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1.
In. Pradines Terra, Laura; García Parodi, Lucía; Bruno, Lorena; Filomeno Andriolo, Paola Antonella. La Unidad de Pie Diabético del Hospital Pasteur: modelo de atención y pautas de actuación: importancia del abordaje interdisciplinario. Montevideo, Cuadrado, 2023. p.265-270.
Monography in Spanish | LILACS, UY-BNMED, BNUY | ID: biblio-1418739
2.
In. Serra Sansone, María del Pilar; Vitureira Liard, Gerardo José; Pereda Domínguez, Jimena; Medina Romero, Gonzalo Alexander; Rodríguez Rey, Marianela Ivonne; Blanc Reynoso, Agustina; Santos, Karina de los; Morán, Rosario; Sotelo, Débora; Barreiro, Carolina. Diabetes y embarazo. Montevideo, Cuadrado, 2023. p.83-100, ilus, tab.
Monography in Spanish | LILACS, UY-BNMED, BNUY | ID: biblio-1419139
3.
In. Serra Sansone, María del Pilar; Vitureira Liard, Gerardo José; Pereda Domínguez, Jimena; Medina Romero, Gonzalo Alexander; Rodríguez Rey, Marianela Ivonne; Blanc Reynoso, Agustina; Santos, Karina de los; Morán, Rosario; Sotelo, Débora; Barreiro, Carolina. Diabetes y embarazo. Montevideo, Cuadrado, 2023. p.233-247.
Monography in Spanish | LILACS, UY-BNMED, BNUY | ID: biblio-1419161
4.
São Paulo; s.n; 2023. 119 p.
Thesis in Portuguese | LILACS | ID: biblio-1532242

ABSTRACT

O rápido envelhecimento populacional observado no Brasil marca a transição demográfica e epidemiológica devido à baixa mortalidade e à alta prevalência de doenças crônicas não transmissíveis, como o diabetes mellitus tipo 2 (DM2). O DM2 é uma doença metabólica caracterizada por elevados níveis de açúcar no sangue e alta morbidade em idosos, associada ao risco cardiovascular. O controle dos níveis glicêmicos é essencial para prevenir complicações agudas e crônicas, evitando prejuízos à capacidade funcional, autonomia e qualidade de vida do indivíduo. As recomendações para o controle glicêmico no DM2 envolvem ações não farmacológicas, como mudanças no estilo de vida (dieta, perda de peso e atividade física regular), e terapia medicamentosa. Os idosos são os maiores consumidores de medicamentos no país, e a polifarmácia, combinada com as mudanças fisiológicas típicas do envelhecimento, torna essa parte da população mais suscetível a problemas relacionados aos medicamentos, que podem afetar o sucesso da terapêutica. Nos últimos anos, estudos em farmacogenômica, uma área que explora a variação interindividual da resposta a medicamentos, demonstraram a associação de variantes em genes com o metabolismo de medicamentos, evidenciando interações farmacogenéticas em diversas classes de antidiabéticos orais. Este estudo buscou compreender os diferentes fatores que influenciam o controle glicêmico em idosos com diabetes referida, residentes no município de São Paulo, participantes do Estudo Saúde, Bem-estar e Envelhecimento (SABE), no período de 2010 a 2015. Foram delineados três artigos que analisaram as características socioeconômicas, aspectos de saúde, estilo de vida e aqueles relacionados ao DM2, como manejo da hiperglicemia e a variabilidade genética na resposta a medicamentos e o controle glicêmico, e seu impacto no desenvolvimento de complicações decorrentes do DM2. O artigo 1 descreve os perfis farmacoepidemiológico e farmacogenético dos idosos. O segundo artigo avalia os fatores associados ao controle glicêmico inadequado, enquanto o artigo 3 estima o risco de desenvolvimento de complicações em 5 anos. A metformina, antidiabético oral da classe das biguanidas e primeira escolha para o tratamento do DM2, foi o medicamento mais utilizado pelos idosos da amostra (61,3%), em monoterapia (35,2%), em mais da metade das associações de 2 AD e em todos os esquemas com 3 AD. Das variantes genéticas associadas à eficácia do tratamento com metformina estudadas, portadores do genótipo TT da variante rs2252281 (SLC47A1) apresentaram maior chance de controle glicêmico inadequado (OR = 4,19 IC 1,22; 14,36). Esse fenômeno foi observado em 32,1% dos idosos e estava associado à utilização de dois ou três antidiabéticos (OR = 2,89 IC 95% 1,47; 5,67), ao tempo de duração do DM2 (OR = 1,46 IC 95% 0,68; 3,12) e à presença de doença cardíaca (OR = 2,02 IC 95% 1,02; 4,01). Problemas nos olhos (RR= 2,13 IC 95% 1,24; 3,66), retinopatia diabética (RR = 3,18 IC 95% 1,05; 9,61) e episódios agudos de hipoglicemia (RR = 2,28 IC 95% 1,49; 3,49) e hiperglicemia (RR = 2,78 IC 95% 1,65; 4,68) tiveram risco aumentado em idosos com controle glicêmico inadequado. Estes resultados reforçam a necessidade de uma abordagem abrangente e individualizada para o manejo da hiperglicemia nos idosos. O controle glicêmico nesta parcela da população é desafiador, e suas implicações no desenvolvimento de complicações do DM2 destacam a importância de manter os níveis de glicose no sangue dentro de faixas saudáveis. A pactuação de metas glicêmicas menos rígidas pode evitar situações adversas, como a hipoglicemia, e a adoção de esquemas terapêuticos menos complexos pode contribuir significativamente para melhora na adesão.


