Modern approaches to monitoring glucose levels

The increasing prevalence of diabetes mellitus (DM) and the emergence of a large number of new hypoglycemic drugs put the question to the assessing the effectiveness of treatment of these patients. Also, a significant role should be given to the probabilistic forecast of both the immediate course of diabetes mellitus itself and the development of complications (mainly cardiovascular diseases), which are the leading cause of mortality and disability in patients. Although the use of such cardiac drugs as statins and angiotensin-converting enzyme inhibitors significantly improves the prognosis of persons with diabetes, achieving target indicators of carbohydrate metabolism, such as glycemia levels and glycated hemoglobin (HbA1c) remains a cornerstone of managing patients with diabetes. This is all the more important since, in modern conditions, an increasing number of patients (especially with type 2 diabetes) are coming under the supervision of a general practitioner. The role of the endocrinologist is limited to establishing a primary diagnosis and, if necessary, adjusting treatment. Determining the level of glycemia and its fluctuations depending on various conditions remains the main method of monitoring the condition of patients and the effectiveness of treatment. The main focus is on self-monitoring of blood glucose levels (SMBG), since assessing the glycated hemoglobin content in real practice does not allow to make quick decisions on changing treatment due to the specifics of this technique. Self-monitoring of glycemia by the patient has become possible due to the appearance of modern glucometers, which allow not only to determine the glucose content in capillary blood, but also to synchronize the obtained results with both the patient’s smartphone and cloud storage, promptly inform the patient about critical fluctuations in glycemia and store test results for a long time. After conducting an appropriate patient education program, self-monitoring of capillary blood glucose levels by using the latest generation of glucometers can be considered optimal for proper glycemic control in patients with diabetes mellitus in outpatient settings and non-critical conditions in inpatients.

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