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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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Marchenkova L.A., Makarova E.V. Motivation for improving glycemia self-monitirng efficiency in patients with diabetes mellitus: problems and solutions. 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.
Ключевые слова: сахарный диабет типа 2, самоконтроль гликемии, комплаенс, модель болезни, локус контроля болезни.
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Blood glucose self-monitoring has always been an important aspect of diabetes mellitus (DM) treatment. Despite the fact that glycemic control principles are simple and transparent, only a small percentage of patients follow the recommendations accordingly endocrinologist prescriptions. This review presents actual information on self-monitoring principles, clinical and psychological barriers that interferes regular effective measurement of blood glucose and role of positive attitude towards glycemic control in DM patients. Full awareness of the disease, knowledge of self-monitoring technique and ability to correct unsatisfactory state – gives the DM patient confidence and helps to achieve good treatment outcomes. The important factor to facilitate patient's motivation for regular and effective self-monitoring is to use modern, accurate and comfortable in everyday usage glucometers.
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. 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
________________________________________________
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. 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
ФГБУ «Российский научный центр медицинской реабилитации и курортологии» Минздрава России. 121099, Россия, Москва, ул. Новый Арбат, д. 32
*lr-march@rambler.ru
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L.A.Marchenkova*, E.V.Makarova
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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