i mikrososudistykh oslozhnenii. Sakharnyi diabet. 2010; 3: 17–22. [in Russian]
5. Holman RR, Paul SK, Bethel MA et al. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med 2008, 359 (15): 1577–89. DOI: 10.1056/NEJMoa0806470
6. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Под ред. И.И.Дедова, М.В.Шестаковой, А.Ю.Майорова. 8-й вып. М.: УП ПРИНТ, 2017; с. 12, 27. / Algoritmy spetsializirovannoi meditsinskoi pomoshchi bol'nym sakharnym diabetom. Pod red. I.I.Dedova, M.V.Shestakovoi, A.Iu.Maiorova. 8-i vyp. M.: UP PRINT, 2017; s. 12, 27. [in Russian]
7. Старостина Е.Г., Галстян Г.Р., Дедов И.И. Роль поведения, связанного с диабетом, в эффективности программы лечения и обучения при сахарном диабете I типа. Проблемы эндокринологии. 1994; 5: 39–40. / Starostina E.G., Galstian G.R., Dedov I.I. Rol' povedeniia, sviazannogo s diabetom, v effektivnosti programmy lecheniia i obucheniia pri sakharnom diabete I tipa. Problemy endokrinologii. 1994; 5: 39–40. [in Russian]
8. Рунова Г.Е. Самоконтроль гликемии при сахарном диабете: медицинские и психологические аспекты. Consilium Medicum. 2016; 18 (5): 98–102. / Runova G.E. Samokontrol' glikemii pri sakharnom diabete: meditsinskie i psikhologicheskie aspekty. Consilium Medicum. 2016; 18 (5): 98–102. [in Russian]
9. Glasgow RE, Anderson RM. In diabetes care, moving from compliance to adherence is not enough: something entirely different is needed. Diabetes Care 1999; 22 (12): 2090–2.
10. Старостина Е.Г., Володина М.Н. Роль комплаентности в ведении больных диабетом. РМЖ. 2015; 8: 477. / Starostina E.G., Volodina M.N. Rol' komplaentnosti v vedenii bol'nykh diabetom. RMZh. 2015; 8: 477. [in Russian]
11. Ciechanowski P, Katon WJ. The interpersonal experience of health care through the eyes of patients with diabetes. Soc Sci Med 2006; 63: 3067–79. DOI: 10.1016/j.socscimed.2006.08.002
12. Peyrot M, Rubin RR, Lauritzen T et al. Psychosocial problems and barriers to improved diabetes management: results of the Cross-National Diabetes Attitudes, Wishes and Needs (DAWN) Study. Diabet Med 2005; 22 (10): 1379–85.
13. Gonzalez JS, Peyrot M, McCarl LA et al. Depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care 2008; 31 (12): 2398–403. DOI: 10.2337/dc08-1341
14. Farmer AJ, Wade AN, French DP et al. Blood Glucose monitoring in type 2 diabetes: a randomised controlled trial. Health Technol Assess 2009; 13 (15): 29–40.
15. Hortensius J, Kars MC, Wierenga WS. Perspectives of patients with type 1 or insulin-treated type 2 diabetes on self-monitoring of blood glucose: a qualitative study. BMC Public Health 2012; 12: 167. DOI: 10.1186/1471-2458-12-167
16. Fisher WA, Kohut T, Schachner H, Stenger P. Understanding Self-monitoring of blood glucose among individuals with type 1 and type 2 diabetes. An information-motivation-behavioral skills analysis. Diabetes Educ 2011; 37: 85–94. DOI: 10.1177/0145721710391479
17. Wagner EH, Austin BT, Davis C et al. Improving chronic illness care: translating evidence into action. Heal Aff 2001; 20 (6): 64–78. DOI: 10.1377/hlthaff.20.6.64
18. Dunn SM. Psychological issues in diabetes management: (I) Blood glucose monitoring and learned helplessness. Practical Diabetes 1987; 4: 108–10. DOI: 10.1002/pdi.1960040304
19. International Organization for Standardization. ISO 15197: 2013 (E): In Vitro Diagnostic Test Systems-Requirements for Blood-Glucose Monitoring Systems for Self-Testing in Managing Diabetes Mellitus. Geneva: International Organization for Standardization, 2013.
20. Caswell M, Frank J, Viggiani MT et al. Accuracy and User Performance Evaluation of a Blood Glucose Monitoring System. Diabetes Technol Ther 2015; 17 (3). DOI: 10.1089/dia.2014.0129
________________________________________________
2. Duran A, Martin P, Runkle I et al. Benefits of self-monitoring blood glucose in the management of newonset type 2 diabetes mellitus: the St Carlos Study, a prospective randomized clinic-based interventional study with parallel groups. J Diabetes 2010; 2: 203–11.
3. Kleefstra N, Hortensius J, Logtenberg SJ et al. Self-monitoring of blood glucose in tablet-treated type 2 diabetic patients (ZODIAC). Neth J Med 2010; 68: 311–6.
