Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 265
Filter
1.
Article in English | LILACS-Express | LILACS | ID: biblio-1340805

ABSTRACT

ABSTRACT Objective: To evaluate sleep characteristics of children and adolescents with type 1 diabetes mellitus (T1DM) and their relationship with glycemic control. Methods: A cross-sectional study was conducted at a public hospital in São Paulo, Brazil. It included 86 patients with T1DM, aged between 10 and 18 years old, who were on insulin therapy, had performed at least three measurements of capillary blood glucose throughout the day, and had normal thyroid function. The clinical, anthropometric, and laboratory data of each patient were evaluated. The Pediatric Daytime Sleepiness Scale (PDSS) and the Munich Chronotype Questionnaire (MCTQ) were used to assess the sleep characteristics. Results: The mean level of glycated hemoglobin (HbA1c) was 9.2±2.1%, and it was higher in adolescents than in children. The mean score of PDSS was 13.9±4.7. Patients with HbA1c<7.5% had lower PDSS scores and longer sleep duration on weekdays than patients with HbA1c≥7.5%. HbA1c levels were negatively correlated with chronotype values and sleep duration on weekdays and positively correlated with social jet lag. Patients who had had T1DM for less than three years had a higher prevalence of daytime sleepiness. The regression analysis showed that higher HbA1c (≥7.5%) and shorter time since the diagnosis of T1DM increased the chance of daytime sleepiness, regardless of age and sex. Conclusions: Patients with higher HbA1c had more daytime sleepiness, a morning chronotype, shorter sleep duration on weekdays and a more significant social jet lag. The shorter diagnosis time for T1DM and greater levels of HbA1c increased the chance of daytime sleepiness.


RESUMO Objetivo: Avaliar as características do sono em crianças e adolescentes portadores de diabetes melito tipo 1 (DM1) e sua relação com o controle glicêmico. Métodos: Estudo transversal realizado em um hospital público de São Paulo. A amostra foi composta de 86 portadores de DM1 entre 10 e 18 anos, aderentes à insulinoterapia, com monitoração mínima de três glicemias capilares ao dia e função tireoidiana normal. Foram avaliados os dados clínicos, antropométricos e laboratoriais de cada paciente. Utilizaram-se a Escala de Sonolência Diurna Pediátrica (ESDP) e o Questionário de Cronotipo de Munique (QCTM). Resultados: A média de hemoglobina glicada (HbA1c) foi 9,2±2,1%, sendo maior em adolescentes. A média do escore da ESDP foi 13,9±4,7. Pacientes com HbA1c<7,5% tiveram menor escore na ESDP e maior duração do sono em dias de semana do que pacientes com HbA1c≥7,5%. Verificaram-se correlações negativas da HbA1c com valores do cronotipo e com duração do sono em dias de semana e correlação positiva da HbA1c com jet lag social. Pacientes com tempo de DM1 menor que três anos tiveram maior prevalência de sonolência diurna. A análise de regressão apontou que, quanto maior a HbA1c e menor o tempo de diagnóstico de DM1, maior a chance de sonolência diurna, independentemente de idade e sexo. Conclusões: Pacientes com HbA1c mais elevada apresentaram mais sonolência diurna, cronotipo matutino, menor duração do sono em dias de semana e maior jet lag social. O menor tempo de diagnóstico de DM1 e HbA1c≥7,5% aumentaram a chance de maior sonolência diurna.

2.
Rev. enferm. UERJ ; 29: e61374, jan.-dez. 2021.
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1354112

ABSTRACT

Objetivo: analisar evidências científicas sobre entrevista motivacional e sua influência no autogerenciamento do cuidado do adolescente com diabetes mellitus tipo 1. Método: revisão integrativa cuja busca aconteceu em junho de 2020 nas bases de dados LILACS, PubMed, CINAHL, Scopus e Web of Science para atender a pergunta: Quais evidências científicas sobre entrevista motivacional e sua influência no autogerenciamento do cuidado ao adolescente com diabetes mellitus tipo 1? Todos os artigos identificados estavam no idioma inglês e publicados entre 2003 e 2020. Resultados: entre os dez estudos incluídos, nove foram realizados nos Estados Unidos e um no Reino Unido. As pesquisas tiveram métodos diversificados na aplicação da entrevista motivacional em circunstâncias diferentes e os resultados mostraram impactos positivos no autogerenciamento dos cuidados de adolescentes com DM1, principalmente em relação ao controle glicêmico e/ou nos níveis de hemoglobina glicada. Conclusão: a entrevista motivacional favorece o autogerenciamento do cuidado e autonomia do adolescente com diabetes.


Objective: this study examined scientific evidence on motivational interviewing and its influence on self-management among adolescents with type-1 diabetes mellitus (DM1). Methods: the survey for this integrative review took place in June 2020 in the LILACS, PubMed, CINAHL, Scopus, and Web of Science databases to answer the question: What scientific evidence is available on motivational interviewing and its influence on self-management among adolescents with DM1? All the articles found were in English and published between 2003 and 2020. Results: of the ten studies included, nine were conducted in the United States and one in the United Kingdom. The studies used different methods for applying motivational interviewing in differing circumstances, and their findings revealed positive impacts on self-management among adolescents with type-1 diabetes, especially on blood glucose monitoring and/or on glycated hemoglobin levels. Conclusion: motivational interviewing is an intervention that favors self-management and autonomy among adolescents with diabetes.


Objetivo: analizar evidencias científicas sobre entrevista motivacional y su influencia en la autogestión del cuidado de adolescentes con diabetes mellitus tipo 1 (DM1). Métodos: revisión integradora llevada a cabo en junio de 2020 en las bases de datos LILACS, PubMed, CINAHL, Scopus y WoS para responder a la pregunta: ¿Cuáles son las evidencias científicas sobre entrevista motivacional y su influencia en la autogestión del cuidado de adolescentes con diabetes mellitus tipo 1? Los artículos encontrados estaban en inglés y fueron publicados entre 2003 y 2020. Resultados: de los diez estudios incluidos, nueve se realizaron en Estados Unidos y uno en Reino Unido. Las investigaciones utilizaron diferentes métodos de aplicación de la entrevista motivacional en diferentes circunstancias y los resultados señalaron impactos positivos en la autogestión de los cuidados de adolescentes con DM1, especialmente cuanto al control glucémico y/o niveles de hemoglobina glucosilada. Conclusión: la entrevista motivacional favorece la autogestión del cuidado y la autonomía de adolescentes con diabetes.

