Самоконтроль и изменение образа жизни пациентов как важнейшая часть комплексной терапии сахарного диабета типа 2
Самоконтроль и изменение образа жизни пациентов как важнейшая часть комплексной терапии сахарного диабета типа 2
Волкова Е.А., Малыгина О.Ф. Самоконтроль и изменение образа жизни пациентов как важнейшая часть комплексной терапии сахарного диабета типа 2. Справочник поликлинического врача. 2018; 2: 47–52.
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Volkova E.A., Malygina O.F. Self-control and lifestyle changes of patients as an important part of complex sugar therapy type 2 diabetes. Handbook for Practitioners Doctors. 2018; 2: 47–52.
Самоконтроль и изменение образа жизни пациентов как важнейшая часть комплексной терапии сахарного диабета типа 2
Волкова Е.А., Малыгина О.Ф. Самоконтроль и изменение образа жизни пациентов как важнейшая часть комплексной терапии сахарного диабета типа 2. Справочник поликлинического врача. 2018; 2: 47–52.
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Volkova E.A., Malygina O.F. Self-control and lifestyle changes of patients as an important part of complex sugar therapy type 2 diabetes. Handbook for Practitioners Doctors. 2018; 2: 47–52.
В статье рассматриваются вопросы самоконтроля сахарного диабета типа 2, роль медицинских работников и самого пациента в достижении целевых значений гликемии, трудности, возникающие при модификации образа жизни пациентов и в достижении хорошего контроля сахарного диабета, значение при этом депрессии больного и когнитивных нарушений. Обсуждаются особенности немедикаментозного лечения, важность обучения пациентов самоконтролю, проблемы вариабельности гликемии и необходимость индивидуализации лечения.
Ключевые слова: сахарный диабет типа 2, обучение пациентов, структурированные учебные программы, немедикаментозные методы лечения, самоконтроль, вариабельность гликемии, глюкометры.
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The article deals with the issues of self-control of type 2 diabetes, the role of health care workers and the patient in achieving the target values of glycemia, the difficulties encountered in modifying the lifestyle of patients and in achieving good control of diabetes, the importance of depression and cognitive impairment. The features of non-drug treatment, the importance of self-control training of patients, the problems of glycemic variability and the need for individualization of treatment are discussed.
Key words: diabetes mellitus type 2, patient education, structured curriculum, non-pharmacological treatments, self-management, variability of blood glucose, blood glucose meters.
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2. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Под ред. И.И.Дедова, М.В.Шестаковой. 8-й вып. М., 2017. / Аlgoritmy spetsializirovannoj meditsinskoj pomoshhi bol'nym sakharnym diabetom. Pod red. I.I.Dedova, M.V.Shestakovoj. 8-j vyp. M., 2017. [in Russian]
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9. Saydah SH, Fradkin J, Cowie CC. Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes. JAMA 2004; 291: 335–42.
10. 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; 17 (1): 54–62. / Volkova E.A., Vorokhobina N.V., Malygina O.F. Lifestyle modification, training and self-control as important components of diabetes treatment and improvement of patients life quality. Consilium Medicum. 2015; 17 (1): 54–62. [in Russian]
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13. Allermann S, Houriet C, Diern P et al. Self monitoring of blood glucose in non insulin treated patients with type 2 diabetes: systematic review and meta-analysis. Curr Med Res Opin 2009; 25: 2903–13.
14. Klonoff DC et al. Consensus Report: The Current Role Of Self-Monitoring of Blood Glucose in Non-Insulin – Treated Type 2 Diabetes. J Diabet Sci Technol 2011; 5.
15. Bosi E, Scavini M, Ceriello A et al. Intensive Structured Self-monitoring of Blood Glucose and Glycemic Control in Noninsulin-Treated Type 2 Diabetes. The PRISMA Randomized Trial. Diabetes Care 2013; 36 (10): 2887–94.
16. Hanefeld M, Temelkova-Kurktschiev T. Control of post-prandial hyperglycemia - an essential part of good diabetes treatment and prevention of cardiovascular complications. Nutr Metab Cardiovasc Dis 2002; 12: 98–107.
17. Nathan DM, Cleary PA, Cacklund JY et al. Intensive diabetes treatment and cardiovascular disease in patients with type I diabetes. N Engl J Med 2005; 353: 2642–53.
