Funding Acknowledgements Type of funding sources: None. Background Decompensated diabetic patients frequently suffer from ischemic complications including silent ST-elevation myocardial infarction (STEMI). Purpose Aim of this study was to define prognostic value of low adherence to self-monitoring of blood glucose (SMBG) in type 2 diabetes mellitus (T2DM) patients as risk factor that leads to silent STEMI. Methods The electronic search in Cochrane Library, Scopus, PubMed and Web of Science for the period of 2016-2018 systematic literature review concentrated on types of educational interventions administered before SMBG in type 2 diabetes mellitus patients who are not using insulin was conducted. 18 studies were eligible for inclusion. We included all randomized controlled trials on SMBG education in T2DM patients compared with standard care in adult patients. As a proof of self-efficacy after SMBG glycated hemoglobin (HbA1c) was chosen as primary endpoint. Study group: 12 (7 females, 5 male, age 56-85 years) T2DM patients with non-insulin dependent diabetes for >5 years, low skills of SMBG that were admitted to surgery department with diabetic foot ulcers for the period of August 2019-September 2019 developed silent STEMI. Control group 10 (5 females, 5 males) T2DM patients that corresponded by age and study parameters, but did SMBG once a week via individual glucometers. Blood glucose, troponin I (cTnI) levels were registered. Statistical analysis:IBM SPSS Statistics v.23, RevMan5. Results During systematic review evidence indicated that a SMBG education was associated with more stress and lower rate in well-being and treatment satisfaction in comparison to a standard care (random-effects SMD: 0.45; 95% CI: 0.25-0.65; P < 0.0001). Depending on type of SMBG record subgroup analysis indicated that SMBG skills depend on SMBG education delivery. Patients that did feet checking, SMBG at least once a week had lower risk of complications development (P<0.05). STEMI development was associated with low SMBG in a form of checking only at visits to general practitioner (HR 1.15, 95% CI:1.04-1.13). Mean level of cTnI for study group patients was 0.045 ng/ml with no specific cardiac complaints. Conclusions There is a higher risk of silent ST-elevation myocardial infarction development in diabetic patients that have low SMBG skills) due to lacking information about importance of self-monitoring of blood glucose level as a predictor of cardiovascular complications.

中文翻译：

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血糖监测依从性低的非胰岛素依赖型 2 型糖尿病患者的无症状心肌梗死

资金确认 资金来源类型：无。背景 失代偿性糖尿病患者经常患有缺血性并发症，包括无症状 ST 段抬高心肌梗塞 (STEMI)。目的 本研究的目的是确定 2 型糖尿病 (T2DM) 患者对血糖自我监测 (SMBG) 依从性低作为导致无症状 STEMI 的危险因素的预后价值。方法 在 Cochrane Library、Scopus、PubMed 和 Web of Science 中进行电子检索 2016-2018 年系统文献综述，重点关注在 SMBG 之前对未使用胰岛素的 2 型糖尿病患者实施的教育干预类型。18 项研究符合纳入条件。我们纳入了所有关于 T2DM 患者 SMBG 教育与成人患者标准护理的随机对照试验。作为选择 SMBG 糖化血红蛋白 (HbA1c) 作为主要终点后的自我效能证明。研究组：12 名（7 名女性，5 名男性，年龄 56-85 岁）T2DM 患者，非胰岛素依赖型糖尿病 > 5 年，SMBG 技能低下，8 月份因糖尿病足溃疡入院手术室2019-2019年9月开发出静音STEMI。对照组 10 名（5 名女性，5 名男性）T2DM 患者，其年龄和研究参数相对应，但通过个体血糖仪每周进行一次 SMBG。记录血糖、肌钙蛋白 I (cTnI) 水平。统计分析：IBM SPSS Statistics v.23, RevMan5。结果 系统评价期间的证据表明，与标准护理相比，SMBG 教育与更大的压力和更低的幸福感和治疗满意度相关（随机效应 SMD：0.45；95% CI：0.25-0.65；P <; 0.0001)。根据 SMBG 记录的类型，亚组分析表明 SMBG 技能取决于 SMBG 教育的提供。每周至少进行一次足部检查和 SMBG 的患者发生并发症的风险较低（P<0.05）。STEMI 发展与低 SMBG 相关，仅在访问全科医生时进行检查（HR 1.15，95% CI：1.04-1.13）。研究组患者的 cTnI 平均水平为 0.045 ng/ml，没有特定的心脏不适。