3.
Rev. enferm. UERJ ; 29: e61374, jan.-dez. 2021. graf
Article in Portuguese | LILACS-Express | LILACS, BDENF | ID: biblio-1365813

ABSTRACT

RESUMO Objetivo analisar evidências científicas sobre entrevista motivacional e sua influência no autogerenciamento do cuidado do adolescente com diabetes mellitus tipo 1. Método revisão integrativa cuja busca aconteceu em junho de 2020 nas bases de dados LILACS, PubMed, CINAHL, Scopus e Web of Science para atender a pergunta: Quais evidências científicas sobre entrevista motivacional e sua influência no autogerenciamento do cuidado ao adolescente com diabetes mellitus tipo 1? Todos os artigos identificados estavam no idioma inglês e publicados entre 2003 e 2020. Resultados entre os dez estudos incluídos, nove foram realizados nos Estados Unidos e um no Reino Unido. As pesquisas tiveram métodos diversificados na aplicação da entrevista motivacional em circunstâncias diferentes e os resultados mostraram impactos positivos no autogerenciamento dos cuidados de adolescentes com DM1, principalmente em relação ao controle glicêmico e/ou nos níveis de hemoglobina glicada. Conclusão a entrevista motivacional favorece o autogerenciamento do cuidado e autonomia do adolescente com diabetes.


RESUMEN Objetivo analizar evidencias científicas sobre entrevista motivacional y su influencia en la autogestión del cuidado de adolescentes con diabetes mellitus tipo 1 (DM1). Métodos revisión integradora llevada a cabo en junio de 2020 en las bases de datos LILACS, PubMed, CINAHL, Scopus y WoS para responder a la pregunta: ¿Cuáles son las evidencias científicas sobre entrevista motivacional y su influencia en la autogestión del cuidado de adolescentes con diabetes mellitus tipo 1? Los artículos encontrados estaban en inglés y fueron publicados entre 2003 y 2020. Resultados de los diez estudios incluidos, nueve se realizaron en Estados Unidos y uno en Reino Unido. Las investigaciones utilizaron diferentes métodos de aplicación de la entrevista motivacional en diferentes circunstancias y los resultados señalaron impactos positivos en la autogestión de los cuidados de adolescentes con DM1, especialmente cuanto al control glucémico y/o niveles de hemoglobina glucosilada. Conclusión la entrevista motivacional favorece la autogestión del cuidado y la autonomía de adolescentes con diabetes.


ABSTRACT Objective this study examined scientific evidence on motivational interviewing and its influence on self-management among adolescents with type-1 diabetes mellitus (DM1). Methods the survey for this integrative review took place in June 2020 in the LILACS, PubMed, CINAHL, Scopus, and Web of Science databases to answer the question: What scientific evidence is available on motivational interviewing and its influence on self-management among adolescents with DM1? All the articles found were in English and published between 2003 and 2020. Results of the ten studies included, nine were conducted in the United States and one in the United Kingdom. The studies used different methods for applying motivational interviewing in differing circumstances, and their findings revealed positive impacts on self-management among adolescents with type-1 diabetes, especially on blood glucose monitoring and/or on glycated hemoglobin levels. Conclusion motivational interviewing is an intervention that favors self-management and autonomy among adolescents with diabetes.

4.
Medicina (B.Aires) ; 81(5): 843-845, oct. 2021. graf
Article in English | LILACS | ID: biblio-1351058

ABSTRACT

Abstract We present a case of subcutaneous insulin resistance syndrome, a rare entity, consisting of subcutaneous and intramuscular insulin resistance, with normal or almost normal sensitivity to insulin when administered intravenously. Its cause is unknown and its treatment is challenging. Our patient required a pancreas transplant.


Resumen Presentamos un caso de síndrome de resistencia subcutánea a la insulina, entidad in frecuente, que consiste en resistencia a la insulina por vía subcutánea e intramuscular, con sensibilidad normal o casi normal a la insulina cuando se aplica por vía intravenosa. Se desconoce su causa y su tratamiento es un desafío. Nuestra paciente requirió trasplante de páncreas.


Subject(s)
Humans , Insulin Resistance , Pancreas Transplantation , Metabolic Syndrome , Diabetes Mellitus, Type 1 , Insulin
5.
Rev. Finlay ; 11(2): 132-142, 2021. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1340753

ABSTRACT

RESUMEN Fundamento: la diabetes mellitus es una enfermedad endocrino-metabólica que se caracteriza por elevados niveles de glucosa en sangre que se produce como consecuencia de una deficiente secreción o acción de la insulina. Constituye un problema creciente de salud. Objetivo: identificar qué conocimientos tienen los adolescentes que padecen de diabetes mellitus tipo I en el Hospital Pediátrico Universitario Paquito González Cueto de Cienfuegos. Método: se realizó un estudio descriptivo de corte transversal con una muestra de 42 adolescentes con diagnóstico de diabetes mellitus tipo I que tienen seguimiento en consulta de endocrinología del Hospital Pediátrico Universitario de Cienfuegos. Las variables analizadas fueron: edad, nivel de escolaridad, tiempo de diagnóstico de la enfermedad y conocimientos relacionados con la diabetes mellitus. Para la obtención de la información fue diseñado un cuestionario el cual fue previamente validado. Resultados: el 71,4 % de los pacientes respondieron correctamente el concepto de la enfermedad. El grupo de 14 a 16 años de edad fue el más representado con 20 pacientes. En cuanto a los síntomas fueron señalados correctos más del 60 %. El nivel de escolaridad predominante fue secundaria básica y el 83,3 % fueron evaluados de bien. Los adolescentes de 1 a 2 años de diagnóstico obtuvieron una evaluación satisfactoria 7 (58,3 %). Conclusiones: el mayor número de pacientes estuvo entre los 14 y los 16 años. Existieron dificultades en la identificación de los síntomas de descompensación, así como en el tratamiento dietético. El mayor número de pacientes estudiados obtuvo una evaluación satisfactoria.


ABSTRACT Background: diabetes mellitus is an endocrine-metabolic disease characterized by high levels of glucose in blood that occurs due to a deficient secretion or action of insulin. It is a growing health problem. Objective: to identify what knowledge adolescents with type I diabetes mellitus have at the Paquito González Cueto Cienfuegos University Pediatric Hospital. Method: a descriptive cross-sectional study was carried out with 42 adolescents diagnosed with type I diabetes mellitus who are followed up in the endocrinology clinic of the Cienfuegos University Pediatric Hospital. The variables analyzed were: age, level of education, time of diagnosis of the disease and knowledge related to diabetes mellitus. A previously validated questionnaire was designed to obtain information. Results: the 30 (71.4 %) patient they answered the concept of the disease correctly. The group of 14 was 16 elderly years the most represented of 20 patients. They were marked as to the symptoms correct over the 60 %. The level of prevailing scholarship was secondary basic and they were the 83.3 % evaluated of good. The teens with 1 to 2 years of diagnosis obtained a satisfactory evaluation 7 (58.3 %). Conclusions: the largest number of patients was between 14 and 16 years old. There were difficulties in identifying decompensating symptoms, as well as in dietary treatment. The largest number of patients studied obtained a satisfactory evaluation.

