Glycemic control importance in patients with comorbid pathology

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Abstract

Diabetes mellitus should be regarded as a medical condition that exists in the context of comorbidity, where on the one hand diabetes itself facilitates comorbid pathology development, and on the other hand comorbid pathology influences its course, treatment tactics and clinical results. Diabetes is presented in European guidelines on stroke treatment and prevention and in European guidelines on ischemic heart disease treatment and prevention not only as risk factor for these conditions development but also as pathology that influences prognosis. Besides, data that allowed to consider DM as a risk factor for embolic complication were reported. Along with hypertension, congestive heart failure, atherosclerotic vascular disease, age and gender, diabetes was included in widely used scale CHA2DS2-VASс as pathology that defines embolic stroke probability and necessity for anticoagulant therapy. According to 2014 European guidelines on pulmonary artery thromboembolia treatment and prevention, type 2 diabetes mellitus is associated with risk of pulmonary embolism development. Moreover, in patients with already developed pulmonary embolism the presence of DM increases mortality by 5 times. A clear connection of glycemia control with risk of micro- and macrovascular complications development decrease is shown, wherefore better compensation of carbohydrate metabolism disturbances became the main treatment course. In concurrence with this it is suggested to establish individual treatment goals depending on patient's age, expected lifetime, severe complications development and severe hypoglycemia risk. For achieving these goals systematic control of glycated hemoglobin level and timely therapy management are necessary. Glucose level self-control is an essential component of diabetes full metabolic compensation achievement, the importance of which cannot be overemphasized. Self-control use allows to control glycemia more accurately, gives the physician information on treatment effectiveness, allows patients to be actively involved in the treatment process, forms their responsibility for its results, and encourages compliance with the recommendations. It is recommended to use individual glucometers with characteristics regulated by ISO 15197:2013 standard for the purpose of glycemia self-control.

About the authors

O. Ya Vasiltseva

Tomsk National Research Medical Center of the Russian Academy of Sciences, Research Institute of Cardiology

Email: vasiltseva@cardio-tomsk.ru
д-р мед. наук, ст. науч. сотр. отд-ния ишемической болезни сердца и атеросклероза НИИ кардиологии 634012, Russian Federation, Tomsk, ul. Kievskaya, d. 111a

I. N Vorozhczova

Siberian State Medical University of the Ministry of Health of the Russian Federation

д-р мед. наук, проф., вед. науч. сотр. отд-ния ультразвуковой и функциональной диагностики НИИ кардиологии; зав. каф. эндокринологии и диабетологии 634050, Russian Federation, Tomsk, Moskovskii trakt, d. 2