The rapid aging of the population observed in Brazil marks the demographic and epidemiological transition due to low mortality and a high prevalence of noncommunicable chronic diseases, such as type 2 diabetes mellitus (TDM2). TDM2 is a metabolic disease characterized by elevated blood sugar levels and high morbidity in the elderly, associated with cardiovascular risk. Controlling glycemic levels is essential to prevent acute and chronic complications, avoiding impairments to functional capacity, autonomy, and quality of life. Recommendations for glycemic control in TDM2 involve non-pharmacological actions, such as lifestyle changes (diet, weight loss, and regular physical activity), and drug therapy. Elderly individuals are the largest consumers of medications in the country, and polypharmacy, combined with the physiological changes typical of aging, makes this population more susceptible to medication-related problems that can affect the success of therapy. In recent years, studies in pharmacogenomics, an area that explores interindividual variation in drug response, have demonstrated the association of genetic variants with drug metabolism, highlighting pharmacogenetic interactions in various classes of oral antidiabetics. This study aimed to understand the different factors influencing glycemic control in elderly individuals with reported diabetes living in São Paulo city, participants in the Health, Well-being, and Aging Study (SABE) from 2010 to 2015. Three articles were outlined, analyzing socioeconomic characteristics, health aspects, lifestyle, and those related to TDM2, such as hyperglycemia management and genetic variability in drug response and glycemic control, and its impact on the development of complications from TDM2. Article 1 describes the pharmacoepidemiological and pharmacogenetic profiles of the elderly. The second article evaluates factors associated with inadequate glycemic control, while the third article estimates the risk of developing complications over 5 years. Metformin, an oral antidiabetic of the biguanide class and the first choice for TDM2 treatment, was the most used medication by the elderly in the sample (61.3%), either in monotherapy (35.2%) or in more than half of the combinations of 2 antidiabetic drugs and all regimens with 3 drugs. Among the studied genetic variants associated with metformin treatment effectiveness, carriers of the TT genotype of the rs2252281 variant (SLC47A1) had a higher chance of poor glycemic control (OR = 4.19 CI 1.22; 14.36). Poor glycemic control was observed in 32.1% of the elderly and was associated with the use of two or three antidiabetics (OR = 2.89 CI 95% 1.47; 5.67), the duration of TDM2 (OR = 1.46 CI 95% 0.68; 3.12), and the presence of heart disease (OR = 2.02 CI 95% 1.02; 4.01). Problems with eyes (RR = 2.13 CI 95% 1.24; 3.66), diabetic retinopathy (RR = 3.18 CI 95% 1.05; 9.61), and acute episodes of hypoglycemia (RR = 2.28 CI 95% 1.49; 3.49) and hyperglycemia (RR = 2.78 CI 95% 1.65; 4.68) had an increased risk in elderly individuals with poor glycemic control. These results emphasize the need for a comprehensive and individualized approach to hyperglycemia management in the elderly. Glycemic control in this population segment is challenging, and its implications for the development of DM2 complications underscore the importance of maintaining blood glucose levels within healthy ranges. Agreeing on less stringent glycemic targets can prevent adverse situations such as hypoglycemia, and the adoption of less complex therapeutic regimens can significantly contribute to improved adherence.


Subject(s)
Humans , Male , Female , Pharmacogenetics , Aged , Aging , Pharmacoepidemiology , Diabetes Mellitus , Drug Utilization , Noncommunicable Diseases , Glycemic Control
5.
Journal de la Faculté de Médecine d'Oran ; 6(2): 787-794, 2023. tables
Article in French | AIM | ID: biblio-1415031

ABSTRACT

Introduction-Le diabète est un véritable problème de santé publique du fait de ses nombreuses complications potentielles, notamment cardiovasculaires. Notre objectif était de décrire le profil clinico-biologique chez une population de diabé tique type 2 et d'étudier la relation entre l'équilibre glycémique et les anomalies lipidiques avec les complications micro et macroangiopathiques. Matériels et méthodes -Nous avons mené une étude rétrospective portant sur 341 pa tients diabétiques type 2.Les données ont été analysées par le logiciel IBM® SPSS statis tics 20.0. Seules, les associations significatives (p ≤ 5%) étaient retenues. Résultats - quatre-vingt deux pourcent et demi des patients ont un taux d'HbA1c ≥7 %. Plus de 60 % ont une dyslipidémie. Cinquante deux pourcent des patients ont un taux du LDLc ≤ 1 g/l, et 64,4 % ont un taux du Non-HDLc >1g/l. Environ 66 % des patients ont une hypertension artérielle. quarante pourcent des patients ont présenté une macroangio pathie et 66,8 % une microangiopathie (p=0,0001). L'analyse par régression logistique, a montré que l'HbA1c est le paramètre biologique le plus associé aux complications macroangiopathiques (p=0,008), alors que pour les complications micro-angiopathiques, l'HTA était le seul facteur associé (p = 0,03). Pour la cardiopathie ischémique, la dyslipi démie et l'HTA étaient les facteurs les plus associés. Conclusion -Notre étude a montré une fréquence élevée des complications micro et macroangiopathiques et des anomalies lipidiques, ainsi qu'un très mauvais équilibre glycémique. L'HbA1c, la dyslipidémie et l'HTA sont les facteurs les plus associés au risque cardiovasculaire.


Background-Diabetes is a real health public problem because of its many potential complications, particularly the cardiovascular ones.The aim of this work was to describe the clinical and biological profile in type 2 diabetic population, then to study the relationship between glycemic control and lipid abnormalities with micro and macro vascular complications. Methods - It was about a retrospective study of 341 type 2 diabetes patients' with an average age of 60.1 ± 11.71 years.The IBM® SPSS statistics 20.0 software was used for analyzing data. Only significant associations (p ≤ 5%) were retained. Results -An HbA1c level ≥7% was observed in 82,5% of patients, More than 60% have dyslipidemia. 52,8% of them have an LDLc level ≤ 1 g/l, and 64,4% have a Non-HDLc level >1g/l. Sixty-six percent of patients have high blood pressure. The macrovascular disorders were observed on 30,9% of patients and microvascular ones on 66,8% of them (p = 0.0001).The logistic regression analysis showed that HbA1c was the most significant biological parameter (p=0,008). while for micro-vascular complications, high blood pressure was the only associated factor (p = 0.03). For ischemic heart disease, dyslipidemia and high blood pressure were the most associated factors. Conclusion - this study showed a high frequency of micro and macrovascular complications, lipid abnormalities and a very poor glycemic control. The elevation of HbA1c level, the high blood pressure and dyslipidemia are the most associated factors with a high cardiovascular risk.


Subject(s)
Public Health , Retrospective Studies , Receptors, Proteinase-Activated , Diabetes Mellitus, Type 2 , Dyslipidemias , Heart Disease Risk Factors , Diabetes Mellitus , Glycemic Control , Hypertension
6.
Rev. chil. endocrinol. diabetes ; 16(3): 80-86, 2023. ilus, tab
Article in Spanish | LILACS | ID: biblio-1451971