6.
Arch. endocrinol. metab. (Online) ; 65(2): 185-197, Mar.-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1248805

ABSTRACT

ABSTRACT Objective: The main aim of the study was to evaluate the patients' glycemic control and adherence to self-care tasks. Materials and methods: Patients with type 1 diabetes mellitus (T1DM) or latent autoimmune diabetes of the adult (LADA) using a multiple daily injection (MDI) regimen with carbohydrate counting (n = 25, Subgroup B) or fixed insulin dose (n = 25, Subgroup C) were allocated to use the application (app) for 12 weeks. Both subgroups were compared with each other and against a control group (n = 25, Group A) comprising patients with T1DM or LADA treated with continuous subcutaneous insulin infusion (CSII) in a parallel-group, open-label, clinical treatment trial. All patients had glycated hemoglobin (A1C) levels measured and were asked to fill out the Diabetes Self-Management Profile (DSMP) questionnaire at study start and end. The patients were instructed to measure capillary glucose six times daily in study weeks 4, 8, and 12. Results: Mean A1C levels decreased 0.725% in Subgroup C in intragroup analysis (p = 0.0063), and had a mean variation of 0.834% compared with Group A (p = 0.003). Mean DSMP scores increased 5.77 points in Subgroup B in intragroup analysis (p = 0.0004) and increased by a mean of 6.815 points in relation to Group A (p = 0.002). Conclusion: OneTouch Reveal improved both A1C levels and DSMP scores in patients with T1DM or LADA compared with standard treatment (CSII).


Subject(s)
Humans , Adult , Diabetes Mellitus, Type 1/drug therapy , Mobile Applications , Self Care , Blood Glucose/analysis , Glycated Hemoglobin A/analysis , Insulin Infusion Systems , Glycemic Control , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use
7.
Rev. Assoc. Med. Bras. (1992) ; 67(4): 505-510, Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1340635

ABSTRACT

SUMMARY OBJECTIVE: To assess the prevalence of altered ankle-brachial index (<0.9 or >1.3) in patients with type 1 diabetes and to compare it with the presence of subclinical atherosclerosis by carotid ultrasound. METHODS: Prospective, cross-sectional study in which 45 adults with type 1 diabetes were evaluated (age 34±10 years, 46.7% men). The data collected included anamnesis, clinical evaluation, calculation of the ankle-brachial index (relationship between systolic blood pressure in the ankle and brachial artery), and performance of carotid ultrasound. RESULTS: Thirty-two patients had ankle-brachial index >1.3 (66.7%) and no patient had ankle-brachial index <0.9. Carotid echocardiography was performed on 21 patients, 4 (19%) of whom had atherosclerosis. Age >35 years and ankle-brachial index >1.4 showed a good correlation with atherosclerosis (r=0.49, p=0.021; r=0.56, p=0.008, respectively). A model associating age >35 years and ankle-brachial index >1.4 showed an excellent relationship with atherosclerosis (r=0.59, p=0.004). CONCLUSIONS: Our study showed that vascular calcification (ankle-brachial index >1.4) was frequent in this population with type 1 diabetes and associated with subclinical atherosclerosis. A model combining ankle-brachial index >1.4 and age >35 years showed an excellent correlation with atherosclerosis and can assist in clinical suspicion and optimize the request for additional tests.


Subject(s)
Humans , Male , Female , Adult , Young Adult , Diabetes Mellitus, Type 1/complications , Atherosclerosis/diagnostic imaging , Cross-Sectional Studies , Prospective Studies , Risk Factors , Ankle Brachial Index
8.
Arch. endocrinol. metab. (Online) ; 65(5): 562-569, 2021. tab
Article in English | LILACS | ID: biblio-1345194

ABSTRACT

ABSTRACT Objective: People with Down's syndrome (DS) have a higher risk of developing type 1 diabetes mellitus (T1D) and may have specific clinical features compared to T1D patients without DS. This study evaluated the clinical and laboratory aspects of T1D in children and adolescents with DS in an admixed population. Subjects and methods: A case-control study comparing patients with T1D and DS (T1D+DS) to patients with T1D without DS (T1D controls) from two tertiary academic Hospitals in São Paulo, Brazil. Results: The sample consisted of 9 patients with T1D+DS and 18 T1D age and sex-matched controls. Anti-glutamic acid decarboxylase 65 antibodies were positive in 7/7 of the 9 T1D+DS patients, confirming the presence of diabetes autoimmunity in this group. Mean age at diagnosis of T1D was 4.9 ± 3.9 years in the T1D+DS group and 6.4 years ± 3 in the T1D control group; early diagnosis (<2 years old) occurred in three T1D+DS patients but only in one T1D control patients, both suggesting lower age of diagnosis in T1D+DS group, although without statistical significance (p = 0.282 and p = 0.093, respectively). The T1D+DS group presented lower total insulin dose (0.7 IU/kg/day ± 0.2) and HbA1c (7.2% ± 0.6) than the control group (1.0 IU/kg/day ± 0.3 and 9.1% ± 0.7, respectively) (p = 0.022 and p = 0.047, respectively). Conclusion: We confirmed the autoimmune etiology of diabetes in people with DS in this admixed population. T1D+DS patients developed diabetes earlier and achieved better metabolic control with a lower insulin dose than T1D controls. These findings are in agreement with previous studies in Caucasian populations.


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Down Syndrome/complications , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/epidemiology , Brazil/epidemiology , Autoimmunity , Case-Control Studies
9.
Texto & contexto enferm ; 30: 20200616, 2021. tab, graf
Article in English | LILACS, BDENF | ID: biblio-1341744

ABSTRACT

ABSTRACT Objective: to analyze the role of the therapeutic toy as a tool for the nursing diagnosis in the setting of care for the child with diabetes. Method: a qualitative multiple-case study conducted with children diagnosed with Type 1 Diabetes mellitus and living in the inland of Paraná. The data were collected in 2018 through interviews, field diary and sessions using the therapeutic toy. Nursing diagnoses were elaborated according to the North American Nursing Diagnosis Association Taxonomy I and a targeted content analysis was performed, resulting in four categories. Results: using the dramatic therapeutic toy allows the child to show their perception of the disease and of the care provided. The sessions with the dramatic therapeutic toy made it possible to identify five nursing diagnoses, which were later worked on by means of an instructional therapeutic toy. Conclusion: systematization of assistance mediated by the use of the toy allows nurses to establish bonds with the child with diabetes and their family, revealing their perceptions of the disease and treatment, thereby stimulating a more active participation of the binomial in the management of this coping process.


