ידיעות אחרונות 28/6/16: מהפכה לחולי הסוכרת, בדיקת סוכר ללא דקירה ומהיום בישראל

הסוף לעשרות הדקירות היומיות שחולי הסוכרת נאלצים לעבור מדי יום: מערכת הפריסטייל ליברה מאפשרת למדוד סוכר באופן מדויק וללא צורך בדקירות ובכיולים, הושקה בישראל בזמן שמחקר שנערך עם המכשיר מגלה שחולי הסוכרת שהשתמשו בו הורידו באחוזים ניכרים את אירועי ההיפוגליקמיה (רמות גלוקוז נמוכות מידי בדם), בדקו לעיתים קרובות יותר את רמת הסוכר שלהם בדם והפכו למאוזנים יותר.

המכשיר החדש, מאושר לשימוש החל מגיל 4 ומהווה פריצת דרך משמעותית עבור סוכרתיים מסוג 1 ו-2, במיוחד לסוכרתיים הנוטלים אינסולין, שרבים מהם הם ילדים.

המערכת מבוססת על טכנולוגיית FLASH – Flash Glucose Monitoring, כאשר חיישן הממוקם על הזרוע מאפשר סריקה באמצעות קורא אלקטרוני, המציג את רמת הסוכר העדכנית, ובנוסף חץ מגמה (המזהה צפי לירידה או לעלייה של רמות הסוכר) ומידע על רמות הסוכר ב- 8 השעות החולפות. המערכת מתאימה כאמור לכלל הסוכרתיים, ומהווה מהפכה של ממש באיכות חייהם, ובהתמודדות עם ניהול ואיזון המחלה.

המערכת החדשה, שפותחה על-ידי חברת Abott, כוללת שני חלקים – שלט אלקטרוני (ה"קורא") וחיישן חד פעמי המתאים ל-14 ימי שימוש. החיישן קטן ועגול בגודל של מטבע חמישה שקלים, מוצמד על החלק העליון האחורי של הזרוע ומודד את רמת הסוכר באמצעות סיב זעיר באורך 5 מ"מ. מדידת הסוכר מתרחשת אחת לדקה באופן אוטומטי על-ידי החיישן.

כדי לראות את רמת הסוכר, המטופל צריך לבצע פעולת "סריקה" – קירוב והעברת השלט על פני החיישן תוך פחות משנייה, אז תופיע רמת הסוכר העדכנית על צג השלט. ניתן לבצע תהליך זה גם כאשר החיישן נמצא מתחת לבגדים ועד 4 ס"מ מהחיישן. התקשורת בן החיישן ל'קורא' מתבצעת באמצעות פרוטוקול אלחוטי סטנדרטי, בדומה למה שקיים היום בטלפונים החכמים.

בכל סריקה של החיישן מוצגים שלושה נתונים חשובים על צג השלט: רמת הסוכר הנוכחית, חץ מגמה, המלמד על המגמה העתידית של רמות הסוכר (קצב העלייה או הירידה או יציבות ברמת הסוכר) וכן גרף של נתוני רמת הסוכר בשמונה השעות האחרונות, אשר נשמרים על החיישן עד לסריקה. השלט האלקטרוני ("הקורא") אוגר את נתוני הסריקות לאורך 90 יום ויש לו גם פתח להכנסת מקלון בדיקה למדידת גלוקוז "סטנדרטית" או לבדיקת קטונים בדם. לשלט כפתור אחד אשר מורה על פעולת הסריקה ומלבד זאת השליטה בו מתבצעת באמצעות מסך מגע צבעוני

בניגוד למדי סוכר רציפים אחרים שקיימים בשוק שדורשים כיול (שמשמעותו – דקירות) והסנסור שלהם במקרה הטוב הוא ל-7 ימים, השימוש בפריסטייל ליברה אינו דורש כיול כלל לאורך 14 ימי השימוש בחיישן ובכך מייתר כמעט לגמרי את הצורך בדקירות. שלושת המצבים היחידים שבהם נדרש לבצע בדיקת אימות במד סוכר הינם במצב של שינוי מהיר ברמת הסוכר, מצב של היפוגליקמיה או כשרמת הגלוקוז בדם אינה תואמת את הסימפטומים שהמטופל חש.

בכנס השנתי של האגודה האמריקאית לסוכרת שהתקיים החודש בניו אורלינס, הוצג מחקר על סוכרתיים מסוג 1 שהשתמשו במערכת הפריסטייל ליברה במשך 6 חודשים לעומת חולים שלא השתמשו בה. מתוצאות המחקר עלה כי בקרב משתמשי המכשיר, זמן השהייה בהיפוגליקמיה הופחת ב-38%, אירועי ההיפוגליקמיה בשעות הלילה הופחתו ב-40% והייתה ירידה של 50% באירועי היפוגליקמיה חמורים. בנוסף – החולים שהשתמשו במערכת ניטרו את רמת הסוכר שלהם כ-15 פעמים ביום בממוצע, המהווה עלייה משמעותית בתדירות הניטור. ככל שהמטופל בודק לעיתים תכופות יותר את רמת הסוכר שלו, כך יש לו יותר מידע לגביו והדבר מוביל לכך שהוא יכול בעצמו להפחית מצבים של היפוגליקמיה או היפרגליקמיה (יותר מדי סוכר בדם).

חברת Abott בחרה בישראל להוביל מודל חדש מסוגו בעולם באמצעות מרכז אותו הקימה גפן מדיקל – FreeStyle Libre Experience Center בתל אביב ובו ניתן יהיה לרכוש את המערכת ולקבל הדרכה וליווי אישי ומקצועי, הכוללים גם הסבר על משמעות הנתונים הרבים המתקבלים מהשימוש במערכת וניתוחם באמצעות כלים ממוחשבים שפותחו לצורך זה.

אלא שהנוחות בחסכון הדקירות הרבות מדי יום כרוכה בתשלום חודשי שאינו זול. השלט האלקטרוני (הקבוע) עולה בישראל 320 שקלים וכל חיישן שנצמד לגוף יעלה 255 שקלים. כך שהעלות החודשית לאדם סוכרתי, לאחר שרכש את השלט הקבוע, עומדת על כ-500 שקלים (יש להחליף את החיישן אחת לשבועיים) .

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