ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/2071-8713-5124ometendo-5124Research ArticleСтатьиArticlesНепрерывное мониторирование концентрации глюкозы крови в практике эндокринологаContinuous monitoring of blood glucose in the practice of endocrinologistPhilippovYu Iyuriyivanovich@gmail.com20121512201294№4 (2012)1522Copyright © Philippov Y.I., 20122012Philippov Y.I.Philippov Y.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/5124

Непрерывное мониторирование гликемии – важный диагностический, обучающий и лечебный инструмент для пациентов с сахарным диабетом (СД), который все шире входит в рутинную клиническую практику эндокринологов. Статья посвящена обзору современных методик, их преимуществам и недостаткам, доказательной базе и месту в повседневной клинической практике на современном этапе. В статье обсуждены ключевые факторы, влияющие на эффективность, а также представлен проект рекомендаций (показания, противопоказания, условия использования) по применению непрерывного мониторирования гликемии у пациентов с СД, приведен алгоритм применения данной методики в современной клинической практике.

Continuous glucose monitoring - an important diagnostic, teaching and treatment tool for patients with diabetes mellitus, which is increasingly becoming a part of routine clinical practice in endocrinology. This article presents an overview of modern techniques, their advantages and disadvantages, evidence basis and place in everyday clinical practice. The article discusses the key factors affecting the efficiency, indications, contraindications, conditions of use of the continuous glucose monitoring systems in patients with diabetes mellitus, gives an algorithm for the application of this technique in clinical practice.

сахарный диабетмониторирование глюкозыобучениегипогликемииdiabetesglucose monitoringtraininghypoglycemiaReferencesKadish A.H. Automation control of blood sugar a servomechanism for glucose monitoring and control. Trans Am Soc Artif Intern Organs 1963;9:363–7.Kadish A.H. Automation control of blood sugar a servomechanism for glucose monitoring and control. Trans Am Soc Artif Intern Organs 1963;9:363–7.Garg S.K., et al. Correlation of fingerstick blood glucose measurements with GlucoWatch biographer glucose results in young subjects with type 1 diabetes. Diabetes Care 1999;22(10):1708–14.Garg S.K., et al. Correlation of fingerstick blood glucose measurements with GlucoWatch biographer glucose results in young subjects with type 1 diabetes. Diabetes Care 1999;22(10):1708–14.Wentholt I.M., Hoekstra J.B., Devries J.H. Continuous glucose monitors: the long-awaited watch dogs? Diabetes Technol Ther 2007;9(5):399–409.Wentholt I.M., Hoekstra J.B., Devries J.H. Continuous glucose monitors: the long-awaited watch dogs? Diabetes Technol Ther 2007;9(5):399–409.Langendam M., et al. Continuous glucose monitoring systems for type 1 diabetes mellitus. Cochrane Database Syst Rev 2012;1:CD008101.Langendam M., et al. Continuous glucose monitoring systems for type 1 diabetes mellitus. Cochrane Database Syst Rev 2012;1:CD008101.Joubert M., Reznik Y. Personal continuous glucose monitoring (CGM) in diabetes management: review of the literature and implementation for practical use. Diabetes Res Clin Pract 2012;96(3):294–305.Joubert M., Reznik Y. Personal continuous glucose monitoring (CGM) in diabetes management: review of the literature and implementation for practical use. Diabetes Res Clin Pract 2012;96(3):294–305.Phillip M., et al. Use of continuous glucose monitoring in children and adolescents (*). Pediatr Diabetes 2012;13(3):215–228.Phillip M., et al. Use of continuous glucose monitoring in children and adolescents (*). Pediatr Diabetes 2012;13(3):215–228.Ибрагимова Л.И., Филиппов Ю.И., Майоров А.Ю. Эффективность обучения и качество жизни у больных сахарным диабетом 1 типа на помповой инсулинотерапии. Сахарный диабет 2012;1:35–40.Ибрагимова Л.И., Филиппов Ю.И., Майоров А.Ю. Эффективность обучения и качество жизни у больных сахарным диабетом 1 типа на помповой инсулинотерапии. Сахарный диабет 2012;1:35–40.Филиппов Ю.И., Пекарева Е.В., Майоров А.Ю. Некоторые аспекты помповой инсулинотерапии и непрерывного мониторирования гликемии в режиме реального времени (ответ на письмо Е.Д. Горбачева). Сахарный диабет 2010;4:119–124.Филиппов Ю.И., Пекарева Е.В., Майоров А.