mvjrМедицинский вестник Юга РоссииMedical Herald of the South of Russia2219-80752618-7876The Rostov State Medical University10.21886/2219-8075-2022-13-1-43-51mvjr-1502Research ArticleЭНДОКРИНОЛОГИЯENDOCRYNOLOGYСамоконтроль гликемии у больных сахарным диабетом 2 типа с позиций доказательной медициныSelf-monitoring of blood glucose in patients with type 2 diabetes mellitus from the standpoint of evidence-based medicinehttps://orcid.org/0000-0003-4027-3727ЗакиевВ. Д.ZakievV. D.

Закиев Вадим Дмитриевич - врач-кардиолог консультативного отделения.

Москва

Vadim D. Zakiev - cardiologist of consultative department.

Moscow

zakiev739@gmail.comhttps://orcid.org/0000-0003-4298-0329МустафинаВ. Р.MustafinaV. R.

Мустафина Виолетта Рафаэлевна - врач-эндокринолог терапевтического отделения.

Москва

Violetta R. Mustafi na, endocrinologist of Internal Medicine department, Moscow Department of Health.

Moscow

violetta-mustafi@mail.ruИнпромед, ОООРоссияLimited liability company InpromedRussian FederationГородская клиническая больница имени В.В. ВиноградоваРоссияV.V. Vinogradov HospitalRussian Federation2022300320221314351Copyright © Закиев В.Д., Мустафина В.Р., 20222022Закиев В.Д., Мустафина В.Р.Zakiev V.D., Mustafina V.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medicalherald.ru/jour/article/view/1502

Согласно клиническим рекомендациям, проведение самоконтроля гликемии пациентами в настоящее время является важной составляющей лечения сахарного диабета 2 типа. Однако самоконтроль гликемии ассоциирован со значительными затратами. Возможно ли сократить использование самоконтроля гликемии с целью оптимизации затрат на лечение сахарного диабета? И если это возможно, то у каких пациентов? Так как, согласно исследованию United Kingdom Prospective Diabetes Study (UKPDS), снижение уровня гликированного гемоглобина на каждый 1% приводит к снижению риска микрососудистых осложнений на 37% и макрососудистых осложнений на 14%, а также к снижению смертности, в статье преимущественно рассмотрено влияние самоконтроля на уровень гликированного гемоглобина в различных клинических ситуациях.

According to clinical guidelines self-monitoring of blood glucose is a part of the treatment of type 2 diabetes mellitus. However, self-monitoring of glycemia is associated with signifi cant costs. Th at’s why the issue if there is a possibility to decrease the use of self-monitoring of blood glucose is actual. Since the United Kingdom Prospective Study (UKPDS) showed that every 1% decrease in glycated hemoglobin leads to a 37% decrease in the risk of microvascular complications and 14% decrease in the risk of macrovascular complications as well as it leads to a decrease in mortality, the article mainly examined the eff ect of selfmonitoring on the level of glycated hemoglobin in various clinical situations.

