Značaj intermitentnog praćenja glikemije za smanjenje glukovarijabilnosti i poboljšanje vrijednosti parametara povezanih s razvojem komplikacija šećerne bolesti

master's thesis

• Title (english): Importance of intermitent blood glucose monitoring in reduction of glucovariability and improvment of parameters related to complications of Diabetes Mellitus
• Author: Ivona Ćudina
• Mentor: Spomenka Ljubić (mentor)
• Committee member: Dario Rahelić (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Spomenka Ljubić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Šećerna bolest tipa jedan i latentna autoimuna šećerna bolest u odrasloj dobi (LADA) nastaju kao posljedica manjka inzulina, a u nereguliranom obliku bolesti dovode do razvitka kroničnih komplikacija; dijabetičke nefropatije i dijabetičke retinopatije. Glukovarijabilnost predstavlja odstupanje koncentracije glukoze u serumu izvan zadanog raspona od 3,9 do 10,0 mmol/L (TIR). Napredak u kontroli šećerne bolesti predstavljaju uređaji za intermitentno praćenje glikemije koji predstavljaju pouzdanu sliku glikemije. Provodilo se retrospektivno istraživanje na uzorku od 46 bolesnika koji su dolazili na dvije kontrole u razmaku od tri mjeseca u Sveučilišnu bolnicu Vuk Vrhovac. Svi su bolesnici imali već utvrđenu dijagnozu šećerne bolesti tipa jedan ili LADA. Rezultati pokazuju kako intermitentnim praćenjem glukoze u razdoblju od tri mjeseca nije došlo do statistički značajne promjene glukovarijabilnosti u obje skupine bolesnika. S druge strane, postoji statistički značajna razlika u vremenu glukoze provedenom ispod ciljnog raspona glukoze (TBR) kod bolesnika sa šećernom bolesti tipa jedan u odnosu na bolesnike s LADA-om, što odgovara činjenici da u tri mjeseca praćenja glikemije postoji smanjena mogućnost nastanka glukovarijabilnosti uzrokovane hipoglikemijom kod bolesnika sa šećernom bolesti tipa jedan u odnosu na LADA bolesnike. Intermitentno praćenje glikemije ne vodi statistički značajnom poboljšanju vrijednosti parametara povezanih s razvojem komplikacija šećerne bolesti u promatranom vremenu. S druge strane, dokazalo se kako manja glukovarijabilnost odgovara nižim koncentracijama glikiranoga hemoglobina i obrnuto. Procjenjuje se da se kod bolesnika sa šećernom bolesti tipa jedan i LADA parametri glukovarijabilnosti dobiveni intermitentnim praćenjem glukoze ubuduće mogu koristiti u procjeni regulacije šećerne bolesti, kao i glikirani hemoglobin. Usprkos činjenici da u tri mjeseca intermitentnog praćenja glukoze nije došlo do većih pomaka u regulaciji bolesti, daljnje promatranje bolesnika u dužem periodu je potrebno.

Abstract (english)

Type one diabetes and type 1 diabetes in adults (LADA) occur as a result of insulin deficiency, and in the unregulated form of the disease lead to the development of chronic complications; diabetic nephropathy and diabetic retinopathy. Glucovariability is a deviation of serum glucose values outside the specified range of 3,9 to 10,0 mmol / l (TIR). Advances in the control of diabetes are made by introducing devices for intermittent glucose monitoring, which represent a reliable picture of glycemia. A retrospective study was conducted on a sample of 46 people who came for two check-ups three months apart at the Vuk Vrhovac University Hospital. All patients had already established diagnosis of type one diabetes or LADA. The results show that intermittent monitoring of glycemia over a period of three months did not show a statistically significant change in glucovariability in both groups of patients. On the other hand, there is a statistically significant difference in time below range of glucose (TBR) in patients with type one diabetes compared to patients with LADA, which corresponds to the fact that in three months of glycemic monitoring there is a reduced possibility of hypoglycaemia in patients with type one diabetes compared to LADA patients. Intermittent monitoring of glycemia does not lead to a statistically significant improvement in the values of parameters associated with the development of complications of diabetes in the observed time. On the other hand, lower glucovariability has been shown to correspond to lower glycated hemoglobin values and vice versa. It is estimated that in patients with type one diabetes and LADA, the glucovariability parameters obtained by intermittent glycemic monitoring may be used in the future to assess the regulation of diabetes together with glycated hemoglobin. Despite the fact that in the three months of intermittent monitoring of glycemia there were no major changes in the regulation of the disease, further observation of patients for a longer period of observation is necessary.

• Keywords: glukovarijabilnost; intermitentno praćenje glikemije; šećerna bolest tipa jedan; TIR
• Keywords (english): glucovariability; intermittent blood glucose monitoring; TIR; type one diabetes
• Language: croatian
• URN:NBN: urn:nbn:hr:105:437040
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-01-28 14:27:40