Nepārtraukta glikozes monitorēšana 1. tipa cukura diabēta pacientiem - ietekme uz kopējo metabolo kompensāciju un dzīves kvalitātes novērtējuma parametriem
Date
2019
Authors
Freiberga, Linda
Journal Title
Journal ISSN
Volume Title
Publisher
Latvijas Universitāte
Abstract
1.tipa cukura diabēts ir hroniska autoimūna slimība ar tai pavadošām akūtām un hroniskām diabēta komplikācijām. Straujas glikēmijas svārstības veicina šo komplikāciju attīstību, tāpēc ir nepieciešams izvērtēt glikēmisko variabilitāti diabēta pacientiem. Nepārtrauktās glikozes monitorēšana sniedz iespēju efektīvi izvērtēt glikēmijas izmaiņas ilgākā laika periodā, piefiksējot visas glikozes līmeņa izmaiņas diennaktī, kā arī to saistību ar insulīna injekcijām un fiziskajām aktivitātēm. Pētījuma mērķis bija noskaidrot, cik pareizi un kā pacienti ikdienas dzīvē kontrolē savu cukura līmeni asinīs, kā arī analizēt hipoglikēmiju biežumu un iemeslus un izvērtēt kopējo metabolo kompensāciju. Tika analizēti 1.tipa cukura diabēta pacientu nepārtrauktās glikozes monitorēšanas rezultāti, izvērtēta kopējā glikēmijas metabolā kompensācija pēc pacientu ambulatorajām kartēm un izvērtēti dzīves kvalitātes parametri pēc nepārtrauktās glikozes monitorēšanas, kā arī tās jēga turpmākajā cukura diabēta kontrolē. Pētījums tika izstrādāts Latvijas Universitātes Medicīniskās pēcdiploma izglītības institūtā, kur pacientu grupa, kas sastāvēja no 10 pacientiem, bija veikuši nepārtraukto glikozes monitorēšanu. Novērtējot glikēmijas variabilitāti, tika secināts, ka svarīgi ir noteikt vidējo glikēmijas variācijas koeficientu, kas norāda uz slimības smagumu un neatbilstošu diabēta paškontroli, kas cieši korelē ar hipoglikēmijas risku. Lai arī pētījumā netika iegūta statistiski ticama korelācija starp hipoglikēmiju biežumu un insulīna devām, tomēr visbiežākais iemesls biežām hipoglikēmijas epizodēm ir tieši intensīvā insulīna terapija. Nepārtrauktā glikozes monitorēšana samazina hipoglikēmijas epizodes un uzlabo diabēta paškontroli, kā arī samazina glikētā hemoglobīna līmeni. Tika secināts, ka starp 10 pacientiem pētījumā tika iegūts vidējais glikētā hemoglobīna līmenis 7,21%, kas pēc ADA vadlīnijām atbilst apmierinošai diabēta kompensācijai. Cukura diabēts kā diagnoze ietekmē lielā mērā pacientu privāto un sociālo dzīvi, jo tiek mainīti ikdienas paradumi, tajā skaitā tiek plānotas ēdienreizes un to saturs, kā arī diabēta paškontrole ierobežo ikdienas aktivitātes.
Type 1 diabetes is a chronic autoimmune disease accompanied by acute and chronic diabetic complications. Rapid glycemic excursions promote development of these complications therefore it is necessary to evaluate the glycemic variability in diabetic patients. continuous glucose monitoring provides an effective way to evaluate glycemic changes over a long period of time by recording all daily glycemic changes as well as their relevance to insulin injections and physical activity. The aim of this study was to find out, how well and how patients with diabetes control their blood sugar level in their daily, as well as to analyze the frequency and causes of hypoglycemia and to evaluate total metabolic compensation. The results of continuous glucose monitoring of type 1 diabetes patients were analyzed. There was evaluate total metabolic compensation by outpatient cards and quality of life parameters after continuous glucose monitoring, as well as its meaning for further control of diabetes. The study was made in University of Latvia Institute of Medical Postgraduate Education, where a group of 10 patients with type 1 diabetes had done the continuous glucose monitoring. Evaluating the glycemic variability, there was concluded that it is important to determine the mean glycemic coefficient of variation, which indicates the severity of the disease and inadequate self-control of diabetes, which correlates closely with the risk of hypoglycemia. Although the study did not produce a statistically significant correlation between frequency of hypoglycemia and insulin doses, the most common cause of frequent hypoglicemic episodes is intensive insulin therapy. Continuous glucose monitoring reduces episodes of hypoglycemia and improves diabetic self-control, and reduces the level of glycated hemoglobin. There was concluded that the mean glycated hemoglobin level was 7,21% among 10 patients, which, according to ADA guidelines, equivalent to tolerable metabolic compensation. Diabetes as a diagnosis mostly affects the patients and their private and social lives by changing daily habits, including planning their meals, as well as diabetic self-control restricts daily activities.
Type 1 diabetes is a chronic autoimmune disease accompanied by acute and chronic diabetic complications. Rapid glycemic excursions promote development of these complications therefore it is necessary to evaluate the glycemic variability in diabetic patients. continuous glucose monitoring provides an effective way to evaluate glycemic changes over a long period of time by recording all daily glycemic changes as well as their relevance to insulin injections and physical activity. The aim of this study was to find out, how well and how patients with diabetes control their blood sugar level in their daily, as well as to analyze the frequency and causes of hypoglycemia and to evaluate total metabolic compensation. The results of continuous glucose monitoring of type 1 diabetes patients were analyzed. There was evaluate total metabolic compensation by outpatient cards and quality of life parameters after continuous glucose monitoring, as well as its meaning for further control of diabetes. The study was made in University of Latvia Institute of Medical Postgraduate Education, where a group of 10 patients with type 1 diabetes had done the continuous glucose monitoring. Evaluating the glycemic variability, there was concluded that it is important to determine the mean glycemic coefficient of variation, which indicates the severity of the disease and inadequate self-control of diabetes, which correlates closely with the risk of hypoglycemia. Although the study did not produce a statistically significant correlation between frequency of hypoglycemia and insulin doses, the most common cause of frequent hypoglicemic episodes is intensive insulin therapy. Continuous glucose monitoring reduces episodes of hypoglycemia and improves diabetic self-control, and reduces the level of glycated hemoglobin. There was concluded that the mean glycated hemoglobin level was 7,21% among 10 patients, which, according to ADA guidelines, equivalent to tolerable metabolic compensation. Diabetes as a diagnosis mostly affects the patients and their private and social lives by changing daily habits, including planning their meals, as well as diabetic self-control restricts daily activities.
Description
Keywords
Medicīna , 1.tipa cukura diabēts , Nepārtrauktā glikozes monitorēšana , Glikēmijas variabilitāte , Hipoglikēmija