RESUMO
Management of type 1 and type 2 diabetes mellitus is getting complex with the apparition of new treatments, but also new technologies. Among these, continuous glucose monitoring systems (CGMS) lead to a better glycemic control and less hypoglycemia in type 1 diabetic patients. Studies are scarce in type 2 diabetes but also seem to show a benefit, particularly in patients using insulin. Nevertheless, type 2 diabetic patients taking advantage of CGMS must be better defined. In any case, a multidisciplinary approach to the use of CGMS and interpretation of data is warranted.
La prise en charge du diabète, que ce soit de type 1 ou de type 2, ne cesse de se complexifier avec l'apparition de nouveaux traitements, mais aussi de nouveaux outils technologiques. Parmi ces derniers, les appareils mesurant la glycémie en continu permettent d'améliorer le contrôle glycémique et diminuent le risque d'hypoglycémie chez les patients diabétiques de type 1. Chez les patients diabétiques de type 2, les études sont moins nombreuses mais semblent aussi montrer un bénéfice, notamment chez les patients traités par insuline. Il convient cependant de bien définir quels patients diabétiques de type 2 seront de bons candidats au CGMS (continuous glucose monitoring system). Dans tous les cas, une prise en charge multidisciplinaire est nécessaire pour la pose de l'appareil et l'interprétation des tracés.
Assuntos
Automonitorização da Glicemia/métodos , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 2/diagnóstico , Hipoglicemiantes/uso terapêutico , Glicemia/análise , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Humanos , Hipoglicemia/induzido quimicamente , Hipoglicemia/diagnóstico , Hipoglicemiantes/efeitos adversos , Insulina/efeitos adversos , Insulina/uso terapêutico , Comunicação InterdisciplinarRESUMO
In Switzerland over 200'000 people with diagnosed diabetes drive a car. Their physicians endorse many roles: usual medical care as well as informing properly about driving recommandations and handling the legal issues behing the licensing procedure. Ability to drive can be impaired in three ways: hypogylcemia, diabetes complications and hyperglycemia. Hypoglycemia is the main risk factor of vehicle accident for diabetic drivers and frequent while driving. However few accidents are reported due to hypoglycemia. Swiss medical guidelines about diabetes and driving mention the requested conditions, but practically how should we do? We sought to answear by creating a specific educationnal program focused on hypoglycemia management. Building patient knowledges through experiences is the main goal of the course diabetes and driving.
