How to improve the quality of type 2 diabetes mellitus management in routine clinical practice. experience of using a glycemic variability diary

封面

如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

Background. In the realities of routine practice; endocrinologists work in multitasking mode. Their efforts are aimed at providing an individualized approach to the management of type 2 diabetes mellitus (DM2) for each patient. The emergence of new tools to ensure quality glycemic control; such as a glycemic variability diary (GVD); can open up a number of new opportunities for doctors and patients and improve the DM2 prognosis.

Analysis of experience in using GVD. The analyzed experience of using GVD in 31 patients with decompensated DM2 in real clinical practice of endocrinologists in the Northwestern Federal District is presented. Using GVD; the estimated time spent by patients in different glycemic ranges and the effectiveness of therapy changes in terms of efficacy and safety in relation to hypoglycemic conditions were assessed. In addition; glycemic variability (GV) was assessed as an independent risk factor for the development of severe hypoglycemic conditions and diabetic microand macroangiopathies [1].

Conclusion. GVD has demonstrated itself as an effective tool that helps improve glycemic control in DM2 patients and makes it possible to qualitatively evaluate the results of the therapy used. In our case; GVD made it possible to visualize the positive dynamics of changes in carbohydrate metabolism after the inclusion of degludec in the ultra-long-acting insulin therapy regimen.

全文:

受限制的访问

作者简介

Kh. Astamirova

City Consultative and Diagnostic Center № 1

Email: nicolay13@mail.ru
ORCID iD: 0000-0002-7828-0052
俄罗斯联邦, St. Petersburg

A. Gatina

City Outpatient Clinic № 19

Email: nicolay13@mail.ru
俄罗斯联邦, St. Petersburg

Ya. Gorbunova

Central Medical and Sanitary Unit № 58 of the FMBA of Russia

Email: nicolay13@mail.ru
俄罗斯联邦, Severodvinsk

Nikolay Demidov

Shcherbinka City Hospital of the Moscow Healthcare Department

编辑信件的主要联系方式.
Email: nicolay13@mail.ru
ORCID iD: 0000-0001-8289-0032

Cand. Sci. (Med.).

