В предлагаемой статье освещается роль самоконтроля гликемии (СКГ) у пациентов с сахарным диабетом. Рассмотрены терапевтические цели в зависимости от возраста больного, наличия тяжелых осложнений и риска гипогликемии; частота измерений уровня глюкозы крови при разных вариантах сахароснижающей терапии; частота измерений уровня глюкозы крови при беременности; значение СКГ для пациента и врача и др. Приведены данные международных исследований по оценке эффективности СКГ. Описаны принципы действия глюкометров и требования к их точности, принятые Международной организацией по стандартизации для систем СКГ в 2013 г.
The proposed article highlights the role of self-management of glycemia (SMG) in patients with diabetes mellitus. Therapeutic goals are considered depending on the patient's age, the presence of serious complications and the risk of hypoglycemia; the frequency of measurement of blood glucose level with different variants of hypoglycemic therapy; frequency of blood glucose measurements during pregnancy; the importance of SMG for the patient and the doctor and others. The data of international studies on the evaluation of the efficacy of SMG are presented. The principles of the action of glucometers and the requirements for their accuracy adopted by the International Organization for Standardization for the systems of the SMG in 2013 are described.
Key words: self-control of glycemia, diabetes mellitus, glucometer.
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1. Global'nyi doklad po diabetu VOZ, 2016. [in Russian]
2. Chen L, Magliano D J, Zimmet PZ. The worldwide epidemiology of type 2 diabetes mellitus- present and future perspectives. Nat Rev Endocrinol 2012; 8: 228–36.
3. Khaled AA, Sekaran M, Ikram SI. Type 2 diabetes and vascular complications: A pathophysiologic view. Biomed Res 2010; 21 (2): 147–50.
4. Snell-Bergeon JK, Wadwa RP. Hypoglycemia, diabetes, and cardiovascular disease. Diabetes Tech Therapeut 2012; 14 (Suppl. 1): S51–S58.
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: 1577–89.
6. The Diabetes Control and Complications Trial Research Group. The effects of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent mellitus. New Engl J Med 1993; 329: 977–86.
7. Algoritmy spetsializirovannoi meditsinskoi pomoshchi bol'nym sakharnym diabetom. Pod red. I.I.Dedova, M.V.Shestakovoi. Vyp. 8-i. M., 2017. [in Russian]
8. Neisser K, Weber C, Wenzel H, Schneider B. Costs of self-measurement of blood glucose (SMBG) regarding morbidity and mortality in type 2 diabetes in a reality of care setting (The ROSSO study No 6). The European Association for the Study of Diabetes. Abstract Volume 42st Annual Meeting, Copenhagen, Malmoe, 2006.
9. Potin V.V., Borovik N.V., Tisel'ko A.V. Sakharnyi diabet i reproduktivnaia sistema zhenshchiny. Zhurn. akusherstva i zhenskikh boleznei. 2006; 1. [in Russian]
10. Lantseva O.E., Kuptsov G.D., Potin V.V. i dr. Intensivnaia insulinoterapiia pri razlichnykh tipakh sakharnogo diabeta u beremennykh. Vestn. ros. assots. akusherov-ginekologov. 1997; 3: 89–94. [in Russian]
11. Reece EA, Hobbins JS. Diabetic embryopathy: pathogenesis, prenatal diagnosis and prevention. Obstet Gynecol Surv 1986; 41: 325–35.
12. Arbatskaya N.Yu., Demidova I.Yu. Diabetes 1 and pregnancy. Consilium Medicum. 2003; 09: 494–500. [in Russian]
13. Caswell M et al. Accuracy and User Performance Evaluation of a Blood Glucose Monitoring System. Diabetes Technol Ther 2015; 3: 1–7.
Авторы
Н.Э.Хачатурян
ГБУЗ «Московский клинический научный центр им. А.С.Логинова» Департамента здравоохранения г. Москвы. 111123, Россия, Москва, ш. Энтузиастов, д. 86;
ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И.Евдокимова» Минздрава России. 127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1 nane18@list.ru
________________________________________________
N.E.Khachaturyan
A.S.Loginov Moscow Clinical Research Center of the Department of Health of Moscow. 111123, Russian Federation, Moscow, sh. Entuziastov, d. 86;
A.I.Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation. 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1 nane18@list.ru