18. Herbert Tilg H, Kaser A. Gut microbiome, obesity, and metabolic dysfunction. J Clin Invest 2011; 121 (6): 2126–32.
19. Robertson С. Translating ADA/EASD Guidelines and the ACE/AACE Road Maps Into Primary Care of Patients With Type 2 Diabetes. J Nurse Рractitioners 2008; 4 (9): 661–71.
20. Siebolds M, Gaedeke O, Schwede U. Self-monitoring of blood glucose – psychological aspects relevant to changes in HbA1c in type 2 diabetic patients treated with diet or diet plus oral antidiabetic medication. Patient Educ Couns 2006; 62: 104–10.
21. Kitasato L, Tojo T, Hatakeyama Y et al. Postprandial hyperglycemia and endothelial function in type 2 diabetes: focus on mitiglinide. Cardiovasc Diabetol 2012; 11 (1): 79.
22. Батрак Г.А., Мясоедова С.Е. Роль самоконтроля гликемии в профилактике диабетических микро- и макрососудистых осложнений. Справочник поликлинического врача. 2017; 3: 59–62. / Batrak G.A., Myasoedova S.E. The role of self-control of glycemia in the prevention of diabetic micro- and macrovascular complications. Handbook for Practitioners Doctors. 2017; 3: 59–62. [in Russian]
23. American Diabetes Association. Postprandial blood glucose (Consensus Statement). Diabetes Care 2001; 24: 775–8.
24. Schwedes U, Siebolds M, Mertes G. Meal-related structured self-monitoring of blood glucose: effect on diabetes control in non-insulin-treated type 2 diabetic patients. Diabetes Care 2002; 25: 1928–32.
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26. Ворохобина Н.В., Фогт С.Н. Волкова Е.А, Шадричева Ф.В. Сахарный диабет и депрессия. Лечащий врач. 2014; 1: 81–3. / Vorokhobina N.V., Fogt S.N. Volkova E.А, SHadricheva F.V. Sakharnyj diabet i depressiya. Lechashhij vrach. 2014; 1: 81–3. [in Russian]
27. Ismail K, Moulton CD, Winkley K et al. The association of depressive symptoms and diabetes distress with glycaemic control and diabetes complications over 2 years in newly diagnosed type 2 diabetes: a prospective cohort study. Diabetologia 2017; 60: 2092–102. DOI: 10.1007/s00125-017-4367-3
________________________________________________
1. Diabetes Atlas, Е.Е.С. IDF Diabetes Atlas Eight edition, 2017.
2. Аlgoritmy spetsializirovannoj meditsinskoj pomoshhi bol'nym sakharnym diabetom. Pod red. I.I.Dedova, M.V.Shestakovoj. 8-j vyp. M., 2017. [in Russian]
3. American Diabetes Association. Standards of Medical Care in Diabetes, 2008. Diabetes Care 2008; 31 (Suppl. 1): S13–S54.
4. Nathan DM, Buse JB, Davidson MB et al. Management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy. Diabetes Care 2006; 29: 1963–72.
5. Lebovitz HE, Austin MM, Blonde L et al. ACE/AACE consensus conference on the implementation of outpatient management of diabetes mellitus: consensus conference recommendations. Endocr Pract 2006; 12 (Suppl. 1): 6–12.
6. Jellinger PS, Davidson JA, Blonde L et al. Road maps to achieve glycemic control in type 2 diabetes mellitus: ACE/AACE Diabetes Road Map Task Force. Endocr Pract 2007; 13: 260–8.
7. Esposito K, Giugliano D, Nappo F et al. Regression of carotid atherosclerosis by control of postprandial hyperglycemia in type 2 diabetes mellitus. Circulation 2004; 110: 214–9.
8. Stratton IM, Adler AI, Neil HA et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35). BMJ 2000; 321: 405–12.
9. Saydah SH, Fradkin J, Cowie CC. Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes. JAMA 2004; 291: 335–42.
10. Volkova E.A., Vorokhobina N.V., Malygina O.F. Lifestyle modification, training and self-control as important components of diabetes treatment and improvement of patients life quality. Consilium Medicum. 2015; 17 (1): 54–62. [in Russian]
11. Poolsup N, Suksornboon N, Rottanasookchit S. Meta-analysis of self monitoring of blood glucose on glycemic control in type 2 diabetes patients: an update. Diabetes Technol Ther 2009; 11: 175–84.