俄罗斯联邦, Shcherbinka, Moscow

T. Ivanenko

City Outpatient Clinic № 114

Email: nicolay13@mail.ru
俄罗斯联邦, St. Petersburg

M. Kolesnikova

City Outpatient Clinic № 86

Email: nicolay13@mail.ru
俄罗斯联邦, St. Petersburg

O. Lapteva

City Outpatient Clinic № 2

Email: nicolay13@mail.ru
俄罗斯联邦, St. Petersburg

I. Morozova

City Outpatient Clinic № 112

Email: nicolay13@mail.ru
俄罗斯联邦, St. Petersburg

V. Parshina

City Outpatient Clinic № 23

Email: nicolay13@mail.ru
俄罗斯联邦, St. Petersburg

O. Presnyakova

City Outpatient Clinic № 117

Email: nicolay13@mail.ru
俄罗斯联邦, St. Petersburg

E. Smirnova

City Outpatient Clinic № 44

Email: nicolay13@mail.ru
ORCID iD: 0000-0003-2487-0038
俄罗斯联邦, St. Petersburg

N. Smirnova

Center named after. L.G. Sokolov, FMBA of Russia

Email: nicolay13@mail.ru
俄罗斯联邦, St. Petersburg

M. Startseva

Arkhangelsk Regional Clinical Hospital

Email: nicolay13@mail.ru
俄罗斯联邦, Arkhangelsk

Z. Khamrazhanov

Vologda Regional Center of Endocrinology

Email: nicolay13@mail.ru
俄罗斯联邦, Vologda

N. Kholmskaya

Vologda Regional Center of Endocrinology

Email: nicolay13@mail.ru
俄罗斯联邦, Vologda

参考

  1. Анциферов М.Б.; Демидов Н.А.; Котеш-кова О.М. и др. Оценка вариабельности уровня гликемии на основе самоконтроля. Результаты пилотного проекта. Эндокринология: новости; мнения; обучение. 2021;10(2):26–31. [Antsiferov M.B.; Demidov N.A.; Koteshkova O.M. Evaluation of the variability of the level of glycemia based on self-control. Pilot project results. Endokrinologiya: novosti; mneniya; obuchenie. 2021;10(2):26–31 (In Russ.)]. doi: 10.33029/2304-9529-2021-10-2-26-31.
  2. Клинические рекомендации «Сахарный диабет 2 типа у взрослых»; МЗ РФ; 2022. [Clinical guidelines “Type 2 diabetes mellitus in adults”; Ministry of Health of the Russian Federation; 2022. (In Russ.)]. URL: https://cr.minzdrav.gov.ru/schema/290_2?ysclid=lpgnbt6y66436133340.
  3. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Под ред. И.И. Дедова; М.В. Шестаковой; А.Ю. Майорова. 11-й вып. М.; 2023. [Standards of specialized diabetes care. Ed. by I.I. Dedov; M.V. Shestakova; A.Yu. Mayorov. 11th Edition. М.; 2023. (In Russ.)]. URL: https://www.endocrincentr.ru/sites/default/files/specialists/science/clinic-recomendations/2023_alg_sum.pdf?ysclid=lpgni1iw9p971215820.
  4. Battelino T.; Danne T.; Bergenstal R.M.; et al. Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range. Diab Care. 2019;42(8):1593–603. doi: 10.2337/dci19-0028 5.
  5. Inaba M.; Okuno S.; Kumeda Y.; et al. Osaka CKD Expert Research Group. Glycated albumin is a better glycemic indicator thanglycated hemoglobin values in hemodialysis patients with diabetes: effect of anemia and erythropoietin injection. J Am Soc Nephrol. 2007;18(3):896–903. doi: 10.1681/ASN.2006070772.
  6. Bry L.; Chen P.C.; Sacks D.B. Effects of Hemoglobin Variants and Chemically Modified Derivatives on Assays for Glycohemoglobin. Clin Chem. 2001;47(2):153–63. doi: 10.1093/clinchem/47.2.153.
  7. American Diabetes Association: Standards of Medical Care in Diabetes. 2023.
  8. Diabetes Technology. Diab Care. 2023;46(Suppl. 1):111–27. doi: 10.2337/dc23-S 007.
  9. Davies M.J.; et al. Management of hyperglycaemia in type 2 diabetes; 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetol. 2022;65(12):1925–66. doi: 10.1007/s00125-022-05787-2.
  10. Галстян Г.Р. Применение инсулина сверхдлительного действия деглудек у взрослых пациентов с сахарным диабетом 2 типа в реальной клинической практике в России. Сахарный диабет. 2023;26(1):55-65Doi: https://doi.org/10.14341/DM12976 [Galstyan G.R. The use of long-acting insulin degludec in adult patients with type 2 diabetes mellitus in real clinical practice in Russia. Diab Mellit. 2023;26(1):55-65 (In Russ.)].
  11. Лифшиц Г.И.; Концепция 4П – новый вектор развития медицины. «Наука быть здоровым». 2019. [Lifshits G.I. The 4P concept is a new vector for the development of medicine. «The science of being healthy». 2019. (In Russ.)]. URL: https://www.cnmt.ru/nbz/leto-2019/konczepcziya-4-p-novyij-vektor-razvitiya-mediczinyi?ysclid=lpgzx86iho265759260.
  12. Пальцев М.А.; Белушкина Н.Н.; Чабан Е.А. 4П-медицина как новая модель здравоохранения. Журнал Оргздрав. Вестник ВШОУЗ. 2015;2. [Paltsev M.A.; Belushkina N.N.; Cha-ban E.A. 4P medicine as a new healthcare model. J Orgzdrav. Bulletin of Higher School of Public Health. 2015;2. (In Russ.)]. URL: https://www.vshouz.ru/journal/2015/4p-meditsina-kak-novaya-model-zdravookhraneniya/?ysclid=lpgzvpzviw400980617.

补充文件

附件文件
动作
1. JATS XML
2. Fig.1.

下载 (589KB)
3. Fig.2.

下载 (34KB)
4. Fig.3.

下载 (100KB)
##common.cookie##