References

  1. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Вып. 8. Под ред. И.И.Дедова, М.В.Шестаковой, А.Ю.Майорова. М., 2017
  2. Шестакова М.В., Сухарева О.Ю. Диагностика и выбор метода лечения сахарного диабета 2-го типа. Клин. фармакология и терапия. 2018; 2: 3-9.
  3. Дедов И.И., Мельниченко Г.А. Эндокринология. Национальное руководство. Под ред. И.И.Дедова, Г.А.Мельниченко. М.: ГЭОТАР-Медиа, 2013.
  4. Ogurtsova K, da Rocha Fernandes J.D, Huang Y et al. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract 2017; 128: 40-50. doi: 10.1016/j.diabres.2017.03.024
  5. Mayer-Davis E.J, Lawrence J.M, Dabelea D et al. Incidence trends of type 1 and type 2 diabetes among youths, 2002-2012. N Engl J Med 2017; 376 (15): 1419-29. doi: 10.1056/NEJMoa1610187
  6. Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза. Российские рекомендации. VI пересмотр. М., 2017
  7. Артериальная гипертония у взрослых. Клинические рекомендации. М., 2016
  8. Стабильная ишемическая болезнь сердца. Клинические рекомендации. М., 2016
  9. Yudkin J.S, Richter B, Gale E.A.M. Intensified glucose lowering in type 2 diabetes: time for a reappraisal. Diabetologia 2010; 53 (10): 2079-85. doi: 10.1007/s00125-010-1864-z
  10. Кочергина И.И. Контроль гликемии у больных сахарным диабетом и кардиальной патологией. Consilium Medicum. 2017; 1 (19): 56-60.
  11. Kengne A.P, Patel A, Marre M et al. Contemporary model for cardiovascular risk prediction in people with type 2 diabetes. Eur J of Cardiovasc Prevent Rehab 2011; 18: 393-8. doi: 10.1177/1741826710394270.
  12. Khaled A.A, Sekaran M, Ikram S.I. Type 2 diabetes and vascular complications: A pathophysiologic view. Biomed Res 2010; 21 (2): 147-50.
  13. Bartnik M, Ryden L, Ferrari R et al. The prevalence of abnormal glucose regulation in patients with coronary artery disease across Europe. The Euro Heart Survey on diabetes and the heart. Eur Heart J 2004; 25 (21): 1880-90.
  14. Duckworth W.C, McCarren M, Abraira С. Glucose Control and Cardiovascular Complications: The VA Diabetes Tria. Diabetes Care 2001; 24 (5): 942-5.
  15. Bouche J.L, Hurrell D.J. Cardiovascular Disease and Diabetes. Diabet spectrum 2008; 21 (3): 54-5.
  16. Левит Ш., Филиппов Ю.И., Горелышев А.С. Сахарный диабет 2-го типа: время изменить концепцию. Сахарный диабет. 2013; 1: 91-102
  17. Асфандиярова Н.С. Смертность при сахарном диабете 2-го типа. Сахарный диабет. 2015; 18 (4): 12-21.
  18. Bai J, Ding X, Du X et al. Diabetes is associated with increased risk of venous thromboembolism: a systematic review and meta-analysis. Thrombosis Research 2015; 135 (1): 90-5. doi: 10.1016/j.thromres.2014.11.003
  19. Dentali F, Ageno W, Pomero F. Time trends and case fatality rate of in-hospital treated pulmonary embolism during 11 years of observation in Northwestern Italy. Thromb Haemost 2016; 115 (2): 399-405. doi: 10.1160/TH15-02-0172
  20. Powers W.J, Derdeyn C.P, Biller J et al. 2015 AHA/ASA Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment: A Guideline for Healthcare Professionals From the AHA/ASA. Stroke 2015; 46 (10): 3020-35. doi: 10.1161/STR.0000000000000074
  21. Meschia J.F, Bushnell C, Boden-Albala B et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the AHA/ASA. Stroke 2014; 45 (12): 3754-832. doi: 10.1161/STR.0000000000000046
  22. Kirchhof P, Benussi S, Kotecha D et al. 2016 ESC. Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Heart J 2016; 37: 2893-962. doi: 10.1093/eurheartj/ehw210
  23. Konstantinides S.V, Torbicki A, Agnelli G et al. Guidelines on the diagnosis and management of acute pulmonary embolism. The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the ESC Endorsed by the ERS. Eur Heart J 2014; 35 (43): 3033-73. doi: 10.1093/eurheartj/ehu393
  24. Российские клинические рекомендации по диагностике, лечению и профилактике венозных тромбоэмболических осложнений (ВТЭО). Флебология. 2015; 4 (2): 1-52.
  25. Васильцева О.Я., Крестинин А.В., Щипунов Е.Ф. и др. Регистр пациентов с заболеваниями сердечно-сосудистой системы: свидетельство о регистрации электронного ресурса №17631; заявл. 28.11.2009; опубл. 01.12.2011. Навигатор в мире науки и образования. 2011; 11 (30): 28.
  26. Васильцева О.Я., Ворожцова И.Н., Карпов Р.С. Госпитальная тромбоэмболия правых камер сердца. Кардиология. 2013; 6: 46-50.
  27. Buerger С, Plock N, Dehghanyar P et al. Pharmacokinetics of unbound linezolid in plasma and tissue interstitium of critically ill patients after multiple dosing using microdialysis. Antimicrob Agents Chemother 2006; 50: 2455-63.
  28. Chin-Hong P.V. Infections in patients with diabetes mellitus: importance of early recognition, treatment and prevention. Adv Stud Med 2006; 6 (2): 71-81.
  29. Асфандиярова Н.С. Смертность при сахарном диабете 2-го типа. Сахарный диабет. 2015; 18 (4): 12-21
  30. Кукушкин Г.В., Старостина Е.Г. Инфекции у больных сахарным диабетом. РМЖ. 2016; 20: 1327-33.
  31. Johnston K.C, Hall C.E, Kissela et al. Glucose regulation in acute stroke patients (GRASP) trial a randomized pilot trial. Stroke 2009; 40: 12: 3804-09. doi: 10.1161/STROKEAHA.109.561498