RESUMEN Objetivo: analizar el papel del juguete terapéutico como herramienta para el diagnóstico de enfermería en el ámbito de los cuidados del niño con diabetes. Método: estudio cualitativo de casos múltiples, realizado con niños con diagnóstico de diabetes mellitus tipo 1, residentes del interior de Paraná. La recolección de datos se llevó a cabo en 2018, a través de entrevistas, diario de campo y sesiones con el uso de juguetes terapéuticos. Los diagnósticos de enfermería se elaboraron de acuerdo con la taxonomía de la North American Nursing Diagnosis Association I y análisis de contenido dirigido, que resultó en cuatro categorías. Resultados: el uso de juguete terapéutico dramático permite al niño demostrar su percepción sobre la enfermedad y la asistencia que se le brinda. Las sesiones con el juguete terapéutico dramático permitieron la identificación de cinco diagnósticos de enfermería, que luego se trabajaron a través del juguete terapéutico instruccional. Conclusión: la sistematización del cuidado mediado por el uso de juguetes permite al enfermero establecer vínculos con el niño diagnosticado con diabetes y su familia además de revelar sus percepciones sobre la enfermedad y el tratamiento y fomentar una participación más activa del binomio en el manejo de este proceso de afrontamiento.


RESUMO Objetivo: analisar o papel do brinquedo terapêutico como ferramenta para o diagnóstico de enfermagem no cenário de atenção à criança com diabetes. Método: estudo de caso múltiplo qualitativo, realizado com crianças com diagnóstico de Diabetes mellitus tipo 1, residentes do interior do Paraná. Os dados foram coletados em 2018, por meio de entrevista, diário de campo e sessões com uso do brinquedo terapêutico. Foram elaborados diagnósticos de enfermagem segundo a taxonomia da North American Nursing Diagnosis Association I e realizada a análise de conteúdo direcionada, resultando em quatro categorias. Resultados: a utilização do brinquedo terapêutico dramático permite à criança demonstrar sua percepção da doença e dos cuidados realizados. As sessões com o brinquedo terapêutico dramático possibilitaram identificar cinco diagnósticos de enfermagem, que foram trabalhados posteriormente por meio do brinquedo terapêutico instrucional. Conclusão: a sistematização da assistência mediada pelo uso do brinquedo possibilita ao enfermeiro estabelecer vínculos com a criança com diabetes e sua família, desvelando suas percepções em relação à doença e ao tratamento, estimulando assim uma participação mais ativa do binômio no manejo deste processo de enfrentamento.


Subject(s)
Humans , Child , Pediatric Nursing , Play and Playthings , Child Care , Diabetes Mellitus, Type 1 , Nursing Process
10.
Rev. Esc. Enferm. USP ; 55: e03725, 2021.
Article in English | LILACS, BDENF | ID: biblio-1279639

ABSTRACT

ABSTRACT Objective: To identify the main challenges faced by children with type 1 diabetes mellitus and describe their coping strategies. Method: Qualitative study conducted with a semi-structured interview with children aged 8 to 11 with type 1 diabetes mellitus diagnosis who received care in the outpatient clinic of a university hospital in the state of Rio de Janeiro, Brazil. The results have been analyzed and categorized as per thematic analysis. Results: Five children have participated. The reports have emerged from the systematization of the qualitative data, in a process of apprehending meaning from statements of children and adolescents, which led to the category "Living with diabetes", including two subcategories: "Challenges to disease coping" and "Family participation and support in the disease process". Conclusion: The process of disease coping is observed to occur differently for each child. However, family participation and support, as well as communication with health professionals, are fundamental in this process.


RESUMEN Objetivo: Identificar los principales desafíos para los niños con diabetes mellitus tipo 1 y describir las estrategias de afrontamiento que utilizan para adaptarse. Método: Estudio cualitativo, realizado a través de entrevistas semiestructuradas con niños de 8 a 11 años diagnosticados con diabetes mellitus tipo 1 y atendidos en el ambulatorio de un hospital universitario del estado de Rio de Janeiro, en Brasil. Los resultados se analizaron y clasificaron según el análisis temático. Resultados: Participaron cinco niños. Los relatos surgieron de la sistematización de los datos cualitativos, en un proceso de aprehensión del significado de los testimonios de niños y adolescentes, que derivó en la categoría "Vivir con diabetes", con dos subcategorías: "Desafíos en el afrontamiento de la enfermedad" y "Participación y apoyo de la familia en el proceso de la enfermedad". Conclusión: Se constata que el proceso de afrontamiento de la enfermedad ocurre singularmente con cada niño. Sin embargo, la participación y el apoyo de la familia, así como la comunicación de los profesionales sanitarios, son esenciales en este proceso.


RESUMO Objetivo: Identificar os principais desafios vivenciados pela criança com diabetes mellitus tipo 1 e descrever as estratégias de enfrentamento que utilizam para se adaptarem. Método: Estudo de abordagem qualitativa, realizado por meio de entrevista semiestruturada com crianças de 8 a 11 anos com diagnóstico de diabetes mellitus tipo 1 atendidas em ambulatório de um hospital universitário no Estado do Rio de Janeiro. Os resultados foram analisados e categorizados segundo análise temática. Resultados: Participaram cinco crianças. Os relatos emergiram da sistematização dos dados qualitativos, em um processo de apreensão de significado dos depoimentos das crianças e adolescentes, que derivou na categoria "Viver com diabetes", com duas subcategorias: "Desafios no enfrentamento do adoecimento" e "Participação e apoio da família no processo do adoecimento". Conclusão: Constata-se que o processo de enfrentamento do adoecimento ocorre de forma singular para cada criança. No entanto, a participação e o apoio da família, assim como a comunicação dos profissionais de saúde, são fundamentais nesse processo.


Subject(s)
Child , Diabetes Mellitus, Type 1 , Pediatric Nursing , Adaptation, Psychological , Family , Chronic Disease
11.
Esc. Anna Nery Rev. Enferm ; 25(3): e20200278, 2021.
Article in Portuguese | LILACS, BDENF | ID: biblio-1142959

ABSTRACT

Resumo Objetivo Descrever o uso do brinquedo terapêutico no cuidado domiciliar de crianças com Diabetes Mellitus tipo 1. Método Estudo qualitativo do tipo Estudo de Caso, realizado com crianças com diagnóstico de Diabetes Mellitus tipo 1, residentes no interior do Paraná. Os dados foram coletados em 2018, por meio de entrevista com as mães, sessões de brinquedo terapêutico com as crianças e anotações no diário de campo. A análise dos dados foi realizada seguindo os preceitos da análise de conteúdo. Resultados As crianças simularam situações cotidianas com o brinquedo terapêutico com naturalidade, evidenciando que cuidados com a glicemia e aplicação da insulina fazem parte da rotina. Contudo, demonstram sinais de insatisfação com a própria saúde, traçando comparações com crianças que não apresentam a doença e demonstrando suas angústias quando submetidas a procedimentos dolorosos. Conclusão A utilização do brinquedo terapêutico permitiu a abertura de um canal efetivo de comunicação entre criança e profissional, possibilitando ao pesquisador compreender a percepção das crianças sobre sua condição de saúde e desenvolver orientações e cuidados direcionados. Implicações para a prática Ao utilizar o brinquedo terapêutico, recurso de intervenção na assistência de enfermagem, como tecnologia de cuidado, amplia-se as possibilidades de atuação da enfermagem pediátrica, auxiliando crianças em condições crônicas.