ABSTRACT

OBJETIVO: Evaluar el tiempo en rango de glucosa y su asociación con otras medidas del control glicémico establecidas por el consenso internacional del tiempo en rango en usuarios de vida real del sistema flash de monitorización de glucosa FreeStyle LibreTM en Chile. MÉTODOS: Se analizaron los datos provenientes de la base de datos Freestyle Libre™ entre diciembre de 2014 y enero de 2022. Las lecturas se dividieron en 10 grupos (deciles) del mismo tamaño (cada decil contenía aproximadamente 498 usuarios) en función del tiempo en rango. Para cada decil se calculó la media de determinaciones diarias, el promedio de glucosa, la HbA1c, la desviación estándar de glucosa, el coeficiente de variación de la glucosa, el tiempo en rango, el tiempo de glucosa (porcentaje) por encima de 250 mg/dL (TA250), el tiempo de glucosa (porcentaje) por encima de 180 mg/dL (TA180), el tiempo por debajo (porcentaje) de 70 mg/dL (TB70) y el tiempo por debajo (porcentaje) de 54 mg/dL (TB54). RESULTADOS: Desde diciembre de 2014 hasta enero de 2022 hubo 4984 lectores. El grupo con el mayor tiempo en rango mostró significativamente una menor glucosa promedio que el grupo con el tiempo en rango más bajo (decil 1: media 248,3 mg/dL, decil 10: media 113,2 mg/L, diferencia ­135,1 mg/dL, p<0.05). Asimismo, el mayor tiempo en rango se asoció con una menor desviación estándar (decil 1: media 93,7mg/dL, decil 10: media 26,7mg/L, diferencia: -67,0 mg/ dL, p<0,05), menor coeficiente de variación (decil 1: media 37,8%, decil 10: media 23,3%, diferencia: -14,5%, p<0,05), menor TA250 (decil 1: media 46,5%, decil 10: media 0,2%, diferencia: -46,3%, p<0.05), menor TA180 (decil 1: media 73,9%, decil 10: media 3,8%, diferencia: -70,1%, p<0.05), menor TB70 (decil 5: mediana 6,13%, decil 10: mediana 1,70%, diferencia: -4,43%, p<0.05) y menor TB54 (decil 5: mediana 1,79%, decil 10: mediana 0,12%, diferencia: -1,67%, p<0.05). El mayor tiempo en rango se asoció también significativamente con más determinaciones diarias (decil 1: media 11,4, decil 10: media 16,6, diferencia: 5,2, p<0,05). La frecuencia media de las determinaciones entre todos los lectores fue de 14,7 determinaciones diarias. CONCLUSIONES: En los pacientes con diabetes en Chile, el empleo del sistema flash de monitorización demuestra la asociación entre el mayor tiempo en rango, la reducción de la variabilidad de la glucosa y un menor riesgo de hiperglucemias e hipoglicemias y también con un mayor compromiso.


OBJECTIVE: To evaluate glucose time in range and its association with other metrics of glucose control established by the International Consensus on TIR amongst real-life patients using the Flash Glucose Monitoring system FreeStyle LibreTM in Chile. METHODS: Data from the Freestyle Libre™ database between December 2014 and January 2022 were analyzed. Readers were divided into 10 groups (deciles) of the same size (each decile had approximately 498 users) according to time in range. For each decile of time in range, the mean of daily scans, average glucose, estimated HbA1c, glucose standard deviation, glucose coefficient of variation, time in range, glucose time (percentage) above 250 mg/dL (TA250), and glucose time (percentage) above 180 mg/dL (TA180), and the median of glucose time (percentage) below 70 mg/dL (TB70) and glucose time (percentage) below 54 mg/dL (TB54), were calculated. RESULTS: From December 2014 to January 2022, there were 4984 readers. The group with the highest TIR showed significantly lower average glucose than the group with the lowest TIR (decile 1: mean 248.3 mg/dL, decile 10: mean 113.2 mg/L, difference: ­135.1 mg/dL, p<0.05). In addition, more time in range was associated with a lower glucose standard deviation (decile 1: mean 93.7 mg/dL, decile 10: mean 26.7 mg/L, difference: -67.0 mg/dL, p<0.05), lower glucose coefficient of variation (decile 1: mean 37.8%, decile 10: mean 23.3%, difference: -14.5%, p<0.05), lower TA250 (decile 1: mean 46.5%, decile 10: mean 0.2%, difference: -46.3%, p<0.05),lower TA180 (decile 1: mean 73.9%, decile 10: mean 3.8%, difference: -70.1%, p<0.05), lower TB70 (decile 5: median 6.13%, decile 10: median 1.70%, difference: -4.43%, p<0.05) and lower TB54 (decile 5: median 1.79%, decile 10: median 0.12%, difference: -1.67%, p<0.05). Greater TIR was also associated with significantly more daily scans (decile 1: mean 11.4, decile 10: mean 16.6, difference: 5.2, p<0.05). Mean scan frequency amongst all readers was 14.7 daily scans. CONCLUSIONS: In patients with diabetes from Chile, the use of the flash glucose monitoring system demonstrates the association between greater TIR, reduced glucose variability, and reduced risk of hyperglycemia and hypoglycemia, and also its association with greater engagement.


Subject(s)
Humans , Blood Glucose Self-Monitoring/methods , Diabetes Mellitus , Glycemic Control/methods , Time Factors , Blood Glucose , Chile , Patient Compliance , Extracellular Fluid , Data Accuracy
7.
Rev. Nutr. (Online) ; 36: e220247, 2023. tab
Article in English | LILACS | ID: biblio-1507422

ABSTRACT

ABSTRACT Objective Evaluate the association between glycemic control in different emotional perceptions and the adherence to carbohydrate counting by adults with type 1 diabetes during the COVID-19 pandemic in Brazil. Methods This cross-sectional, descriptive, and analytical study was approved by the Research Ethics Committee (Opinion nº 4,147,663) and conducted in July 2020 using a Google Forms® form. Socioeconomic and demographic data were collected; glycemic monitoring according to the individuals' emotions at the time of measurement (happy, motivated, or hopeful; stressed or anxious; sad, distressed, or with depressive symptoms); data on adherence to carbohydrate counting and social distancing. Pearson's Chi-Square test was applied with adjusted residual analysis (p<0.05). Results Approximately 64.62% of the 472 participants, had hyperglycemia when stressed/anxious, and 52.97% when they felt sad/distressed/depressive (p<0.000). Associations were observed between having normoglycemia in any emotional situation and performing the carbohydrate counting (p<0.000); perceiving oneself as happy/motivated/hopeful and having hyperglycemia, and not measuring blood glucose was associated with not having the carbohydrate counting (p<0.000); being stressed or anxious was associated with not measuring blood glucose and not having the carbohydrate counting (p<0.000). Conclusion The need for multidisciplinary care to enhance mental health and adherence to treatment for people with type 1 diabetes is highlighted.