  32. Федотова А.И., Катков В.А., Максимов И.В., Марков В.А. Опыт применения протокола инфузионной инсулинотерапии в остром периоде инфаркта миокарда у пациентов с сахарным диабетом. СМЖ. 2011; 26 (4) 2: 132-5.
  33. Кардиоваскулярная профилактика 2017. Российские национальные рекомендации. Рос. кардиол. журн. 2018; 6: 7-122.
  34. Capes S.E, Hunt D, Malmberg K et al. Stress hyperglycaemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview. Lancet 2000; 355 (4): 773-8.
  35. Capes S.E, Hunt D, Malmberg K et al. Stress hyperglycemia and prognosis of stroke in nondiabetic and diabetic patients: a systematic overview. Stroke 2001; 32: 10: 2426-32.
  36. Дедов И.И., Шестакова М.В. Эпидемиология сахарного диабета и микрососудистых осложнений. Сахарный диабет. 2010; 3: 17-22
  37. Holman R.R, Paul S.K, Bethel M.A et al. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med 2008, 359 (15): 1577-89. doi: 10.1056/NEJMoa0806
  38. Стронгин Л.Г., Григорян И.Г., Густов А.В., Беляева Н.Г. Инсулинотерапия сахарного диабета 2-го типа в остром периоде инсульта: значение метода введения инсулина. Проблемы эндокрин. 2014; 60 (5): 4-8. doi: 10.14341/probl20146054-8
  39. The CREATE-ECLA Trial Group Investigators. Effect of glucose-insulin-potassium infusion on mortality in patients with acute ST-segment elevation myocardial infarction the CREATE-ECLA Randomized Controlled Trial. JAMA 2005; 293 (4): 437-46.
  40. NICE-SUGAR study investigators. Intensive versus conventional glucose control in critically ill patients. N Engl J Med 2009; 360 (13): 1283-97.
  41. Bruno A, Kent T.A, Coull B.M et al. Treatment of hyperglycemia in ischemic stroke (THIS): a randomized pilot trial. Stroke 2008; 39 (2): 384-9. doi: 10.1161/strokeaha.107.493544
  42. The CREATE-ECLA Trial Group Investigators. Effect of glucose-insulin-potassium infusion on mortality in patients with acute ST-segment elevation myocardial infarction the CREATE-ECLA Randomized Controlled Trial. JAMA 2005; 293 (4): 437-46.
  43. Wiener R.S, Wiener D.C, Larson R.J. Benefits and risks of tight glucose control in critically ill adults: a meta-analysis. JAMA 2008; 300: 933-44.
  44. Лаптев Д.Н., Шмушкович И.А. Аритмогенный эффект гипогликемии. Сахарный диабет. 2012; 1: 25-30.
  45. Gerstein H.C, Miller M.E, Byington R.P et al. Action to Control Cardiovascular Risk in Diabetes Study Group. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med 2008; 358 (24): 2545-59.
  46. Patel A, MacMahon S, Chalmers J et al. ADVANCE Collaborative Group. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med 2008; 358 (24): 2560-72.
  47. Duckworth W, Abraira C, Moritz T et al. VADT Investigators. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med 2009; 360 (2): 129-39.
  48. Дедов И.И., Шестакова М.В., Аметов А.С. и др. Инициация и интенсификация сахароснижающей терапии у больных сахарным диабетом 2-го типа: обновление консенсуса совета экспертов Российской ассоциации эндокринологов (2015 г.). Сахарный диабет. 2015; 1: 5-23.
  49. Garber A.J, Abrahamson M.J, Barzilay J.I et al. AACE and ACE Clinical Practice Guidelines for Developing a Diabetes Mellitus Comprehensive Care Plan - 2015. Endocr Pract 2015; 21 (12): 1403-14. doi: 10.4158/EP151063.CS
  50. Tian F, Chen Y, Liu H et al. Assessment of characteristics of neointimal hyperplasia after drug-eluting stent implantation in patients with diabetes mellitus: an optical coherence tomography analysis. Cardiology 2014; 128 (1): 34-40.
  51. Богданов А.Н., Добрынина И.Ю., Добрынин Ю.В. Ишемический инсульт при сахарном диабете 2-го типа. Наука XXI века: вопросы, гипотезы, ответы. 2014; 4 : 43-52. / Bogdanov A.N., Dobrynina I.Yu., Dobrynin Yu.V. Ishemicheskij insul't pri saharnom diabete 2-go tipa. Nauka XXI veka: voprosy, gipotezy, otvety. 2014; 4 : 43-52. [in Russian]
  52. Рунова Г.Е. Самоконтроль гликемии при сахарном диабете: медицинские и психологические аспекты. Consilium Medicum. 2016; 18 (5): 98-102.
  53. Clar C, Barnard K, Cummins E et al. Self-monitoring of blood glucose in type 2 diabetes: systematic review. Health Technol Assess 2010; 14 (12). doi: 10.3310/hta14120
  54. Freckmann G, Baumstark A, Jendrike N et al. System accuracy evaluation of 27 blood glucose monitoring systems according to DIN EN ISO 15197. Diabetes Technol Ther 2010; 12 (3): 221-31.
  55. International Standard E.N ISO 15197: 2013. In Vitro diagnostic test systems: Requirements for blood-glucose monitoring systems for self-testing in managing diabetes mellitus. Second Edition 2013-05-15. International Organization for Standardization, 2013; р. 46.
  56. Dunne N, Viggiani M.T, Pardo S et al. Accuracy Evaluation of CONTOUR® PLUS Compared With Four Blood Glucose Monitoring Systems. Diabetes Ther 2015; 6 (3): 377-88.
  57. Аметов А.С., Черникова Н.А. Гликемический контроль у пациентов с сахарным диабетом 2-го типа. Consilium Medicum. 2016; 18 (4): 24-7

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