Automonitoraggio glicemico nei pazienti diabetici

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Riassunto

L’automonitoraggio della glicemia mediante utilizzo di strumentazione point of care testing costituisce una componente essenziale nella gestione del paziente diabetico, al fine di: (a) raggiungere e conservare nel tempo il buon controllo glicemico, onde prevenire le complicanze dell’iperglicemia; (b) prevenire e individuare episodi di ipoglicemia, talora più gravi dell’iperglicemia per le gravi conseguenze a breve termine; (c) evitare la comparsa di iperglicemia severa, fino al coma ipersomolare; (d) modulare cambiamenti idonei nello stile di vita del paziente; (e) stabilire la necessità di iniziare il trattamento con insulina nel diabete mellito gestazionale.

I fattori che possono compromettere l’accuratezza della misurazione dei glucometri e in buona sostanza di tutti i dispositivi per le analisi decentrate concernono essenzialmente tutte le fasi del processo diagnostico, dalla pre-analitica alla post-analitica. Inoltre, l’automonitoraggio della glicemia può avere un ruolo determinante nel migliorare il controllo metabolico se è parte di una strategia educativa più ampia. Poiché l’accuratezza della misura ottenuta con il glucometro dipende sia dallo strumento sia dall’utilizzatore, viene raccomandato che i pazienti ricevano un’educazione iniziale al corretto utilizzo della strumentazione e all’interpretazione dei dati per aggiustare la terapia, competenze che dovranno poi essere rivalutate nel tempo.

Parole chiave

Automonitoraggio glicemico Diabete mellito 

Self-monitoring of blood glucose in diabetic patients

Summary

The self-monitoring of blood glucose through the use of instrumentation point of care testing is an essential component in the management of the diabetic patient, in order to achieve and maintain glycaemic control, prevent and identify hypoglycaemia, prevent severe hyperglycaemia, adjust lifestyle changes and establish the need to begin treatment with insulin in gestational diabetes mellitus.

The factors that can affect the accuracy of the measurement of blood glucose meters and of all devices for decentralized analysis may occur essentially in all stages of the diagnostic process, from the pre-analytical to post-analytical phase. In addition, self-monitoring of blood glucose may have a role in improving metabolic control if it is part of a wider educational strategy. Since the accuracy of the measures obtained by the meter depends on both the instrument and the user, it is recommended that patients receive initial education in the proper use of instrumentation and interpretation of data to adjust therapy, skills that must then be revaluated in time.

Keywords

SMBG Self-monitoring of blood glucose Diabetes mellitus 

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Copyright information

© Springer-Verlag Italia 2013

Authors and Affiliations

  1. 1.UO Diagnostica Ematochimica Patologia e Medicina di LaboratorioAzienda Ospedaliera di ParmaParmaItalia
  2. 2.Sezione di Biochimica Clinica, Dipartimento di Scienze della Vita e della RiproduzioneUniversità degli Studi di Verona, Ospedale Policlinico G.B. RossiVeronaItalia

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