RESUMO Objetivo O estudo objetivou avaliar a associação entre o controle glicêmico em diferentes percepções emocionais e a adesão à contagem de carboidratos por adultos com diabetes tipo 1 durante a pandemia de COVID-19 no Brasil. Métodos Trata-se de um estudo transversal, descritivo e analítico aprovado pelo Comitê de Ética em Pesquisa (Parecer 4.147.663), realizado em julho de 2020 por meio de formulário Google Forms®. Foram coletados dados socioeconômicos e demográficos; monitoramento glicêmico de acordo com as emoções do indivíduo no momento da mensuração (feliz, motivado ou esperançoso; estressado ou ansioso; triste, angustiado ou com sintomas depressivos); dados sobre adesão à contagem de carboidratos e distanciamento social. Aplicou-se o teste qui-quadrado de Pearson com análise residual ajustada (p<0,05). Resultados Dos 472 participantes, 64,62% apresentavam hiperglicemia quando estressados/ansiosos, e 52,97%, quando se sentiam tristes/angustiados/depressivos (p<0,000). Foram observadas associações entre ter normoglicemia em qualquer situação emocional e realizar a contagem de carboidratos (p<0,000), perceber-se feliz/motivado/esperançoso e ter hiperglicemia, assim como não medir a glicemia foi associado a não ter a contagem de carboidratos (p<0,000). Estar estressado ou ansioso foi associado a não medir a glicemia e não ter a contagem de carboidratos (p<0,000). Conclusão Destaca-se a necessidade de atendimento multidisciplinar para potencializar a saúde mental e a adesão ao tratamento de pessoas com diabetes tipo 1.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Dietary Carbohydrates , Diabetes Mellitus, Type 1/psychology , Glycemic Control/psychology , COVID-19/psychology , Perception , Behavior , Brazil , Cross-Sectional Studies
8.
Arq. odontol ; 59: 123-131, 2023. tab
Article in English | LILACS, BBO | ID: biblio-1518972

ABSTRACT

Aim: This study compared alveolar bone loss, teeth with furcation, and mandibular cortical modification between individuals with type 1 diabetes mellitus (T1DM) and nondiabetic individuals. Methods: Radiographs of 50 T1DM individuals and 100 nondiabetic individuals were examined to evaluate the presence of teeth with furcation, alveolar bone loss, and mandibular cortical modifications. The Mann-Whitney, Chi-square, and Student's t tests were used to analyze personal characteristics and bone status. Linear and logistic regression was performed to explore associations. Results: A significant difference was observed in the average number of teeth with furcation and in the median of alveolar bone loss between T1DM and the nondiabetic participants. T1DM individuals are more likely to have alveolar bone loss (OR = 3 2.250), teeth with furcation (OR = 8.903), and mandibular cortical modification (OR = 15.667) than are nondiabetic individuals. Among T1DM individuals, the glycemic control has a high influence in mandibular cortical modifications (p < 0.05). Conclusions: A high association between uncontrolled blood glucose and mandibular cortical modifications was observed among T1DM individuals. Alveolar bone loss of T1DM individuals was associated with age, time of diagnosis, glycemic control, and the existence of chronic complications.


Objetivo:Comparar a perda óssea alveolar, a presença de dentes com lesão de furca e a alteração da cortical óssea entre indivíduos com DMT1 e indivíduos não-diabéticos. Métodos: Foram examinadas radiografias de 50 indivíduos diabéticos e de 100 não-diabéticos para avaliar a presença de dentes com lesão de furca, perda óssea alveolar e alteração cortical mandibular. Para analisar as características individuais e as condições ósseas foram usados os testes de Mann-Whitney,Qui-quadrado e t de Student. Regressões linear e logística foram realizadas para identificar associações. Resultados: Foi encontrada diferença significativa na média de dentes com lesão de furca e na mediana da perda óssea alveolar entre diabéticos e não-diabéticos. Indivíduos com DMT1 possuem mais chance de apresentar perda óssea alveolar (OR = 32,250), lesão de furca (OR=8,903) e alteração da cortical mandibular (OR = 15,667) em comparação aos indivíduos não-diabéticos. Entre os diabéticos, o controle da glicemia possui grande influência nas alterações da cortical mandibular (p < 0,05). Conclusões: Existe uma alta associação entre os níveis de glicemia descontrolada e alterações na cortical mandibular entre os indivíduos com DMT1. A perda óssea alveolar de indivíduos com DMT1 foi associada aos fatores idade, tempo de diagnóstico, controle da glicemia e a presença de complicações crônicas.


Subject(s)
Alveolar Bone Loss , Furcation Defects , Diabetes Mellitus, Type 1 , Glycemic Control
9.
Journal of the ASEAN Federation of Endocrine Societies ; : 13-20, 2023.
Article in English | WPRIM | ID: wpr-984373

ABSTRACT

Objective@#To determine the association between serum 25-hydroxyvitamin D (25(OH)D) and measures of glycemic control, hemoglobin A1c (HbA1c) and fasting plasma glucose (FPG), in adult patients with diabetes mellitus.@*Methodology@#This is an analytical cross-sectional study of 270 patients with diabetes admitted to a tertiary hospital. Serum 25(OH)D levels were categorized as follows: sufficient (>30 ng/mL), insufficient (20 to 30 ng/mL), and deficient (<20 ng/mL). The correlation of HbA1c and FPG with serum 25(OH)D and other variables was determined using Spearman’s rho (ρ) coefficient. The risk factors associated with HbA1c ≥7% and FPG ≥126 mg/dL were determined using logistic regression analysis to generate crude and adjusted odds ratios. The null hypothesis was rejected at 0.05 α-level of significance.@*Results@#The median serum 25(OH)D was 18.92 (range 3.56–56.3) ng/mL. Ninety percent (245 patients) had vitamin D levels below 30 ng/mL. This study showed that vitamin D level is significantly but weakly correlated with patient’s age (ρ=0.339) and duration of diabetes (ρ=0.147), whereas it had inverse correlations with BMI (ρ=-0.134), HbA1c (ρ=-0.261), and FPG (ρ=-0.198).@*Conclusion@#In this study, we found a possible association between vitamin D levels and measures of glycemic control among this group of adult Filipino patients with diabetes mellitus, but further investigations in other cohorts of individuals with diabetes are needed.


Subject(s)
Vitamin D , Diabetes Mellitus , Glycemic Control
10.
J. Health Biol. Sci. (Online) ; 10(1): 1-12, 01/jan./2022.
Article in Portuguese | LILACS | ID: biblio-1367660

ABSTRACT

Objetivos: contribuir para a geração de dados de avaliação econômica de estratégias de empoderamento farmacoterapêutico para pacientes com Diabetes Mellitus tipo 2 (DM tipo 2). Métodos: este estudo farmacoeconômico é aninhado a um ensaio clínico com controle não randomizado que incluiu pacientes ≥18 anos de idade, cadastrados no HIPERDIA. Os pacientes foram alocados em um modelo de Markov conforme valores de hemoglobina glicada do acompanhamento. As probabilidades do surgimento de complicações relativas ao DM, incluindo-se óbito, foram estimadas por dez anos. Cada complicação do DM tipo 2 teve seu custo estabelecido para determinação do custo anual. Resultados: entre os participantes da intervenção, não ocorrem óbitos ocasionados por DM tipo 2, e a progressão de complicações mantém-se estável durante os anos simulados, enquanto, no grupo controle, 60% dos pacientes podem evoluir para óbito nos dez anos, e a probabilidade de serem acometidos por complicações relacionadas ao DM tipo 2 é crescente. Com relação aos custos, ao final de dez anos, os pacientes que participaram da Estratégia Individual de Empoderamento Farmacoterapêutico (EIEF) tiveram um custo médio de UU$134,45 poupando a vida de 100% dos pacientes, e os pacientes do atendimento convencional um custo médio de UU$237,12 e 40% dos pacientes acompanhados chegariam ao final do ciclo com vida. Conclusão: a EIEF parece ser uma alternativa economicamente viável em longo prazo, bem como para a promoção do controle glicêmico.