Ю. Некоторые аспекты помповой инсулинотерапии и непрерывного мониторирования гликемии в режиме реального времени (ответ на письмо Е.Д. Горбачева). Сахарный диабет 2010;4:119–124.Ramchandani N., et al. Real-life utilization of real-time continuous glucose monitoring: the complete picture. Journal of diabetes science and technology 2011;5(4):860–70.Ramchandani N., et al. Real-life utilization of real-time continuous glucose monitoring: the complete picture. Journal of diabetes science and technology 2011;5(4):860–70.Markowitz J.T., et al. Psychosocial correlates of continuous glucose monitoring use in youth and adults with type 1 diabetes and parents of youth. Diabetes Technol Ther 2012;14(6):523–6.Markowitz J.T., et al. Psychosocial correlates of continuous glucose monitoring use in youth and adults with type 1 diabetes and parents of youth. Diabetes Technol Ther 2012;14(6):523–6.Дедов И.И., et al. САХАРНЫЙ ДИАБЕТ: диагностика, лечение, профилактика. 2011: Медицинское информационное агенство.Дедов И.И., et al. САХАРНЫЙ ДИАБЕТ: диагностика, лечение, профилактика. 2011: Медицинское информационное агенство.Wojciechowski P., et al. Efficacy and safety comparison of continuous glucose monitoring and self-monitoring of blood glucose in type 1 diabetes: systematic review and meta-analysis. Pol Arch Med Wewn 2011;121(10):333–43.Wojciechowski P., et al. Efficacy and safety comparison of continuous glucose monitoring and self-monitoring of blood glucose in type 1 diabetes: systematic review and meta-analysis. Pol Arch Med Wewn 2011;121(10):333–43.Ludwig-Seibold C.U., et al. Continuous glucose monitoring in children, adolescents, and adults with type 1 diabetes mellitus: analysis from the prospective DPV diabetes documentation and quality management system from Germany and Austria. Pediatr Diabetes 2012;13(1):12–4.Ludwig-Seibold C.U., et al. Continuous glucose monitoring in children, adolescents, and adults with type 1 diabetes mellitus: analysis from the prospective DPV diabetes documentation and quality management system from Germany and Austria. Pediatr Diabetes 2012;13(1):12–4.Rubin R.R., Borgman S.K., Sulik B.T. Crossing the technology divide: practical strategies for transitioning patients from multiple daily insulin injections to sensor-augmented pump therapy. Diabetes Educ 2011. 37 Suppl 1:5S-18S; quiz 19S-20S.Rubin R.R., Borgman S.K., Sulik B.T. Crossing the technology divide: practical strategies for transitioning patients from multiple daily insulin injections to sensor-augmented pump therapy. Diabetes Educ 2011. 37 Suppl 1:5S-18S; quiz 19S-20S.Mauras N., et al. Continuous glucose monitoring in type 1 diabetes. Endocrine 2012.Mauras N., et al. Continuous glucose monitoring in type 1 diabetes. Endocrine 2012.Langeland L.B., et al. Short-term continuous glucose monitoring: effects on glucose and treatment satisfaction in patients with type 1 diabetes mellitus; a randomized controlled trial. Int J Clin Pract 2012;66(8):741–747.Langeland L.B., et al. Short-term continuous glucose monitoring: effects on glucose and treatment satisfaction in patients with type 1 diabetes mellitus; a randomized controlled trial. Int J Clin Pract 2012;66(8):741–747.Hermanides J., Phillip M., DeVries J.H. Current application of continuous glucose monitoring in the treatment of diabetes: pros and cons. Diabetes Care 2011;34 Suppl 2:S197–201.Hermanides J., Phillip M., DeVries J.H. Current application of continuous glucose monitoring in the treatment of diabetes: pros and cons. Diabetes Care 2011;34 Suppl 2:S197–201.Tsalikian E., et al. Feasibility of prolonged continuous glucose monitoring in toddlers with type 1 diabetes. Pediatr Diabetes 2012;13(4):301–7.Tsalikian E., et al. Feasibility of prolonged continuous glucose monitoring in toddlers with type 1 diabetes. Pediatr Diabetes 2012;13(4):301–7.Mauras N., et al. A randomized clinical trial to assess the efficacy and safety of real-time continuous glucose monitoring in the management of type 1 diabetes in young children aged 4 to №10 years. Diabetes Care 2012;35(2):204–10.Mauras N., et al. A randomized clinical trial to assess the efficacy and safety of real-time continuous glucose monitoring in the management of type 1 diabetes in young children aged 4 to №10 years. Diabetes Care 2012;35(2):204–10.Vazeou A. Continuous blood glucose monitoring in diabetes treatment. Diabetes Research and Clinical Practice 2011;93 Suppl 1:S125–S130.Vazeou A. Continuous blood glucose monitoring in diabetes treatment. Diabetes Research and Clinical Practice 2011;93 Suppl 1:S125–S130.Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study, G., et al., The effect of continuous glucose monitoring in well-controlled type 1 diabetes. Diabetes Care 2009; 32(8):1378–83.Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study, G., et al., The effect of continuous glucose monitoring in well-controlled type 1 diabetes. Diabetes Care 2009; 32(8):1378–83.Deiss D. et al. Improved glycemic control in poorly controlled patients with type 1 diabetes using real-time continuous glucose monitoring. Diabetes Care 2006;29(12):2730–2.Deiss D. et al. Improved glycemic control in poorly controlled patients with type 1 diabetes using real-time continuous glucose monitoring. Diabetes Care 2006;29(12):2730–2.O'Connell M.A., et al. Glycaemic impact of patient-led use of sensor-guided pump therapy in type 1 diabetes: a randomised controlled trial. Diabetologia 2009;52(7):1250–7.O'Connell M.A., et al. Glycaemic impact of patient-led use of sensor-guided pump therapy in type 1 diabetes: a randomised controlled trial. Diabetologia 2009;52(7):1250–7.Klonoff D.C., et al. Continuous glucose monitoring: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2011;96(10):2968–79.Klonoff D.C., et al. Continuous glucose monitoring: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2011;96(10):2968–79.Szypowska A., et al. Beneficial effect of real-time continuous glucose monitoring system on glycemic control in type 1 diabetic patients: systematic review and meta-analysis of randomized trials. Eur J Endocrinol 2012;166(4):567–74.Szypowska A., et al. Beneficial effect of real-time continuous glucose monitoring system on glycemic control in type 1 diabetic patients: systematic review and meta-analysis of randomized trials. Eur J Endocrinol 2012;166(4):567–74.Combs C.A. Continuous glucose monitoring and insulin pump therapy for diabetes in pregnancy. Journal of Maternal-Fetal and Neonatal Medicine. 0(0):1–3.Combs C.A. Continuous glucose monitoring and insulin pump therapy for diabetes in pregnancy. Journal of Maternal-Fetal and Neonatal Medicine. 0(0):1–3.Vigersky R.A., et al. Short- and long-term effects of real-time continuous glucose monitoring in patients with type 2 diabetes. Diabetes Care 2012;35(1):32–8.Vigersky R.A., et al. Short- and long-term effects of real-time continuous glucose monitoring in patients with type 2 diabetes. Diabetes Care 2012;35(1):32–8.Golden S.H., et al. in Methods for Insulin Delivery and Glucose Monitoring: Comparative Effectiveness. 2012: Rockville (MD).Golden S.H., et al. in Methods for Insulin Delivery and Glucose Monitoring: Comparative Effectiveness. 2012: Rockville (MD).Hemmingsen B., et al. Targeting intensive glycaemic control versus targeting conventional glycaemic control for type 2 diabetes mellitus. Cochrane Database Syst Rev 2011;6:CD008143.Hemmingsen B., et al. Targeting intensive glycaemic control versus targeting conventional glycaemic control for type 2 diabetes mellitus. Cochrane Database Syst Rev 2011;6:CD008143.Slover R.H., 2nd. Continuous glucose monitoring in children and adolescents. Curr Diab Rep 2012;12(5):510–6.Slover R.H., 2nd. Continuous glucose monitoring in children and adolescents. Curr Diab Rep 2012;12(5):510–6.Davey R.J., et al. The effect of short-term use of the Guardian RT continuous glucose monitoring system on fear of hypoglycaemia in patients with type 1 diabetes mellitus. Prim Care Diabetes 2012;6(1):35–9.Davey R.J., et al. The effect of short-term use of the Guardian RT continuous glucose monitoring system on fear of hypoglycaemia in patients with type 1 diabetes mellitus. Prim Care Diabetes 2012;6(1):35–9.Hirose M., Beverly E.A., Weinger K. Quality of Life and Technology: Impact on Children and Families With Diabetes. Curr Diab Rep, 2012.Hirose M., Beverly E.A., Weinger K. Quality of Life and Technology: Impact on Children and Families With Diabetes. Curr Diab Rep, 2012.Schwartz S., Scheiner G. The Role of Continuous Glucose Monitoring in the Management of Type-1 and Type-2 Diabetes, in Evidence Based Management of Diabetes. 2012.Schwartz S., Scheiner G. The Role of Continuous Glucose Monitoring in the Management of Type-1 and Type-2 Diabetes, in Evidence Based Management of Diabetes. 2012.

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