Resumen Objetivo Describir el uso de juguetes terapéuticos en el cuidado domiciliario de niños con Diabetes Mellitus tipo 1. Método Estudio de caso tipo estudio cualitativo realizado con niños diagnosticados de Diabetes mellitus tipo 1, residentes del interior de Paraná. Los datos fueron recolectados en 2018, a través de entrevistas con madres, sesiones de juego terapéutico con niños y notas en el diario de campo. El análisis de datos se realizó siguiendo los preceptos del análisis de contenido. Resultados Los niños simularon situaciones cotidianas con el juguete terapéutico de forma natural, demostrando que los cuidados con la aplicación de glucosa e insulina son parte de su rutina. Sin embargo, muestran signos de insatisfacción con su propia salud, haciendo comparaciones con niños que no padecen la enfermedad y demostrando su angustia al ser sometidos a procedimientos dolorosos. Conclusión El uso de juguetes terapéuticos permitió la apertura de un canal de comunicación eficaz entre los niños y los profesionales, posibilitando al investigador comprender la percepción de los niños sobre su estado de salud, y desarrollar orientaciones y cuidados focalizados. Implicaciones para la práctica Al utilizar el juguete terapéutico, recurso de intervención en el cuidado de enfermería, como tecnología asistencial, se amplían las posibilidades del trabajo de enfermería pediátrica y se presta ayuda a los niños en condiciones crónicas.


Abstract Objective To describe the use of therapeutic toys in home care for children with type 1 Diabetes Mellitus. Method A qualitative case study carried out with children diagnosed with type 1 Diabetes mellitus, residents in the inland of Paraná. Data was collected in 2018, through interviews with mothers, therapeutic play sessions with children and notes in the field diary. Data analysis was performed following the precepts of content analysis. Results The children simulated everyday situations with the therapeutic toy naturally, showing that the care measures with blood glucose and insulin application are part of the routine. However, they show signs of dissatisfaction with their own health, drawing comparisons with children who do not suffer from the disease and demonstrating their distress when subjected to painful procedures. Conclusion The use of therapeutic toys allowed for the opening of an effective communication channel between children and professionals, enabling the researcher to understand the children's perception of their health condition, and to develop guidelines and targeted care measures. Implications for the practice When using the therapeutic toy, a resource for intervention in Nursing care, as a care technology, the possibilities for pediatric Nursing work are expanded, helping children in chronic conditions.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Play and Playthings/psychology , Child Care/methods , Diabetes Mellitus, Type 1/therapy , Pediatric Nursing/methods , Qualitative Research
12.
Article in Chinese | WPRIM | ID: wpr-911389

ABSTRACT

Objective:To investigate the long-term effect of the implantation of human umbilical cord-derived mesenchymal stem cells (HUC-MSCs) for type 1 diabetes mellitus.Methods:Fifteen patients with type 1 diabetes mellitus were treated with HUC-MSCs from September 2009 to December 2011 at Department of Endocrinology and Metabolism, the Second People′s Hospital. Patients were followed-up for 10 years and the parameters were collected including fasting blood glucose, HbA 1C, mean amplitude of glycemic excursions (MAGE), fasting C-peptide, daily insulin doses and glutamic acid decarboxylase antibody (GADA). Results:Among 15 patients, 1 patient (6.67%) was found with breast cancer. All patients with type 1 diabetes mellitus decreased daily insulin doses due to frequent hypoglycemia one week later. Six months later, 4 patients (26.67%) stopped insulin injection. While among the 4 patients, 1 patient (6.67%) had not yet used insulin until today and GADA was negative, the other 3 patients (20.00%) restarted insulin within 3-5 years after implantation with significantly less daily insulin doses [(18.00±1.00)U vs (29.00±1.73)U, P<0.01]. The remaining 11 patients (73.33%) with type 1 diabetes mellitus who did not stop insulin also had significantly lower daily insulin doses [(18.09±0.83)U vs (29.64±0.89)U, P<0.01]. The level of MAGE was signicantly decreased compared to those of pre-implantation [(6.14±0.25)mmol/L vs (9.72±0.32)mmol/L, P <0.01], while fasting C-peptide level was significantly improved[(0.91±0.03)nmol/L vs (0.11±0.01)nmol/L, P <0.01]. There were no significant differences in fasting blood glucose and HbA 1C before and after implantation. Conclusions:The implantation of HUC-MSCs for the treatment of type 1 diabetes mellitus can restore the function of islet β cells, decrease daily insulin doses and reduce blood glucose fluctuations in the long term. Although precise mechanisms are unknown, this therapy is expected to be an effective strategy for treatment of type 1 diabetes mellitus.

13.
Rev. Fac. Med. (Bogotá) ; 68(3): 347-351, July-Sept. 2020. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1143720

ABSTRACT

Abstract Introduction: Children with type 1 diabetes mellitus (DM1) are more likely to develop celiac disease (CD), which is an underdiagnosed condition due to its variable clinical presentation. Therefore, children with DM1 require periodic monitoring to achieve an early diagnosis of CD. Objectives: To identify positivity for the detection of anti-tissue transglutaminase IgA antibodies (tTG-IgA) in children with DM1, as well as to describe gastrointestinal (GI) symptoms, anthropometric status indicators and gluten intake levels. Materials and methods: Descriptive cross-sectional study. The population was composed of children with DM1 who attended the outpatient service of two pediatric endocrinology centers in Bogotá, Colombia. The Biocard-Celiac® test was used to detect the presence of tTG-IgA. In addition, participants were asked about their GI symptoms and underwent an anthropometric nutritional assessment. Gluten intake was assessed by recording dietary intake for 72 hours. A statistical data analysis was performed using the SPSS software version 22.0. Results: The final sample included 45 children with an average age of 10.6±4.1 years, of which 53% were males. None of the participants had a positive result in the tTG-IgA test. The most frequent GI symptoms were flatulence (48.9%) and abdominal pain (28.9%). Only 3 children (6.7%) were below the height-for-age standard. The average gluten intake was 5.29±3.02 g/day. Conclusions: Although children with DM1 are at increased risk of developing CD, none of the participants tested positive for tTG-IgA.