Objectives: contribute to the data generation for the economic evaluation of pharmacotherapeutic empowerment strategies for type 2 diabetes mellitus patients (type 2 DM). Method: This pharmacoeconomic study is nested in a clinical trial with non-randomized control that included patients ≥18 years old, registered in HIPERDIA. The patients were allocated to a Markov model according to the follow-up glycated hemoglobin values. The probabilities of the appearance of complications related to DM, including death, have been estimated for ten years. Each complication of type 2 DM had its cost established to determine the annual cost. Results: Among the participants in the intervention, there are no deaths caused by type 2 DM, and the progression of complications remains stable during the simulated years, whereas in the control group, 60% of the patients can progress to death in ten years and the probability of being affected by complications related to type 2 DM is increasing. Regarding costs, at the end of ten years, patients who participated in Individual Pharmacotherapeutic Empowerment Strategy (IPES) had an average cost of US$ 134.45, saving 100% of patient's lives, and conventional care patients cost an average of US$ 237.12 and 40% of the patients followed would reach the end of the life cycle. Conclusion: The IPES seems like an economically viable and long-term economic alternative and promotes glycemic control.


Subject(s)
Diabetes Mellitus , Cost-Benefit Analysis , Costs and Cost Analysis , Empowerment , Glycemic Control
11.
J. Health Biol. Sci. (Online) ; 10(1): 1-7, 01/jan./2022. tab, graf
Article in English | LILACS | ID: biblio-1361637

ABSTRACT

Aim: to identify which complications and prognosis of diabetic patients, hospitalized, who acquired COVID-19, through a systematic review. Methods: a systematic review based on the PRISMA flowchart, including cohort studies, available in Portuguese, English, Spanish, French, and Mandarin, published from 2019 to 2020, using the PICOS strategy, in the databases: PubMed, Web of Science, Scielo, Lilacs, Scopus and Science Direct, which in addition to the inclusion criteria after questionnaires to assess methodological quality and risk of bias. Results: of the 811 articles researched, 6 were included in this research. These studies showed that patients with COVID-19 and higher DM with worse prognosis, spent more time in the ICU, constantly needed indifference, greater complications when related to other comorbidities, high mortality rate, and glycemic control associated with advanced age directly affected patients. Outcomes even of non-diabetic subjects. Conclusion: this review identified the severity of the pathophysiological association is related to older age and biochemical and inflammatory factors linked to the two pathogens and that these subjects are more prone to specialized hospital care, which, however, result in high rates of hospital mortality.


Objetivo: identificar quais complicações e prognósticos dos pacientes diabéticos, internados, que adquiriram COVID-19, por meio de uma revisão sistemática. Métodos: foi realizada uma revisão sistemática baseada no fluxograma PRISMA, incluindo estudos de coorte, disponíveis em português, inglês, espanhol, francês e mandarim, publicados de 2019 a 2020, utilizando a estratégia PICOS, nas bases de dados: PubMed, Web of Science, Scielo, Lilacs, Scopus e Sciece Direct. Além dos critérios de inclusão passam por questionários para avaliar a qualidade metodológica e risco de viés. Resultados: dos 811 artigos pesquisados, 6 foram incluídos nesta pesquisa. Esses estudos mostraram que pacientes com COVID-19 e DM apresentam pior prognóstico, maior permanência em UTI, necessidade constante de ventilação invasiva, maiores complicações quando relacionadas a outras comorbidades, elevado índice de mortalidade, e o controle glicêmico associado à idade avançada afetavam diretamente os desfechos inclusive de pacientes não diabéticos. Conclusão: esta revisão identificou que a gravidade da associação fisiopatológica está relacionada à idade mais avançada e aos fatores bioquímicos e inflamatórios ligados aos dois patógenos e que esses sujeitos são mais propensos ao atendimento hospitalar especializado, o que, no entanto, resulta em altas taxas de mortalidade hospitalar.


Subject(s)
COVID-19 , Health Strategies , Hospital Mortality , Diabetes Mellitus , Glycemic Control
12.
Medicina (Ribeirão Preto) ; 55(4)dez. 2022. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1417526

ABSTRACT

Introdução: A hiperglicemia pode estar presente em até 38% dos pacientes hospitalizados.O controle glicêmico está associado a melhores desfechos clínicos. Objetivo: avaliar o comportamento da variabilidade glicêmica em pacientes hospitalizados com Diabetes Mellitus 2. Metodologia: Estudo transversal, composto por pacientes hospi-talizados com e sem diabetes, adultos e idosos, de ambos os gêneros, em terapia nutricional enteral. As glicemias foram medidas por testes de glicemia capilar e classificadas como normoglicemia, hiperglicemia e variabilidade glicêmica, avaliados a partir do desvio-padrão glicêmico e coeficiente de variação glicêmico. Foram avaliados dados bioquímicos como Proteína C-reativa. A análise de variância de duas vias (ANOVA) foi utilizada para comparar os grupos, além da correlação de Spearman. Resultados: Participaram 85 indivíduos, com diabetes mellitus 2 (20%; n= 17), e sem diabetes mellitus (80%; n = 68), sendo 34% (n = 29) adultos e 66% (n=56) idosos. Adultos e idosos com diabetes mellitus apresentaram hiperglicemia em relação aos pacientes não diabéticos (p<0,01), valores supe-riores de desvio-padrão glicêmico (p<0,01) e coeficiente de variação glicêmica em relação aos pacientes sem dia-betes (p= 0,03), no entanto, não foram classificados com variabilidade glicêmica. Os valores da Proteína C-reativa foram correlacionados com o desvio-padrão glicêmico (R= 0,29; p= 0,0065), no entanto, a quantidade de carboi-dratos infundida na dieta enteral não se correlacionou estatisticamente com as glicemias nem com a variabilidade glicêmica dos pacientes (p>0,05). Conclusão: pacientes hospitalizados com ou sem diabetes mellitus 2 não apre-sentaram variabilidade glicêmica, demonstrando um controle glicêmico na hospitalização. (AU)