4. Dedov I.I., Shestakova M.V. Epidemiologiia sakharnogo diabeta i mikrososudistykh oslozhnenii. Sakharnyi diabet. 2010; 3: 17–22. [in Russian]
5. Holman RR, Paul SK, Bethel MA et al. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med 2008, 359 (15): 1577–89. DOI: 10.1056/NEJMoa0806470
6. Algoritmy spetsializirovannoi meditsinskoi pomoshchi bol'nym sakharnym diabetom. Pod red. I.I.Dedova, M.V.Shestakovoi, A.Iu.Maiorova. 8-i vyp. M.: UP PRINT, 2017; s. 12, 27. [in Russian]
7. Starostina E.G., Galstian G.R., Dedov I.I. Rol' povedeniia, sviazannogo s diabetom, v effektivnosti programmy lecheniia i obucheniia pri sakharnom diabete I tipa. Problemy endokrinologii. 1994; 5: 39–40. [in Russian]
8. Runova G.E. Samokontrol' glikemii pri sakharnom diabete: meditsinskie i psikhologicheskie aspekty. Consilium Medicum. 2016; 18 (5): 98–102. [in Russian]
9. Glasgow RE, Anderson RM. In diabetes care, moving from compliance to adherence is not enough: something entirely different is needed. Diabetes Care 1999; 22 (12): 2090–2.
10. Starostina E.G., Volodina M.N. Rol' komplaentnosti v vedenii bol'nykh diabetom. RMZh. 2015; 8: 477. [in Russian]
11. Ciechanowski P, Katon WJ. The interpersonal experience of health care through the eyes of patients with diabetes. Soc Sci Med 2006; 63: 3067–79. DOI: 10.1016/j.socscimed.2006.08.002
12. Peyrot M, Rubin RR, Lauritzen T et al. Psychosocial problems and barriers to improved diabetes management: results of the Cross-National Diabetes Attitudes, Wishes and Needs (DAWN) Study. Diabet Med 2005; 22 (10): 1379–85.
13. Gonzalez JS, Peyrot M, McCarl LA et al. Depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care 2008; 31 (12): 2398–403. DOI: 10.2337/dc08-1341
14. Farmer AJ, Wade AN, French DP et al. Blood Glucose monitoring in type 2 diabetes: a randomised controlled trial. Health Technol Assess 2009; 13 (15): 29–40.
15. Hortensius J, Kars MC, Wierenga WS. Perspectives of patients with type 1 or insulin-treated type 2 diabetes on self-monitoring of blood glucose: a qualitative study. BMC Public Health 2012; 12: 167. DOI: 10.1186/1471-2458-12-167
16. Fisher WA, Kohut T, Schachner H, Stenger P. Understanding Self-monitoring of blood glucose among individuals with type 1 and type 2 diabetes. An information-motivation-behavioral skills analysis. Diabetes Educ 2011; 37: 85–94. DOI: 10.1177/0145721710391479
17. Wagner EH, Austin BT, Davis C et al. Improving chronic illness care: translating evidence into action. Heal Aff 2001; 20 (6): 64–78. DOI: 10.1377/hlthaff.20.6.64
18. Dunn SM. Psychological issues in diabetes management: (I) Blood glucose monitoring and learned helplessness. Practical Diabetes 1987; 4: 108–10. DOI: 10.1002/pdi.1960040304
19. International Organization for Standardization. ISO 15197: 2013 (E): In Vitro Diagnostic Test Systems-Requirements for Blood-Glucose Monitoring Systems for Self-Testing in Managing Diabetes Mellitus. Geneva: International Organization for Standardization, 2013.
20. Caswell M, Frank J, Viggiani MT et al. Accuracy and User Performance Evaluation of a Blood Glucose Monitoring System. Diabetes Technol Ther 2015; 17 (3). DOI: 10.1089/dia.2014.0129
Авторы
Л.А.Марченкова*, Е.В.Макарова
ФГБУ «Российский научный центр медицинской реабилитации и курортологии» Минздрава России. 121099, Россия, Москва, ул. Новый Арбат, д. 32
*lr-march@rambler.ru
Russian Scientific Center of Medical Rehabilitation and Balneology of the Ministry of Health of the Russian Federation. 121099, Russian Federation, Moscow, ul. Novyi Arbat, d. 32
*lr-march@rambler.ru
ФГБУ «Российский научный центр медицинской реабилитации и курортологии» Минздрава России. 121099, Россия, Москва, ул. Новый Арбат, д. 32
*lr-march@rambler.ru
________________________________________________
Russian Scientific Center of Medical Rehabilitation and Balneology of the Ministry of Health of the Russian Federation. 121099, Russian Federation, Moscow, ul. Novyi Arbat, d. 32
*lr-march@rambler.ru
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