Resumen Introducción. Los niños con diabetes mellitus tipo 1 (DM1) tienen mayor probabilidad de desarrollar enfermedad celiaca (EC), la cual es una condición subdiagnosticada debido a que su presentación clínica varía; por lo tanto, es necesario monitorear periódicamente a esta población con el objetivo de diagnosticar a tiempo la EC. Objetivos. Identificar la positividad para la detección de anticuerpos IgA antitransglutaminasa tisular (IgA-TGT) en población pediátrica con DM1, así como describir los síntomas gastrointestinales (SGI), los indicadores antropométricos y los niveles de ingesta de gluten. Materiales y métodos. Estudio descriptivo de corte transversal. La población estuvo compuesta por niños con DM1 que asistieron al servicio de consulta externa en dos centros de endocrinología pediátrica en Bogotá D.C., Colombia. Para detectar la presencia de IgA-TGT se aplicó el test Biocar-dTM Celiac®. Además, se indagó sobre los SGI y se realizó valoración nutricional antropométrica de los participantes. Para evaluar la ingesta de gluten se llevó a cabo un registro dietético de 72 horas. El análisis estadístico de los datos se realizó con el programa SPSS versión 22.0. Resultados. La muestra final estuvo compuesta por 45 niños con una edad promedio de 10.6±4.1 años, de los cuales 53% eran varones. Ninguno de los pacientes presentó positividad cualitativa en el test aplicado para detección de IgA-TGT. Los SGI más frecuentes fueron flatulencias (48.9%) y dolor abdominal (28.9%). Solo en 3 niños (6.7%) se observó talla baja con respecto a su edad. La ingesta promedio de gluten fue 5.29±3.02 g/día. Conclusiones. Pese a que los niños con DM1 tienen mayor riesgo de desarrollar EC, ninguno de los participantes presentó positividad para IgA-TGT.

14.
Arch. endocrinol. metab. (Online) ; 64(4): 412-417, July-Aug. 2020. tab
Article in English | LILACS | ID: biblio-1131101

ABSTRACT

ABSTRACT Objective The consequences of sleep deprivation in type 1 diabetes (T1D) patients are poorly understood. Our aim was to determine how sleep disorders influence lipid profile and insulin sensitivity in T1D patients. Materials and methods This was a cross-sectional study at a public university hospital. Demographic information and medical histories were obtained during regular scheduled visit of T1D patients to the outpatient clinic. Insulin sensitivity was obtained using the estimated glucose disposal rate (eGDR) formula. Sleep quality was assessed using the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Berlin Questionnaire. Results The adult participants (n = 66, 62% women) had a median age of 28.0 years (interquartile range 21.8-33.0). Six patients (9%) had metabolic syndrome according to the International Diabetes Federation criteria. Thirty patients (46%) were considered poor sleepers according to the Pittsburgh Sleep Quality Index. The LDL-c and total cholesterol levels of poor sleepers were higher than those of good sleepers (103 v. 81; p = 0.003 and 178.0 v. 159.5 mg/dL; p = 0.009, respectively). Three patients (4%) were at high risk of obstructive sleep apnea syndrome (OSAS) according to the Berlin Questionnaire. The eGDR was lower in the group of patients with high probability of having OSAS (6.0 v. 9.1 mg.kg-1.min-1;p = .03). Conclusions Poor subjective quality of sleep and higher risk of OSAS were correlated with a worsened lipid profile and decreased insulin sensitivity, respectively. Therefore, T1D patients with sleep disturbances might have an increased cardiovascular risk in the future.


Subject(s)
Humans , Male , Female , Adult , Sleep Wake Disorders , Insulin Resistance , Diabetes Mellitus, Type 1 , Cross-Sectional Studies , Surveys and Questionnaires , Lipids
15.
Rev. Assoc. Med. Bras. (1992) ; 66(6): 778-783, June 2020. graf
Article in English | LILACS, SES-SP | ID: biblio-1136274

ABSTRACT

SUMMARY OBJECTIVE This study aimed to propose a co-expression-network (CEN) based gene functional inference by extending the "Guilt by Association" (GBA) principle to predict candidate gene functions for type 1 diabetes mellitus (T1DM). METHODS Firstly, transcriptome data of T1DM were retrieved from the genomics data repository for differentially expressed gene (DEGs) analysis, and a weighted differential CEN was generated. The area under the receiver operating characteristics curve (AUC) was chosen to determine the performance metric for each Gene Ontology (GO) term. Differential expression analysis identified 325 DEGs in T1DM, and co-expression analysis generated a differential CEN of edge weight > 0.8. RESULTS A total of 282 GO annotations with DEGs > 20 remained for functional inference. By calculating the multifunctionality score of genes, gene function inference was performed to identify the optimal gene functions for T1DM based on the optimal ranking gene list. Considering an AUC > 0.7, six optimal gene functions for T1DM were identified, such as regulation of immune system process and receptor activity. CONCLUSIONS CEN-based gene functional inference by extending the GBA principle predicted 6 optimal gene functions for T1DM. The results may be potential paths for therapeutic or preventive treatments of T1DM.


RESUMO OBJETIVO O objetivo deste estudo é realizar uma inferência funcional genética baseada na rede de coexpressão (CEN), expandindo o escopo do princípio de "Culpa por Associação" (GBA - Guilt by Association) para prever as funções genéticas do diabetes mellitus tipo 1 (T1DM). MÉTODOS Primeiro, os dados transcritos do T1DM foram recuperados do repositório de dados genômicos para a análise dos genes diferenciais (DEGs), e foi gerada uma CEN diferencial ponderada. A área sob a curva ROC (AUC) foi escolhida para determinar a métrica de desempenho para cada termo de Ontologia Genética (GO). A análise da expressão diferencial identificou 325 DEGs no T1DM, e a análise de coexpressão gerou uma CEN diferencial com aresta de peso >0,8. RESULTADOS Um total de 282 anotações de GO com DEGs >20 foram mantidas para inferência funcional. Ao calcular a pontuação de multifuncionalidade dos genes, a inferência da função genética foi realizada para identificar as funções genéticas ideais para T1DM com base na lista de classificação genética ideal. Considerando um valor de AUC >0,7, foram identificadas seis funções genéticas ideais para a T1DM, tais como a regulação do processo imunológico e da atividade dos receptores. CONCLUSÕES A inferência funcional genética baseada em CEN, ao expandir o princípio de GBA, previu seis funções genéticas ideais para o T1DM. Os resultados podem ser caminhos potenciais para tratamentos terapêuticos ou preventivos do T1DM.