Самоконтрольсахарный диабетдоказательная медицинаобзорblood glucose self-monitoringdiabetes mellitusevidence-based medicineReferencesДедов И.И., Шестакова М.В., Майоров А.Ю., Викулова О.К., Галстян Г.Р., и др. «Алгоритмы специализированной медицинской помощи больным сахарным диабетом» Под редакцией И.И. Дедова, М.В. Шестаковой, А.Ю. Майорова. 9-й выпуск. Сахарный диабет. 2019;22(1S1):1144. DOI: 10.14341/DM221S1Dedov I.I., Shestakova M.V., Mayorov A.Y., Vikulova O.K., Galstyan G.R., et al. Standards of specialized diabetes care. Edited by Dedov I.I., Shestakova M.V., Mayorov A.Yu. 9th edition. Diabetes Mellitus. 2019;22(1s1):1-144. (in Russ.) DOI: 10.14341/DM221S1Freckmann G, Schmid C, Baumstark A, Pleus S, Link M, Haug C. System accuracy evaluation of 43 blood glucose monitoring systems for self-monitoring of blood glucose according to DIN EN ISO 15197. J Diabetes Sci Technol. 2012;6(5):106075. DOI: 10.1177/193229681200600510.Freckmann G, Schmid C, Baumstark A, Pleus S, Link M, Haug C. System accuracy evaluation of 43 blood glucose monitoring systems for self-monitoring of blood glucose according to DIN EN ISO 15197. J Diabetes Sci Technol. 2012;6(5):1060-75. DOI: 10.1177/193229681200600510.Анциферов М.Б., Котешкова О.М. Управление сахарным диабетом: организация и значение самоконтроля. Трудный пациент. 2009;7(10):41–46. eLIBRARY ID: 16908683Antsiferov M.B., Koteshkova O.M. Diabetes mellitus management: organization and importance of self-control. Diffi cult patient. 2009;7(10):41–46. (in Russ.)eLIBRARY ID: 16908683Peters ML, Huisman EL, Schoonen M, Wolff enbuttel BHR. Th e current total economic burden of diabetes mellitus in the Netherlands. Neth J Med. 2017;75(7):281-297. PMID: 28956787.Peters ML, Huisman EL, Schoonen M, Wolff enbuttel BHR. Th e current total economic burden of diabetes mellitus in the Netherlands. Neth J Med. 2017;75(7):281-297. PMID: 28956787.de Lagasnerie G, Aguadé AS, Denis P, Fagot-Campagna A, Gastaldi-Menager C. Th e economic burden of diabetes to French national health insurance: a new cost-of-illness method based on a combined medicalized and incremental approach. Eur J Health Econ. 2018;19(2):189-201. DOI: 10.1007/s10198-017-0873-y.de Lagasnerie G, Aguadé AS, Denis P, Fagot-Campagna A, Gastaldi-Menager C. Th e economic burden of diabetes to French national health insurance: a new cost-of-illness method based on a combined medicalized and incremental approach. Eur J Health Econ. 2018;19(2):189-201. DOI: 10.1007/s10198-017-0873-y.Дедов И.И., Калашникова М.Ф., Белоусов Д.Ю., Колбин А.С., Рафальский В.В., и др. Анализ стоимости болезни сахарного диабета 2 типа в Российской Федерации: результаты Российского многоцентрового наблюдательного фармакоэпидемиологического исследования ФОРСАЙТ-СД2. Сахарный диабет. 2017;20(6):403-419. DOI: 10.14341/DM9278Dedov I.I., Kalashnikova M.F., Belousov D.Y., Kolbin A.S., Rafalskiy V.V., et al. Cost-of-Illness Analysis of Type 2 Diabetes Mellitus in the Russian Federation: Results from Russian multicenter observational pharmacoepidemiologic study of diabetes care for patients with type 2 diabetes mellitus (FORSIGHT-Т2DM). Diabetes mellitus. 2017;20(6):403-419. (In Russ.) DOI: 10.14341/DM9278American Diabetes Association. Economic costs of diabetes in the U.S. in 2012. Diabetes Care. 2013;36(4):1033-46. DOI: 10.2337/dc12-2625.American Diabetes Association. Economic costs of diabetes in the U.S. in 2012. Diabetes Care. 2013;36(4):1033-46. DOI: 10.2337/dc12-2625.Ulrich S, Holle R, Wacker M, Stark R, Icks A, et al. Cost burden of type 2 diabetes in Germany: results from the population-based KORA studies. BMJ Open. 2016;6(11):e012527. DOI: 10.1136/bmjopen-2016-012527.Ulrich S, Holle R, Wacker M, Stark R, Icks A, et al. Cost burden of type 2 diabetes in Germany: results from the population-based KORA studies. BMJ Open. 2016;6(11):e012527. DOI: 10.1136/bmjopen-2016-012527.Javanbakht M, Baradaran HR, Mashayekhi A, Haghdoost AA, Khamseh ME, et al. Cost-of-illness analysis of type 2 diabetes mellitus in Iran. PLoS One. 2011;6(10):e26864. DOI: 10.1371/journal.pone.0026864.Javanbakht M, Baradaran HR, Mashayekhi A, Haghdoost AA, Khamseh ME, et al. Cost-of-illness analysis of type 2 diabetes mellitus in Iran. PLoS One. 2011;6(10):e26864. DOI: 10.1371/journal.pone.0026864.