Paradigmenwechsel in der Glukosekontrolle: Urin-, Blut-, interstitielle Glukosemessung

Die selbstständige Blutzuckerkontrolle ist für viele Patienten mit Diabetes mellitus heute ein fester Bestandteil des Krankheitsmanagements. Eine kontinuierliche interstitielle Glukosemessung ermöglicht eine weitere Verbesserung der Dosisanpassung bei Patienten unter intensivierter konventioneller Insulinbehandlung und bei Patienten mit Insulinpumpen.

Abstract

Today, self-measurement of glucose concentrations represents an integral part in disease management for many patients with diabetes mellitus. Starting with urine glucose test stripes about 50 years ago, patients were enabled to perform measurements of glucose control by their own. Proceeding from urine glucose measurements to capillary blood glucose in the 1960ies provided totally new opportunities and created the basis for modern intensified insulin treatment with an adaptation of insulin dosages according to actual blood glucose concentrations. Today, we are moving from punctual capillary blood glucose measurements to continuous measurement of glucose concentrations in the interstitial fluid. Again, opening a new century of glucose control for patients with diabetes mellitus. The opportunity of continuous glucose monitoring allows further improvement in insulin dose adaptation in patients on intensified conventional insulin treatment and those on insulin pumps. Connecting continuous glucose sensors with insulin pumps allow for continuous adaptation of insulin supply based on actual glucose readings and might pave the way to an artificial pancreas. With all these progress in glucose sensing technologies, it is still essential to teach the patients about the meaning of their glucose readings, and to draw adequate therapeutical conclusions.

Kernaussagen

• Messungen zur Glukosekontrolle selbst durchzuführen ist für viele Patienten mit Diabetes mellitus ein fester Bestandteil des Krankheitsmanagements.

• Der Übergang von der Uringlukosemessung zur Kapillarblutglukose in den 1960er-Jahren schuf die Grundlage für die moderne intensivierte Insulinbehandlung durch die Anpassung der Insulindosierung an die tatsächlichen Blutzuckerkonzentration.

• Heute gehen wir von der punktuellen kapillaren Blutglukosemessung zur kontinuierlichen Messung der Glukosekonzentration in der interstitiellen Flüssigkeit über.

• Die Möglichkeit der kontinuierlichen Glukosemessung erlaubt eine weitere Verbesserung der Anpassung der Insulindosis bei Patienten, die eine intensivierte konventionelle Insulinbehandlung erhalten oder eine Insulinpumpe tragen.

• Die Kopplung kontinuierlicher Glukosesensoren an Insulinpumpen ermöglicht eine kontinuierliche Anpassung der Insulinzufuhr auf der Grundlage der aktuellen Glukosemesswerte und könnte den Weg zu einer künstlichen Bauchspeicheldrüse ebnen.

• Bei allen technologischen Fortschritten ist es nach wie vor unerlässlich, die Patienten über die Bedeutung ihrer Glukosemesswerte aufzuklären und angemessene therapeutische Schlussfolgerungen zu ziehen.

Schlüsselwörter

Glukosemessung - Uringlukose - Blutglukose - interstitielle Glukose - Glukosekontrollierte Insulintherapie

Keywords

glucose measurement - urinary glucose - blood glucose - interstitial glucose - glucose-controlled insulin treatment

Publication History

Article published online:
09 June 2022

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