12. O’Kane N, Bunting B et al. ESMON studygroup.Efficacy of self monitoring of blood glucose in patients with newly diagnose type 2 diabetes: randomized controlled trial. BMJ 2008; 336: 1174–7.
13. Allermann S, Houriet C, Diern P et al. Self monitoring of blood glucose in non insulin treated patients with type 2 diabetes: systematic review and meta-analysis. Curr Med Res Opin 2009; 25: 2903–13.
14. Klonoff DC et al. Consensus Report: The Current Role Of Self-Monitoring of Blood Glucose in Non-Insulin – Treated Type 2 Diabetes. J Diabet Sci Technol 2011; 5.
15. Bosi E, Scavini M, Ceriello A et al. Intensive Structured Self-monitoring of Blood Glucose and Glycemic Control in Noninsulin-Treated Type 2 Diabetes. The PRISMA Randomized Trial. Diabetes Care 2013; 36 (10): 2887–94.
16. Hanefeld M, Temelkova-Kurktschiev T. Control of post-prandial hyperglycemia - an essential part of good diabetes treatment and prevention of cardiovascular complications. Nutr Metab Cardiovasc Dis 2002; 12: 98–107.
17. Nathan DM, Cleary PA, Cacklund JY et al. Intensive diabetes treatment and cardiovascular disease in patients with type I diabetes. N Engl J Med 2005; 353: 2642–53.
18. Herbert Tilg H, Kaser A. Gut microbiome, obesity, and metabolic dysfunction. J Clin Invest 2011; 121 (6): 2126–32.
19. Robertson С. Translating ADA/EASD Guidelines and the ACE/AACE Road Maps Into Primary Care of Patients With Type 2 Diabetes. J Nurse Рractitioners 2008; 4 (9): 661–71.
20. Siebolds M, Gaedeke O, Schwede U. Self-monitoring of blood glucose – psychological aspects relevant to changes in HbA1c in type 2 diabetic patients treated with diet or diet plus oral antidiabetic medication. Patient Educ Couns 2006; 62: 104–10.
21. Kitasato L, Tojo T, Hatakeyama Y et al. Postprandial hyperglycemia and endothelial function in type 2 diabetes: focus on mitiglinide. Cardiovasc Diabetol 2012; 11 (1): 79.
22. Batrak G.A., Myasoedova S.E. The role of self-control of glycemia in the prevention of diabetic micro- and macrovascular complications. Handbook for Practitioners Doctors. 2017; 3: 59–62. [in Russian]
23. American Diabetes Association. Postprandial blood glucose (Consensus Statement). Diabetes Care 2001; 24: 775–8.
24. Schwedes U, Siebolds M, Mertes G. Meal-related structured self-monitoring of blood glucose: effect on diabetes control in non-insulin-treated type 2 diabetic patients. Diabetes Care 2002; 25: 1928–32.
25. Аmetov А.S. Sakharnyj diabet 2 tipa. Problemy i resheniya. 2-e izd. M.: GEHOTАR-Media, 2013; s. 136–73. [in Russian]
26. Vorokhobina N.V., Fogt S.N. Volkova E.А, SHadricheva F.V. Sakharnyj diabet i depressiya. Lechashhij vrach. 2014; 1: 81–3. [in Russian]
27. Ismail K, Moulton CD, Winkley K et al. The association of depressive symptoms and diabetes distress with glycaemic control and diabetes complications over 2 years in newly diagnosed type 2 diabetes: a prospective cohort study. Diabetologia 2017; 60: 2092–102. DOI: 10.1007/s00125-017-4367-3
Авторы
Е.А.Волкова*, О.Ф.Малыгина
ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И.Мечникова» Минздрава России. 191015, Россия, Санкт-Петербург, ул. Кирочная, д. 41 *doctorelena555@gmail.com
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E.A.Volkova*, O.F.Malygina
I.I.Mechnikov North-West State Medical University of the Ministry of Health of the Russian Federation. 191015, Russian Federation, Saint Petersburg, ul. Kirochnaia, d. 41 *doctorelena555@gmail.com