[o_udovichenko]

Сообщение от Light

Если мониторинг превратить в цель, то он мало что даст, кроме снижения качества жизни (больно, дорого, страшно).
Если же его делают средством для последующей оценки ситуации и адекватных действий, то он значительно способствует компенсации диабета. Но для этого мало обучить больного самоконтролю, надо грамотно обучить его в Школе диабета.

У меня закончились одобрялки для Light, но полностью поддерживаю!

Я несколько месяцев назад видел исследование (кажется, на Medscape), но сейчас не могу его найти. В нем анализировалась эффективность самоконтроля при СД 2 без инсулина, вывод - снижение HbA1c на 0,5% в случае, если на данные самоконтроля оперативно реагируют (врач и пациент).
Сейчас искал его, нашел только Кохрейновский обзор:
(лежит на [Ссылки доступны только зарегистрированным пользователям ], но привожу текст, т.к. Medscape требует регистрации):

Self ‐ monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin
Posted 07/01/2007
Introduction

Date of Most Recent Substantive Amendment: 2005 02 23
Background

Self – monitoring of blood glucose (SMBG) has been found to be effective for patients with type 1 diabetes and for patients with type 2 diabetes using insulin. There is much debate on the effectiveness of SMBG as a tool in the self – management for patients with type 2 diabetes who are not using insulin.
Objectives

The objective of this review was to assess the effects of SMBG in patients with type 2 diabetes mellitus who are not using insulin.
Search strategy

Studies were obtained from searches of multiple electronic bibliographic databases supplemented with hand searches of references of retrieved articles. Date of last search: September 2004.
Selection criteria

We included randomised controlled trails investigating the effects of SMBG compared with usual care and/or with self – monitoring of urine glucose in patients with type 2 diabetes who where not using insulin. Included studies should have used at least one of the following outcome measures: glycaemic control, quality of life, well – being, patient satisfaction, or hypoglycaemic episodes.
Data collection and analysis

Two reviewers independently extracted data from included studies and assessed study quality. Data from the studies were compared to decide whether they were sufficiently homogeneous to pool in a meta – analysis.
Main results

Six randomised controlled trials were included in the review. Four trials compared SMBG with usual care, one trial compared SMBG with self – monitoring of urine glucose and there was one three – armed trial comparing SMBG with self – monitoring of urine glucose and usual care. Because of the differences in patient characteristics, interventions and outcomes between the studies, it was not possible to perform a meta – analysis. The methodological quality of studies was low. Two of the six studies reported a significant lowering effect of self – monitoring of blood glucose on HbA1c. However, one of these studies had a co – intervention with education on diet and lifestyle. There were few data on the effects of other outcomes and these effects were not statistically significant.
Authors' conclusions

From this review we concluded that self – monitoring of blood glucose might be effective in improving glycaemic control in patients with type 2 diabetes who are not using insulin. To assess the potential beneficial effects of SMBG in these patients a large and well – designed randomised controlled trial is required. This long – term trial should also investigate patient – related outcomes like quality of life, well – being and patient satisfaction, and provide adequate education to the patient to allow SMBG to be effective.
Cochrane Rev Abstract. 2007; ©2007 The Cochrane Collaboration

В общем, исследований на эту тему может быть много.
И у меня тут по ходу возникла мысль: на просторах бывшего СССР в тех местах, где вообще недоступен HbA1c, самоконтроль может быть некой его заменой (хоть так эндокринолог может получить информацию о том, каков уровень сахара вечером, после еды и т.п.).