3. The effect of increased adherence to glycemic control on coronary heart disease and quality of life in patients with concomitant impaired glucose metabolism

Abstract

Aim of the study - to evaluate the impact of increased adherence to glycemic control on the improvement of quality of life and the course of ischemic heart disease (IHD) in patients with diabetes. The study includes 44 patients (26 males -59%, 18 females - 41%), diagnosed with IHD (functional class І-ІІІ of exertion angina) and accompanying type 2 DM. Depending on the glycaemia control method, the patients were divided in two groups. In group I (CGM, n=21) the glycaemia control was based on CGM, when in group II (self-blood glucose monitoring - SBGM, n=23) it was based on individual glucose level self-measurement, performed 4 times per day. Distribution of patients between groups I and II by gender, age, anthropometric characteristics, DM duration, functional heart and kidney condition, acute cardio-vascular events in anamnesis and harmful habits (smoking) is without significant differences. Besides glycaemia monitoring, the patients recorded their arterial pressure, pulse and duration of their physical exertions (minutes a day). During patients' elective visits (0-3 months) glycated hemoglobin was measured in both patient groups, and they filled in the life quality questionnaire. The use of CGM for monitoring glycaemia level in patients with IHD and type II DM during 3 months has been associated with statistically significant decrease of glycated hemoglobin level, increase of physical activity. Also CGM improved physical condition and life quality according to the physical health scores SF-36 (physical function, physical function role, physical pain, general health) and social function scores, with reliable increase in group I compared to group II. There are no differences in body weight decrease or improved carbohydrate metabolic data have been detected. Administration of the CGM in patients with IHD is associated with improved quality of life and higher satisfaction level, decreased fasting HbA1c and glucose, and also increasing level of physical exertion level.