Introduction: Hyperglycemia may be present in up to 38% of hospitalized patients. Glycemic control is associated with better clinical outcomes. Objective: assess the behavior of glycemic variability in hospitalized patients with Diabetes Mellitus 2. Methodology: Cross-sectional study composed of hospitalized patients with and without diabetes, adults and elderly, of both genders, undergoing enteral nutritional therapy. Blood glucose was measured by capillary blood glucose tests and classified as normoglycemia, hyperglycemia, and glycemic variability, assessed from the glycemic standard deviation and glycemic variation coefficient. Biochemical data such as C-reactive protein were assessed. Two-way analysis of variance (ANOVA) was used to compare the groups, in addition to Spearman's correlation. Results: Eighty-five individuals with diabetes mellitus 2 (20%; n=17) and without diabetes mellitus (80%; n=68) participated in the study; 34% (n=29) were adults, and 66% (n=56) were elderly. Adults and elderly people with diabetes mellitus presented hyperglycemia concerning non-diabetic patients (p<0.01), higher values of glycemic standard deviation (p<0.01), and glycemic variation coefficient concerning patients without diabetes (p= 0.03); however, they were not classified with glycemic variability. The C-reactive protein values were correlated with the glycemic standard deviation (R= 0.29; p= 0.0065); however, the amount of carbohydrates infused in the enteral diet was not statistically correlated with glycemia or with the glycemic variability of patients (p>0.05). Conclusion: hospitalized patients with or without diabetes mellitus 2 did not show glycemic variability, demonstrating glycemic control during hospitalization. (AU)


Introducción: La hiperglucemia puede estar presente hasta en un 38% de los pacientes hospitalizados. El con-trol glucémico se asocia con mejores resultados clínicos. Objetivo: evaluar el comportamiento de la variación glucémica en pacientes con Diabetes Mellitus 2. Metodología: Estudio transversal, compuesto por pacientes hos-pitalizados con y sin diabetes, adultos y ancianos, con terapia nutricional enteral. Las glucemias fueron medidas por exámenes de glucemia capilar y clasificadas como normo glucemia, hiperglucemia y variación glucémica, evaluados a partir de la desviación estándar y coeficiente de variación glucémico. Fueron evaluados datos bioquí-micos como Proteína C-reactiva. El análisis de la variación de las dos vías (ANOVA) fue utilizada para comparar los grupos, junto a la correlación de Spearman. Resultados: Participaron 85 individuos, con diabetes mellitus 2 (20%; n+17), y sin diabetes mellitus (80%; n = 68). Adultos 34% (n=29) y ancianos 66% (n=56). Pacientes con diabetes mellitus presentaron hiperglucemia en relación a los pacientes nodiabéticos (p< 0,01), valores superiores de desviación estándar glucémico (p< 0,01) y coeficiente de variación glucémica en relación a los pacientes sin dia-betes (p= 0,03), sin embargo, no fueron clasificados con variación glucémica. Los valores de la Proteína C-reactiva fueron correlacionados con la desviación estándar glucémica (R = 0,29; P= 0,0065), la cantidad de carbohidratos administrada, no se correlacionó estadísticamente con las glucemias ni con la variación glucémica de los pacientes (p>0,05). Conclusión: pacientes hospitalizados con o sin diabetes mellitus 2 no presentaron variación glucémica, demostrando control glucémico en la hospitalización. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , C-Reactive Protein , Nutrition Therapy , Diabetes Mellitus, Type 2 , Glycemic Control , Hospitalization
14.
Rev. Soc. Argent. Diabetes ; 56(suple. 2): 23-28, may. - ago. 2022. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1396205

ABSTRACT

La última década se ha destacado por los importantes avances en el desarrollo de nuevas tecnologías para pacientes que viven con diabetes mellitus (DM). Las innovaciones han estado orientadas principalmente a: mejorar la calidad de vida, reducir el impacto que genera la ocurrencia de hipoglucemias y reducir la carga de la enfermedad colaborando en la toma diaria de decisiones1. El monitoreo continuo de glucosa (MCG) es una herramienta que ha experimentado un importante avance al aportar información dinámica del estado metabólico en los pacientes y permitir la toma de decisiones, demostrado por un control metabólico estable, menores excursiones glucémicas, y una reducción significativa en la aparición y gravedad de las hipoglucemias2-5. Las presentes recomendaciones tienen como objetivo brindar herramientas rápidas para la interpretación de datos metabólicos y la consiguiente toma de decisiones terapéuticas. A tal fin se realizó una exhaustiva revisión de las principales guías y recomendaciones vigentes; posteriormente, el Grupo de Trabajo adaptó esa información según una serie de preguntas con criterio clínico práctico. El avance de los MCG es innegable, no solo en el desarrollo tecnológico, sino que se han convertido en una herramienta educativa para las personas con DM, su entorno y el equipo de salud al posibilitar un ajuste dinámico del tratamiento, prevenir complicaciones agudas y mejorar la calidad de vida. En esta ecuación enfatizamos la importancia de la educación diabetológica continua de la persona con DM y su entorno, participando activamente en la toma de decisiones para, de esta manera, cumplir con los objetivos propuestos: mejorar la calidad de vida, reducir la carga de la enfermedad y disminuir las excursiones glucémicas agudas.


The last decade has been highlighted by important advances in the development of new technologies for patients living with diabetes. The innovations have been oriented above all to improve the quality of life, reduce the impact generated by the occurrence of hypoglycemia and reduce the burden of the disease by collaborating in daily decision-making1. Continuous glucose monitoring (CGM) is a tool that has undergone significant progress, providing dynamic information on the metabolic status of patients, allowing decision making, demonstrated by stable metabolic control, lower glycemic excursions and a significant reduction in the occurrence and severity of hypoglycemia2-5. The purpose of these recommendations, developed by members of the Innovation Committee of the Argentine Society of Diabetes, is to provide rapid tools for the interpretation of metabolic data and the subsequent therapeutic decisionmaking. To this end, an exhaustive review of the main current guidelines and recommendations has been carried out, later the working group adapted this information according to a series of questions with practical clinical criteria. The progress of CGMs is undeniable, not only in technological development, but it has become an educational tool for people with diabetes, their environment, and the health team, offering the possibility of a dynamic adjustment of treatment, prevention of acute complications and improving quality of life. In this equation, we emphasize the importance of continuous diabetes education for the person with diabetes and their environment, actively participating in decision-making, and in this way, meeting the proposed objectives: improving quality of life, reducing the burden of disease, and decreasing acute glycemic excursions.


Subject(s)
Hypoglycemia , Blood Glucose , Glycemic Index , Glycemic Control , Glucose
15.
Rev. Soc. Argent. Diabetes ; 56(suple. 2): 29-35, may. - ago. 2022. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1396486

ABSTRACT

La presente recomendación busca brindar un marco de seguridad para la prescripción de actividad física en niños, niñas y adolescentes con diabetes mellitus tipo 1 (DM1), considerando la evaluación de las situaciones que puedan presentarse antes, durante y después de su práctica. Incluye las estrategias terapéuticas sobre el tipo de ejercicio, el control glucémico capilar (o mediante el uso de monitoreo continuo de glucosa, MCG) y la adecuación de la insulinoterapia y de la ingesta de hidratos de carbono. Se prioriza que, para optimizar los beneficios del ejercicio como parte del tratamiento de la DM1, es importante una completa y constante educación diabetológica para el paciente y sus cuidadores brindada por un equipo interdisciplinario entrenado en el manejo integral de niños, niñas y adolescentes con DM1.