Subject(s)
Humans , Diabetes Mellitus, Type 1/genetics , Biomarkers , ROC Curve , Gene Expression Profiling , Transcriptome
16.
Rev. Soc. Bras. Clín. Méd ; 18(2): 104-107, abril/jun 2020.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1361464

ABSTRACT

Objetivo: Analisar a percepção dos diabéticos tipo 1 sobre a insulinoterapia. Métodos: Trata-se de estudo epidemiológico analítico de percepção, tendo sido realizado com pacientes de um Serviço de Apoio e Assistência aos Diabéticos e seus Familiares, no período de abril a agosto de 2018. Resultados: Os 33 diabéticos tipo 1 avaliados eram predominantemente do sexo feminino (60,6%) e a média de idade foi de 21±9 anos. A maioria afirmou portar o Cartão de Identificação do Diabético (78,8%). Mais de dois terços dos pacientes afirmaram saber quando aplicar a insulina de correção. A aferição da glicemia capilar foi relatada por 78,8%. Das insulinas utilizadas no esquema basal, a glargina e a NPH foram citadas como as mais utilizadas. Do total de pacientes, 97% referiram fazer autoaplicação, e 90,9% disseram posicionar a agulha corretamente sobre a pele. Quanto aos locais de aplicação, 84,8% realizavam rodízio. A maioria dos pacientes (78,8%) que aplicavam a insulina não referiu desconforto durante ou após a aplicação, e 69,7% mostraram conhecimento sobre o significado de distrofia. Conclusão: O serviço de educação continuada desenvolvido pelo Serviço de Apoio e Assistência aos Diabéticos e seus Familiares é efetivo na aquisição de bons hábitos e dos devidos cuidados para esses pacientes. A educação do indivíduo com diabetes tipo 1 e de sua família, bem como o acompanhamento por uma equipe multidisciplinar, é essencial para o bom controle da doença,


Objective: To analyze the perception of type 1 diabetes (DM 1) patients of insulin therapy. Methods: This is an epidemiological study of analysis of perception and was performed at the service for care and support of diabetes patients and their families from April to August 2018. Results: The 33 type 1 diabetes mellitus patients evaluated were predominantly female (60.6%) and the mean age was 21 years ± 9 years. Most reported having the diabetes medical ID card (78.8%). More than two thirds of the patients reported knowing when to apply the correction insulin. The capillary glycemia measurement was reported by 78.8%. Of the insulins used in the baseline regimen, Glargine and NPH were cited as the most used. Of the total patients, 97% reported self-application and 90.9% reported positioning the needle correctly on the skin. As for the application sites, 84.8% reported rotating sites. Most patients (78.8%) who applied insulin did not report discomfort during or after application, and 69.7% showed knowledge about the meaning of dystrophy. Conclusion: The continuing education service developed by the Service for Care and Support of Diabetics and their Families is effective in promoting good habits and the proper care of these patients for their disease.The education of the individual with type 1 diabetes and of his/her family, as well as follow-up by a multidisciplinary team, is essential for good disease control.

17.
Surg. cosmet. dermatol. (Impr.) ; 12(4 S2): 227-fev.-nov. 2020.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1367992

ABSTRACT

Paciente do sexo feminino, com diabetes tipo I e tireoidite de Hashimoto, apresentou necrobiose lipoídica aos 15 anos de idade. Foi tratada com 100mg/dia de ciclosporina, porém um abscesso na região inguinal levou à interrupção do tratamento. Posteriormente, utilizou dimetil fumarato em doses crescentes até 120mg/dia por três meses e, devido à ausência de resultados, cessou o uso do medicamento. A terceira tentativa foi com isotretinoína 40mg/dia por oito meses, com cicatrização da ferida. Recentemente, após cirurgia reparadora de cicatriz no joelho, houve aparecimento de lesões de necrobiose lipoídica no local da sutura. Tomou novamente 40mg/dia de isotretinoína, e a lesão regrediu em três meses


A woman with type I diabetes and Hashimoto's disease presented necrobiosis lipoidica at 15 years of age. Cyclosporine 100 mg/day was prescribed; however, an abscess in the inguinal region led to treatment interruption. Then, she tried dimethyl fumarate at increasing doses up to 120 mg/day. The lack of results led to the discontinuation of the therapy. The third attempt was isotretinoin 40 mg/day for eight months, with wound healing. Recently, after a knee scar repair surgery, necrobiosis lipoidica lesions appeared at the suture site. The patient received isotretinoin 40 mg/day again, and the lesion regressed in three months.

18.
Rev. bras. enferm ; 73(supl.4): e20180975, 2020. tab
Article in English | LILACS-Express | LILACS, BDENF | ID: biblio-1137665

ABSTRACT

ABSTRACT Objectives: to analyze how children with type 1 diabetes mellitus and their families explain the pathology, based on their understanding of the factors related to the discovery of diabetes, the etiology, treatment, and prognosis of the disease. Methods: qualitative methodological approach, based on medical anthropology and the narrative method. In-depth interviews were conducted with 12 families of children with type 1 diabetes mellitus attending follow-up consultations at a specialized center. The statements were subjected to inductive thematic analysis. Results: the explanatory models identified describe the families search for the clarification of the signs and symptoms that the child had. Faced with the disease, families reorganized themselves to meet new health care needs of children, such as adequate nutrition, physical exercise, and blood glucose monitoring. Final Considerations: knowing the explanatory models allows the understanding of how families give meaning to the child's illness, favoring daily nursing care and an effective control of the disease.


RESUMEN Objetivos: analizar como niños con diabetes mellitus tipo 1 y sus familias explican la patología, a partir de la comprensión que poseen sobre los factores relacionados a la descubierta del diabetes, etiología, tratamiento y pronóstico de la enfermedad. Métodos: abordaje metodológico cualitativo, fundamentado en la antropología médica y método narrativo. Se han realizado entrevistas en profundidad con 12 familias de niños con diabetes mellitus tipo 1en seguimiento en un centro especializado. Se ha sometido las narrativas al análisis temático inductivo. Resultados: los modelos explicativos identificados describen la búsqueda de las familias por el esclarecimiento de los señales y síntomas que el niño presentaba. Delante de la enfermedad, las familias se reorganizaron para atender a las nuevas necesidades de cuidados de salud de los niños, como alimentación adecuada, práctica de ejercicios físicos y seguimiento glucémico. Consideraciones Finales: conocer los modelos explicativos permite comprender como las familias ha dado sentido a la experiencia de la enfermedad del niño, favoreciendo el cuidado diario de enfermería y el efectivo control de la enfermedad.


RESUMO Objetivos: analisar como crianças com diabetes mellitus tipo 1 e suas famílias explicam a patologia, a partir da compreensão que possuem sobre os fatores relacionados à descoberta do diabetes, etiologia, tratamento e prognóstico da doença. Métodos: abordagem metodológica qualitativa, fundamentada na antropologia médica e método narrativo. Realizaram-se entrevistas em profundidade com 12 famílias de crianças com diabetes mellitus tipo 1 em seguimento em um centro especializado. Submeteram-se as narrativas à análise temática indutiva. Resultados: os modelos explicativos identificados descrevem a busca das famílias pelo esclarecimento dos sinais e sintomas que a criança apresentava. Diante da doença, as famílias se reorganizaram para atender às novas necessidades de cuidados de saúde das crianças, como alimentação adequada, prática de exercícios físicos e monitorização glicêmica. Considerações Finais: conhecer os modelos explicativos permite compreender como as famílias dão sentido à experiência do adoecimento da criança, favorecendo o cuidado diário de enfermagem e o efetivo controle da doença.