Закиев В.Д. Стоимость профилактики осложнений сахарного диабета 2 типа. Сборник тезисов XIII Международной (XXII Всероссийской) Пироговской научной медицинской конференции студентов и молодых ученых. Москва: ФГБОУ ВО РНИМУ им. Н.И. Пирогова, 2018 г.Zakiev V.D. Stoimost’ profi laktiki oslozhnenij saharnogo diabeta 2 tipa. Sbornik tezisov XIII Mezhdunarodnoj (XXII Vserossijskoj) Pirogovskoj nauchnoj medicinskoj konferencii studentov i molodyh uchenyh, Moskva: FGBOU VO RNIMU im. N.I. Pirogova. Moscow., 2018. (In Russ.).National Prescribing Centre. Data focused commentary: type 2 diabetes: self-monitoring blood glucose 2012. Доступна по: http://www.npc.nhs.uk/therapeutics/cardio/diabetes_2/resources/dfc_self_monitoring_of_blood_glucose.pdf Ссылка активна на 10.12.2021.National Prescribing Centre. Data focused commentary: type 2 diabetes: self-monitoring blood glucose 2012. Available at: http://www.npc.nhs.uk/therapeutics/cardio/diabetes_2/resources/dfc_self_monitoring_of_blood_glucose.pdf Accessed at December 10, 2021Robson J, Smithers H, Chowdhury T, Bennett-Richards P, Keene D, et al. Reduction in self-monitoring of blood glucose in type 2 diabetes: an observational controlled study in east London. Br J Gen Pract. 2015;65(633):e256-63. DOI: 10.3399/bjgp15X684421.Robson J, Smithers H, Chowdhury T, Bennett-Richards P, Keene D, et al. Reduction in self-monitoring of blood glucose in type 2 diabetes: an observational controlled study in east London. Br J Gen Pract. 2015;65(633):e256-63. DOI: 10.3399/bjgp15X684421.Simon J, Gray A, Clarke P, Wade A, Neil A, et al. Cost eff ectiveness of self monitoring of blood glucose in patients with non-insulin treated type 2 diabetes: economic evaluation of data from the DiGEM trial. BMJ. 2008;336(7654):1177-80. DOI: 10.1136/bmj.39526.674873.BE.Simon J, Gray A, Clarke P, Wade A, Neil A, et al. Cost eff ectiveness of self monitoring of blood glucose in patients with non-insulin treated type 2 diabetes: economic evaluation of data from the DiGEM trial. BMJ. 2008;336(7654):1177-80. DOI: 10.1136/bmj.39526.674873.BE.Malanda UL, Welschen LM, Riphagen II, Dekker JM, Nijpels G, Bot SD. Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin. Cochrane Database Syst Rev. 2012;1:CD005060. DOI: 10.1002/14651858.CD005060.pub3.Malanda UL, Welschen LM, Riphagen II, Dekker JM, Nijpels G, Bot SD. Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin. Cochrane Database Syst Rev. 2012;1:CD005060. DOI: 10.1002/14651858.CD005060.pub3.Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321(7258):40512. DOI: 10.1136/bmj.321.7258.405.Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321(7258):405-12. DOI: 10.1136/bmj.321.7258.405.Дедов И.И., Шестакова М.В., Аметов А.С., Анциферов М.Б., Галстян Г.Р., и др. Инициация и интенсификация сахароснижающей терапии у больных сахарным диабетом 2 типа: обновление консенсуса совета экспертов Российской ассоциации эндокринологов (2015). Сахарный диабет. 2015;18(1):5-23. DOI: 10.14341/DM201515-23Dedov I.I., Shestakova M.V., Ametov A.S., Antsiferov M.B., Galstyan G.R., et al. Initiation and intensifi cation of antihyperglycemic therapy in type 2 diabetes mellitus: Update of Russian Association of Endocrinologists expert consensus document (2015). Diabetes mellitus. 2015;18(1):5-23. (In Russ.) DOI: 10.14341/DM201515-23Holstein A, Egberts EH. Risk of hypoglycaemia with oral antidiabetic agents in patients with Type 2 diabetes. Exp Clin Endocrinol Diabetes. 2003;111(7):405-14. DOI: 10.1055/s-2003-44287.Holstein A, Egberts EH. Risk of hypoglycaemia with oral antidiabetic agents in patients with Type 2 diabetes. Exp Clin Endocrinol Diabetes. 