These recommendations seek to provide a safety framework for the prescription of physical activity in children and adolescents with DM1, considering the evaluation of the situations that may arise before, during and after the practice of physical activity. It includes therapeutic strategies on the type of exercise, intensive capillary glycemic control or through the use of continuous glucose monitoring (CGM) and the adequacy of insulin therapy and carbohydrate intake. It is prioritized that to optimize the benefits of exercise as part of the treatment of DM1, a complete and constant diabetes education is important, provided by an interdisciplinary team trained in the comprehensive management of children and adolescents with DM1


Subject(s)
Diabetes Mellitus, Type 1 , Sports , Carbohydrates , Exercise , Glycemic Control , Glucose , Insulin
16.
Rev. Soc. Argent. Diabetes ; 56(suple. 2): 44-47, may. - ago. 2022. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1396856

ABSTRACT

La diabetes mellitus tipo 2 (DM2) es un factor de riesgo cardiovascular (FRCV) mayor. La DM confiere dos a cuatro veces más riesgo cardiovascular (RCV). El riesgo es aún más elevado en el paciente con DM2 que ha sufrido un infarto agudo de miocardio (IAM) o un accidente cerebrovascular (ACV). La dislipidemia de la DM2 consiste en triglicéridos elevados de ayuno, con mayor excursión posprandial, bajos niveles de HDLc, y alteraciones cuantitativas y cualitativas de LDLc y HDLc. El control glucémico apropiado en DM2 mejora en gran medida las alteraciones lipoproteicas. La terapia hipolipemiante es clave para reducir el RCV en la DM2. La reducción del RCV que se consigue con estatinas se basa en la reducción del LDLc y sus efectos pleiotrópicos. En pacientes que persisten con el perfil lipídico alterado, a pesar de dosis altas de estatinas, se debe considerar el agregado de otros agentes hipolipemiantes para reducir las lipoproteínas aterogénicas.


Type 2 diabetes (T2D) is a major cardiovascular risk factor (CVRF). Diabetes confers two to four times more cardiovascular risk (CVR). The risk is even higher in patients with T2D who have suffered an acute myocardial infarction (AMI) or cerebrovascular accident (CVA). The dyslipidemia of T2D consists of high fasting triglycerides, with greater postprandial excursion, low levels of HDLc and qualitative alterations of LDLc and HDLc. Appropriate glycemic control in T2D greatly improves lipoprotein abnormalities. Lipid-lowering therapy is key to reducing CVR in T2D. The CVR reduction achieved with statins is based on the reduction of LDLc. In patients who persist with an altered lipid profile despite highdose statins, the addition of other lipid-lowering agents to reduce atherogenic lipoproteins may be considered.


Subject(s)
Diabetes Mellitus , Cholesterol , Risk Factors , Heart Disease Risk Factors , Glycemic Control , Cholesterol, HDL
18.
Cienc. Salud (St. Domingo) ; 6(2): 35-42, 20220520.
Article in Spanish | LILACS | ID: biblio-1379344

ABSTRACT

Introducción: el ejercicio físico constituye uno de los pilares fundamentales en el tratamiento de las personas con diabetes. Ajustar el régimen terapéutico permite una participación segura y un alto desempeño de la actividad física. Objetivo: describir los efectos y la importancia del ejercicio físico en las personas con diabetes mellitus. Método: se realizó una investigación documental, se utilizó como buscador de información científica Google Académico. Se evaluaron libros, artículos de investigación y de revisión de diferentes bases de datos: LILACS, PubMed, SciElo, Cochrane y páginas web, en idioma español, inglés o portugués. Resultados: en las personas con diabetes se recomiendan los ejercicios físicos aeróbicos, los mismos incrementan la sensibilidad a la insulina influyendo favorablemente sobre el control metabólico; los ejercicios de resistencia también son beneficiosos con el objetivo de mejorar la fuerza muscular. Antes de desarrollar un programa de ejercicios, la persona con diabetes mellitus debe someterse a una evaluación médica detallada. La indicación del tipo de ejercicio, su intensidad y duración debe ser personalizada. El control glucémico antes, durante y después del ejercicio es fundamental. En los niños pequeños fomentar el juego es la mejor manera de garantizar una actividad física placentera. Conclusiones: el ejercicio físico debe indicarse en las personas con diabetes mellitus por sus múltiples beneficios relacionados con la salud. Su indicación debe ser individualizada


Introduction: Physical exercise is one of de fundamental pillars in the treatment of people with diabetes. Adjusting the therapeutic regimen allows safe participation and high performance of physical activity. Aim: To describe the effects and importance of physical exercise in people with diabetes mellitus. Method: A documentary investigation was carried out. It was used as a search engine for scientific information Google Academic. Books, research and review articles from different databases were evaluated: LILACS, PubMed, SciElo, Cochrane and web pages in Spanish, English and Portuguese. Results: In people with diabetes, aerobic physical exercises are recommended, they increase insulin sensitivity and have a favorable influence on metabolic control. Resistance exercises are also beneficial in order to improve muscle strength. Before developing an exercise program, the person with diabetes mellitus must undergo a detailed medical evaluation. The indication of the type of exercise, its intensity and duration must be personalized. Glycemic control before, during and after exercise is essential. Encouraging play in young children is the best way to ensure enjoyable physical activity. Conclusions: The physical exercise should be indicated in people with diabetes mellitus due to its multiple health- related benefits; its indication must be individualized.


