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1.
Arch. endocrinol. metab. (Online) ; 59(1): 23-28, 02/2015. tab
Article in English | LILACS | ID: lil-746442

ABSTRACT

Objective To evaluate the data of continuous subcutaneous insulin infusion protocol (CSII) for diabetics waived by the Health State Secretariat of Distrito Federal (HSSDF) and therapeutic responses three months after the transfer of multiple daily injections regimen for CSII. Subjects and methods Eighty patients (49 female) took part in this experimental study, mean age and disease duration were 27.9 years and 13 years, respectively; 96% patients had type 1 diabetes mellitus. Results The entire sample (ECO) and 3 subgroups (group 1 – A1c decrease, group 2 – A1c stable, and group 3 – A1c increase), stratified according to a ≥ 0.5% change in A1c, were analyzed. Group 1 involved 64% of the patients. The ECO showed a significant A1c decrease: MDI 8.1 ± 1.4% vs. CSII 7.3 ± 0.9%, p < 0.0001 (0.8% difference pro CSII therapy). Group 1 demonstrated an A1c decrease from 8.7% to 7.3% (1.4% difference). Group 2 mean A1c was 7.1%. Rate of hypoglycemia (< 50 mg/dL) decreased 61% in the ECO and 79% in Group 2. Conclusion This study reinforces the safety and efficacy of CSII with a robust A1c reduction and hypoglycemia. The pioneer care HSSDF ambulatory attests to be achievable the free dispensing by Unified Health System (UHS) following a protocol, and this approach results in less wastage to the patient and represents a rational policy of therapy with CSII for UHS. Arch Endocrinol Metab. 2015;59(1):23-8 .


Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Young Adult , Diabetes Mellitus, Type 1/drug therapy , Hypoglycemic Agents/administration & dosage , Insulin/administration & dosage , Ambulatory Care Facilities , Brazil , Diabetes Mellitus, Type 1/blood , /drug therapy , Hospitals, Public , Glycated Hemoglobin/metabolism , Hypoglycemia/blood , Insulin Infusion Systems , Infusions, Subcutaneous/methods , Outpatients , Prospective Studies
2.
Rev. HCPA & Fac. Med. Univ. Fed. Rio Gd. do Sul ; 32(2): 199-207, 2012. ilus, tab
Article in Portuguese | LILACS | ID: biblio-834416

ABSTRACT

A via subcutânea é indicada como via de segunda opção para a administração de fármacos de forma contínua ou intermitente nos pacientes em cuidados paliativos que não podem utilizar a via oral. No entanto, há controvérsias e pouca aderência ao seu uso. A dissecção venosa e/ou punção de subclávia ainda são procedimentos frequentes nos pacientes com doença avançada, vivenciando a fase final da vida. A via subcutânea é um método consensualmente reconhecido como seguro internacionalmente, não produzindo nenhuma complicação grave quando comparado ao intravenoso e, tecnicamente, a aplicação do cateter subcutâneo é mais fácil. No Brasil, os relatos científicos da administração de fármacos por via subcutânea são incipientes e, na prática clínica, ainda pouco utilizada. Uma discussão sobre essa técnica é premente no meio hospitalar. O objetivo deste estudo é realizar uma revisão teórica sobre o uso da via subcutânea na prática clínica com pacientes em cuidados paliativos. A busca foi realizada nas bases de dados no período de 1998 a 2010, nos meses de setembro e outubro de 2011. A análise do material encontrado apontou que é uma técnica de fácil aplicabilidade e manutenção em ambiente hospitalar ou domiciliar; melhora a autonomia e a qualidade de vida do paciente, sendo esse o objetivo primordial em cuidados paliativos.


Subcutaneous route is the second option for continuous or intermittent administration of medication to patients in need of palliative care who cannot receive oral medication. However, there is controversy over the use of the subcutaneous route and, thus, poor adherence to it. Vein dissection and/or subclavian puncture are frequent procedures in patients with advanced diseases during their terminal phase of life. Subcutaneous route is considered to be a safe method that does not cause severe complications when compared with the intravenous route. In addition, the technique used for subcutaneous catheter placement is much simpler. In Brazil, there are few reports on the administration of medication using the subcutaneous route, and this technique is seldom used in clinical practice. Therefore, there is urgent need for discussing the use of this technique in hospitals. The objective of this review of the literature was to investigate the use of the subcutaneous route in palliative care. We searched the databases in September and October of 2011. The studies included in our search were published between 1998 and 2010. The analysis of the articles selected suggests that the subcutaneous route is easy to use and maintain in both hospital and home environments. This technique improves the patients’ autonomy and quality of life, which is the main goal of palliative care.


Subject(s)
Humans , Palliative Care , Infusions, Subcutaneous/methods , Injections, Subcutaneous/methods , Pharmaceutical Preparations/administration & dosage
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