19.
Rev. méd. Minas Gerais ; 30: e-3007, 2020.
Article in Portuguese | LILACS | ID: biblio-1117837

ABSTRACT

Introdução: A associação entre perda auditiva e Diabetes Mellitus tipo 1 (DM1) é ainda pouco estudada. A perda auditiva é uma das complicações crônicas relacionadas ao grau de controle glicêmico, que os pacientes podem apresentar com a progressão da doença. Objetivo: Investigar o comprometimento auditivo por meio das emissões otoacústicas transitórias (EOAT) por banda de frequência em adolescentes com DM1 e relação com o controle glicêmico. Métodos: Foram incluídos 80 adolescentes, 50% do gênero masculino, entre 10 e 19 anos de idade: 40 com DM1 e 40 controles saudáveis, pareados por gênero e idade. Os dados clínicos e laboratoriais foram pesquisados nos prontuários médicos. O controle glicêmico foi avaliado por meio dos exames de hemoglobina glicada e os pacientes com DM1 analisados de acordo com o controle glicêmico. A avaliação auditiva foi realizada por meio da imitanciometria, audiometria, e posteriormente EOAT, em sala tratada acusticamente, pelo protocolo "TE Test" de clique não-linear (1 KHz a 4 kHz) a 80 dB NPS de intensidade (AuDX - Biologic). Resultados: As respostas às EOAT foram ausentes em 5,12% em pacientes com DM1, com diferença significativa em relação aos controles (p=0,04). A análise das EOAT por bandas de frequência mostrou maior proporção de alteração nos adolescentes com DM1 mal controlados quando comparados aos bem controlados, nas frequências de 1000Hz, 2000Hz e 3000Hz (p<0,05). Conclusão: As EOAT por bandas de frequência permitiram a identificação precoce de comprometimento auditivo em adolescentes com DM1 e mostraram associação entre DM1 mal controlado e perda auditiva. (AU)


Introduction: The association between hearing loss and type 1 diabetes mellitus (DM1) is still poorly studied. Hearing loss is one of the chronic complications related to the degree of glycemic control that patients may present with the progression of the disease. Objective: To investigate auditory impairment through transient otoacoustic emissions (TEOAE) by frequency band in adolescents with DM1 and in relation to glycemic control. Methods: Were included 80 adolescents, 50% males, between 10 and 19 years of age: 40 with DM1 and 40 healthy controls, matched by gender and age. Clinical and laboratory data were taken from the medical records. Glycemic control was evalueted by glycated hemoglobin and the patients with DM1 were analyzed according to glycemic control. To the auditory evaluation were used the immittance and audiometry, and the TEOAE. The test was performed in the acoustically treated room, the non-linear TE test protocol (1 KHz to 4 kHz) at 80 dB SPL (AuDX - Biologic ). Results: TEOAE responses were absent in 5.12% of patients with DM1, with a significant difference in relation to controls (p = 0.04). The analysis of TEOAE by frequency bands showed a higher proportion of alteration in adolescents with DM1 poorly controlled when compared to well controlled ones, in the frequencies of 1000Hz, 2000Hz and 3000Hz (p <0.05). Conclusion: TEOAE by frequency bands allowed the early identification of auditory impairment in adolescents with DM1 and showed an association between poorly controlled DM1 and hearing loss. (AU)


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Young Adult , Acoustic Stimulation/methods , Diabetes Mellitus, Type 1/physiopathology , Blood Glucose/metabolism , Case-Control Studies , Cross-Sectional Studies , Cochlea , Diabetes Mellitus, Type 1/complications , Hearing Loss/etiology , Hearing Tests/methods
20.
Article in English | LILACS | ID: biblio-1057225

ABSTRACT

ABSTRACT Objective: To analyze the variables associated with the presence of diabetic ketoacidosis in type 1 diabetes mellitus (T1DM) diagnosis and its impact on the progression of the disease. Methods: We reviewed the records of 274 children and adolescents under 15 years, followed in a Pediatric Endocrinology clinic of a university hospital in Curitiba-PR. They had their first appointment between January 2005 and April 2015. Results: Most patients received their T1DM diagnosis during a diabetic ketoacidosis episode. The associated factors were: lower age and greater number of visits to a physician's office prior to diagnosis; diabetic ketoacidosis was less frequent in patients who had siblings with T1DM and those diagnosed at the first appointment. Nausea and vomiting, abdominal pain, tachydyspnea, and altered level of consciousness were more common in the diabetic ketoacidosis group. There was no association with socioeconomic status, duration of symptoms before diagnosis, and length of the honeymoon period. Conclusions: Prospective studies are necessary to better define the impact of these factors on diagnosis and disease control. Campaigns to raise awareness among health professionals and the general population are essential to promote early diagnosis and proper treatment of diabetes mellitus in children and adolescents.


RESUMO Objetivo: Avaliar as variáveis associadas ao diagnóstico de diabetes melito tipo 1 (DM1) na vigência de cetoacidose diabética e seu impacto na evolução da doença. Métodos: Foram avaliadas 274 crianças e adolescentes com idade até 15 anos acompanhados em um ambulatório de endocrinologia pediátrica de um hospital universitário de Curitiba, Paraná, cuja primeira consulta ocorreu entre janeiro de 2005 e abril de 2015. Resultados: A maioria dos pacientes teve diagnóstico de DM1 na vigência de cetoacidose diabética. Os fatores associados foram: menor idade e maior número de consultas prévias ao diagnóstico; a cetoacidose diabética foi menos frequente quando havia um irmão com DM1 e quando o diagnóstico foi feito na primeira consulta médica. Náuseas ou vômitos, dor abdominal, taquidispneia e alteração do nível de consciência foram mais frequentes no grupo com cetoacidose diabética ao diagnóstico. Não se observou associação com nível socioeconômico, tempo de sintomas antes do diagnóstico e duração do período de lua de mel. Conclusões: São necessários estudos prospectivos para definir melhor o impacto desses fatores no diagnóstico e no controle da doença. Campanhas de conscientização dos profissionais de saúde e da população são necessárias para que haja diagnóstico precoce e tratamento adequado do diabetes melito em crianças e adolescentes.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Diabetic Ketoacidosis/etiology , Diabetic Ketoacidosis/epidemiology , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/epidemiology , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Risk Factors , Diabetic Ketoacidosis/pathology , Diabetic Ketoacidosis/therapy , Disease Progression , Diabetes Mellitus, Type 1/diagnosis , Diabetes Mellitus, Type 1/therapy , Diagnosis, Differential , Ambulatory Care/statistics & numerical data , Insulin/therapeutic use
SELECTION OF CITATIONS
SEARCH DETAIL