2003;111(7):405-14. DOI: 10.1055/s-2003-44287.Schwedes U, Siebolds M, Mertes G; SMBG Study Group. Meal-related structured self-monitoring of blood glucose: eff ect on diabetes control in non-insulin-treated type 2 diabetic patients. Diabetes Care. 2002;25(11):1928-32. DOI: 10.2337/diacare.25.11.1928.Schwedes U, Siebolds M, Mertes G; SMBG Study Group. Mealrelated structured self-monitoring of blood glucose: eff ect on diabetes control in non-insulin-treated type 2 diabetic patients. Diabetes Care. 2002;25(11):1928-32. DOI: 10.2337/diacare.25.11.1928.Guerci B, Drouin P, Grangé V, Bougnères P, Fontaine P, et al. Self-monitoring of blood glucose signifi cantly improves metabolic control in patients with type 2 diabetes mellitus: the Auto-Surveillance Intervention Active (ASIA) study. Diabetes Metab. 2003;29(6):587-94. DOI: 10.1016/s1262-3636(07)70073-3.Guerci B, Drouin P, Grangé V, Bougnères P, Fontaine P, et al. Selfmonitoring of blood glucose signifi cantly improves metabolic control in patients with type 2 diabetes mellitus: the AutoSurveillance Intervention Active (ASIA) study. Diabetes Metab. 2003;29(6):587-94. DOI: 10.1016/s1262-3636(07)70073-3.Davidson MB, Castellanos M, Kain D, Duran P. Th e eff ect of self monitoring of blood glucose concentrations on glycated hemoglobin levels in diabetic patients not taking insulin: a blinded, randomized trial. Am J Med. 2005;118(4):422-5. DOI: 10.1016/j.amjmed.2004.12.006.Davidson MB, Castellanos M, Kain D, Duran P. Th e eff ect of self monitoring of blood glucose concentrations on glycated hemoglobin levels in diabetic patients not taking insulin: a blinded, randomized trial. Am J Med. 2005;118(4):422-5. DOI: 10.1016/j.amjmed.2004.12.006.Farmer A, Wade A, Goyder E, Yudkin P, French D, et al. Impact of self monitoring of blood glucose in the management of patients with non-insulin treated diabetes: open parallel group randomised trial. BMJ. 2007;335(7611):132. DOI: 10.1136/bmj.39247.447431.BE.Farmer A, Wade A, Goyder E, Yudkin P, French D, et al. Impact of self monitoring of blood glucose in the management of patients with non-insulin treated diabetes: open parallel group randomised trial. BMJ. 2007;335(7611):132. DOI: 10.1136/bmj.39247.447431.BE.Barnett AH, Krentz AJ, Strojek K, Sieradzki J, Azizi F, et al. Th e effi cacy of self-monitoring of blood glucose in the management of patients with type 2 diabetes treated with a gliclazide modifi ed release-based regimen. A multicentre, randomized, parallel-group, 6-month evaluation (DINAMIC 1 study). Diabetes Obes Metab. 2008;10(12):1239-47. DOI: 10.1111/j.1463-1326.2008.00894.x.Barnett AH, Krentz AJ, Strojek K, Sieradzki J, Azizi F, et al. Th e Efficacy of self-monitoring of blood glucose in the management of patients with type 2 diabetes treated with a gliclazide modifi ed release-based regimen. A multicentre, randomized, parallel-group, 6-month evaluation (DINAMIC 1 study). Diabetes Obes Metab. 2008;10(12):1239-47. DOI: 10.1111/j.1463-1326.2008.00894.x.O’Kane MJ, Bunting B, Copeland M, Coates VE; ESMON study group. Efficacy of self monitoring of blood glucose in patients with newly diagnosed type 2 diabetes (ESMON study): randomised controlled trial. BMJ. 2008;336(7654):1174-7. DOI: 10.1136/bmj.39534.571644.BE.O’Kane MJ, Bunting B, Copeland M, Coates VE; ESMON study group. Efficacy of self monitoring of blood glucose in patients with newly diagnosed type 2 diabetes (ESMON study): randomised controlled trial. BMJ. 2008;336(7654):1174-7. DOI: 10.1136/bmj.39534.571644.BE.Kleefstra N, Hortensius J, Logtenberg SJ, Slingerland RJ, Groenier KH,. Self-monitoring of blood glucose in tablettreated type 2 diabetic patients (ZODIAC). Neth J Med. 2010;68(1):311-6. PMID: 20739728.Kleefstra N, Hortensius J, Logtenberg SJ, Slingerland RJ, Groenier KH,. Self-monitoring of blood glucose in tablet-treated type 2 diabetic patients (ZODIAC). Neth J Med. 2010;68(1):311-6. PMID: 20739728.Harashima S, Fukushima T, Sasaki M, Nishi Y, Fujimoto S, et al. Self-monitoring of blood glucose (SMBG) improves glycaemic control in oral hypoglycaemic agent (OHA)treated type 2 diabetes (SMBG-OHA study). Diabetes Metab Res Rev. 2013;29(1):77-84. DOI: 