Varanauskiene Egle
Department of Endocrinology, Kaunas Medical University Hospital, Kaunas University of Medicine, Eiveniu 2, Kaunas LT-50009, Lithuania.
Diabetes Res Clin Pract. 2008 Dec 15;82 Suppl 2:S112-7. doi: 10.1016/j.diabres.2008.09.025. Epub 2008 Oct 29.
Increased cardiovascular risk in diabetes cannot be attributed to the higher prevalence of classic risk factors.
Most of the cardiovascular risk factors have shown to be directly related to the degree of postprandial glycemia (PPG). PPG should be recognized as a marker for the increased risk of cardiovascular disease.
Two important methods available-self-monitoring of blood glucose (SMBG) reveals immediate hour-to-hour blood glucose, while long-term glycemia is assessed by HbA1c. Reducing PPG and glycemia excursions is as important as lowering fasting plasma glucose and HbA1c levels.
SMBG plays a key role in diabetes care, and has proven to be effective for insulin treated type 2 diabetic patients. Debate continues on the effectiveness of SMBG in non-insulin treated type 2 diabetes. Whether non-insulin treated type 2 diabetic patients benefit from SMBG, a large-scale randomized controlled trial with the follow-up period to investigate long-term effects should be carried out. A general recommendation is that insulin treated patients perform SMBG at least three times per day. SMBG frequency for non-insulin users should be individualized to treatment regimen and level of control.
糖尿病患者心血管风险增加不能归因于经典危险因素的较高患病率。
大多数心血管危险因素已被证明与餐后血糖（PPG）水平直接相关。PPG应被视为心血管疾病风险增加的一个指标。
有两种重要方法——自我血糖监测（SMBG）可显示即时的逐小时血糖情况，而长期血糖水平则通过糖化血红蛋白（HbA1c）进行评估。降低PPG和血糖波动与降低空腹血糖和HbA1c水平同样重要。
SMBG的有效性：SMBG在糖尿病护理中起着关键作用，并且已被证明对接受胰岛素治疗的2型糖尿病患者有效。关于SMBG在非胰岛素治疗的2型糖尿病中的有效性仍存在争议。对于非胰岛素治疗的2型糖尿病患者是否能从SMBG中获益，应开展一项具有随访期以调查长期效果的大规模随机对照试验。一般建议是接受胰岛素治疗的患者每天至少进行三次SMBG。非胰岛素使用者的SMBG频率应根据治疗方案和控制水平进行个体化调整。