10.1002/dmrr.2363.Harashima S, Fukushima T, Sasaki M, Nishi Y, Fujimoto S, et al. Self-monitoring of blood glucose (SMBG) improves glycaemic control in oral hypoglycaemic agent (OHA)-treated type 2 diabetes (SMBG-OHA study). Diabetes Metab Res Rev. 2013;29(1):77-84. DOI: 10.1002/dmrr.2363.Young LA, Buse JB, Weaver MA, Vu MB, Mitchell CM, et al. Glucose Self-monitoring in Non-Insulin-Treated Patients With Type 2 Diabetes in Primary Care Settings: A Randomized Trial. JAMA Intern Med. 2017;177(7):920-929. DOI: 10.1001/jamainternmed.2017.1233.Young LA, Buse JB, Weaver MA, Vu MB, Mitchell CM, et al. Glucose Self-monitoring in Non-Insulin-Treated Patients With Type 2 Diabetes in Primary Care Settings: A Randomized Trial. JAMA Intern Med. 2017;177(7):920-929. DOI: 10.1001/jamainternmed.2017.1233.Hortensius J, Kleefstra N, Landman GWD, Houweling BT, Groenier KH, et al. Eff ects of three frequencies of selfmonitored blood glucose on HbA1c and quality of life in patients with type 2 diabetes with once daily insulin and stable control: a randomized trial. BMC Res Notes. 2018;11(1):26. DOI: 10.1186/s13104-018-3138-7.Hortensius J, Kleefstra N, Landman GWD, Houweling BT, Groenier KH, et al. Eff ects of three frequencies of self-monitored blood glucose on HbA1c and quality of life in patients with type 2 diabetes with once daily insulin and stable control: a randomized trial. BMC Res Notes. 2018;11(1):26. DOI: 10.1186/s13104-018-3138-7.Welschen LM, Bloemendal E, Nijpels G, Dekker JM, Heine RJ, et al Self-monitoring of blood glucose in patients with type 2 diabetes who are not using insulin: a systematic review. Diabetes Care. 2005;28(6):1510-7. DOI: 10.2337/diacare.28.6.1510.Welschen LM, Bloemendal E, Nijpels G, Dekker JM, Heine RJ, et al Self-monitoring of blood glucose in patients with type 2 diabetes who are not using insulin: a systematic review. Diabetes Care. 2005;28(6):1510-7. DOI: 10.2337/diacare.28.6.1510.McIntosh B, Yu C, Lal A, Chelak K, Cameron C, et al. Efficacy of self-monitoring of blood glucose in patients with type 2 diabetes mellitus managed without insulin: a systematic review and meta-analysis. Open Med. 2010;4(2):e102-13. PMID: 21686299; PMCID: PMC3116681.McIntosh B, Yu C, Lal A, Chelak K, Cameron C, et al. Efficacy of self-monitoring of blood glucose in patients with type 2 diabetes mellitus managed without insulin: a systematic review and meta-analysis. Open Med. 2010;4(2):e102-13. PMID: 21686299; PMCID: PMC3116681.Zhu H, Zhu Y, Leung SW. Is self-monitoring of blood glucose eff ective in improving glycaemic control in type 2 diabetes without insulin treatment: a meta-analysis of randomised controlled trials. BMJ Open. 2016;6(9):e010524. DOI: 10.1136/bmjopen-2015-010524.Zhu H, Zhu Y, Leung SW. Is self-monitoring of blood glucose eff ective in improving glycaemic control in type 2 diabetes without insulin treatment: a meta-analysis of randomised controlled trials. BMJ Open. 2016;6(9):e010524. DOI: 10.1136/bmjopen-2015-010524.Schütt M, Kern W, Krause U, Busch P, Dapp A, et al. Is the frequency of self-monitoring of blood glucose related to long-term metabolic control? Multicenter analysis including 24,500 patients from 191 centers in Germany and Austria. Exp Clin Endocrinol Diabetes. 2006;114(7):384-8. DOI: 10.1055/s-2006-924152.Schütt M, Kern W, Krause U, Busch P, Dapp A, et al. Is the frequency of self-monitoring of blood glucose related to long-term metabolic control? Multicenter analysis including 24,500 patients from 191 centers in Germany and Austria. Exp Clin Endocrinol Diabetes. 2006;114(7):384-8. DOI: 10.1055/s-2006-924152.Barnard KD, Young AJ, Waugh NR. Self monitoring of blood glucose - a survey of diabetes UK members with type 2 diabetes who use SMBG. BMC Res Notes. 2010;3:318. DOI: 10.1186/1756-0500-3-318.Barnard KD, Young AJ, Waugh NR. Self monitoring of blood glucose - a survey of diabetes UK members with type 2 diabetes who use SMBG. BMC Res Notes. 2010;3:318. DOI: 10.1186/1756-0500-3-318.

The authors declare that there are no conflicts of interest present.