Subject(s)
Humans , Exercise , Diabetes Mellitus/therapy , Diabetes Mellitus/metabolism , Exercise Therapy , Glycemic Control
19.
ABCS health sci ; 47: e022222, 06 abr. 2022. ilus, tab, graf
Article in English | LILACS | ID: biblio-1398276

ABSTRACT

INTRODUCTION: Optimal serum levels of vitamin D are of great importance, especially in populations with comorbidities such as Diabetes Mellitus (DM). OBJECTIVE: The study evaluated the relationship between hypovitaminosis D and glycemic control in older adults with type 2 DM. METHODS: Cross-sectional and prospective study, part of the EELO project (Study on Aging and Longevity), conducted in Southern Brazil. Glycated hemoglobin (diabetes ≥6.5%) and serum levels of vitamin D (25(OH)D) were evaluated. Hypovitaminosis D was determined using cutoff points <20 and <30 ng/mL). Multivariate logistic regression was used to assess the risk of having uncontrolled DM. RESULTS: Of the 120 older adults included in the study, aged between 60 and 87 years, 74.2% were women, 66.7% used hypoglycemic medications and 75.8% exhibited uncontrolled diabetes. An inverse correlation was observed between the levels of 25(OH) D and glycated hemoglobin (rS=-0.19, p=0.037), suggesting that low levels of vitamin D are associated with poor glycemic control in diabetic individuals. The prevalence of hypovitaminosis D when using the cutoff points of <20 and <30 ng/mL were 34.2% and 75.0%, respectively. The odds ratio (OR) analysis showed that individuals with 25(OH)D<20ng/mL have almost 4 times more risk of having uncontrolled DM (OR:3.94; CI95%:1.25-12.46, p=0.02) when compared to the older adults with sufficient levels of vitamin D. CONCLUSION: The results indicate that the optimal serum levels currently recommended for 25(OH)D should preferably be 30 ng/mL or higher to contribute to better glycemic control in older adults with type 2 DM.


INTRODUÇÃO: Os níveis séricos ideais de vitamina D são de grande importância, especialmente na população com comorbidades como o Diabetes Mellitus (DM). OBJETIVO: O estudo avaliou a relação entre hipovitaminose D e controle glicêmico em idosos com DM tipo 2. MÉTODOS: Estudo transversal e prospectivo, parte do projeto EELO (Estudo sobre Envelhecimento e Longevidade), no Sul do Brasil. A hemoglobina glicada (diabetes ≥6,5%) e os níveis séricos de vitamina D (25(OH)D) foram avaliados. Hipovitaminose D foi determinada usando ponto de corte <20 e <30 ng/mL. Regressão logística multivariada foi utilizada para avaliar o risco de ter DM descompensado. RESULTADOS: Dos 120 idosos incluídos no estudo, idade entre 60 a 87 anos, 74,2% eram mulheres, 66,7% faziam uso de medicamentos hipoglicemiantes e 75,8% apresentavam diabetes descompensada. Uma correlação inversa foi observada entre os níveis de 25(OH)D e hemoglobina glicada (rS=-0,19; p=0.037), sugerindo que baixos níveis de vitamina D está associado a um pior controle glicêmico em diabéticos. A prevalência de hipovitaminose D quando se utiliza ponto de corte <20 e <30 ng/mL foi de 34,2% e 75,0%, respectivamente. A análise Odds ratio (OR) mostrou que indivíduos com 25(OH)D<20 ng/mL tem quase 4 vezes mais risco de ter DM descompensado (OR:3,94; IC95%:1,25­12,46; p=0,02) quando comparado aos idosos com níveis suficientes de vitamina D. CONCLUSÃO: Os resultados indicam que os níveis sérios ideais atualmente recomendados para 25(OH)D maior ou igual a 30 ng/ml contribuem para o melhor controle glicêmico na população idosa com DM tipo 2.


Subject(s)
Humans , Male , Female , Aged , Vitamin D Deficiency , 25-Hydroxyvitamin D 2/deficiency , Diabetes Mellitus, Type 2 , Glycemic Control , Glycated Hemoglobin , Health of the Elderly , Cross-Sectional Studies , Prospective Studies
20.
REME rev. min. enferm ; 26: e-1433, abr.2022.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1377624

ABSTRACT

Objetivo: sintetizar a produção científica sobre a técnica da autoaplicação de insulina em adultos com diabetes Mellitus no contexto domiciliar Método: revisão integrativa realizada entre dezembro de 2019 e janeiro de 2020, a partir da busca de publicações em periódicos indexados no PubMed, CINAHL, EMBASE, SCOPUS, Web of Science, LILACS e BDENF utilizando-se os termos controlados diabetes Mellitus, self care, insulin, health education, disposable equipment, medical wastedisposal e self administration e seus correspondentes em português, combinados com o operador booleano AND. Foram incluídos artigos originais publicados entre 2009 e 2019, nos idiomas inglês, português e espanhol e que responderam à questão norteadora: qual a produção científica sobre a técnica da autoaplicação de insulina em adultos com diabetes Mellitus no contexto domiciliar nos últimos 10 anos? Resultados: compuseram a amostra final oito artigos. Predominaram estudos realizados no Brasil, por enfermeiros no contexto da atenção primária à saúde. Em relação à técnica de autoaplicação de insulina, os resultados foram agrupados em quatro eixos: pré-aplicação, técnica de preparo da insulina, aplicação e pós-aplicação. Observaram-se ações inadequadas em todos os eixos tais como: transporte, armazenamento, autoaplicação, reutilização de agulhas e descarte incorreto. Tais inadequações podem resultar em procedimentos dolorosos, prejuízos no controle glicêmico e complicações para a saúde da pessoa com diabetes Mellitus. Conclusão: os resultados evidenciaram que a realidade da autoaplicação de insulina em adultos com diabetes Mellitus no domicílio pode ser modificada a partir da educação em saúde pelo enfermeiro, bem como colaborar para o planejamento das ações estratégicas para diminuir tais problemas.(AU)


Objective: to synthesize the scientific production on the technique of self-administration of insulin in adults with diabetes Mellitus in the home context. Method: integrative review carried out between December 2019 and January 2020, based on the search for publications in journals indexed in PubMed, CINAHL, EMBASE, SCOPUS, Web of Science, LILACS and BDENF using the controlled terms diabetes Mellitus, self-care, insulin, health education, disposable equipment, medical waste disposal and self-administration and their corresponding words in Portuguese, combined with the Boolean operator AND. Original articles published between 2009 and 2019, in English, Portuguese and Spanish, were included, which answered the guiding question: what is the scientific production on the technique of self-administration of insulin in adults with diabetes Mellitus in the home context in the last 10 years? Results: the final sample comprised eight articles. Studies carried out in Brazil by nurses in the context of primary health care predominated. Regarding the insulin self-administration technique, the results were grouped into four axes: pre-administration, insulin preparation technique, administration, and post-administration. Inadequate actions were observed in all axes such as: transport, storage, self-application, reuse of needles and incorrect disposal. Such inadequacies can result in painful procedures, impaired glycemic control, and health complications for the person with diabetes Mellitus. Conclusion: the results showed that the reality of self-administration of insulin in adults with diabetes Mellitus at home can be modified based on health education by nurses, as well as collaborating in the planning of strategic actions to reduce such problems.(AU)


Objetivo: sintetizar la producción científica sobre la técnica de autoadministración de insulina en adultos con diabetes Mellitus en el contexto domiciliario. Método: revisión integradora realizada entre diciembre de 2019 y enero de 2020, a partir de la búsqueda de publicaciones en revistas indexadas en PubMed, CINAHL, EMBASE, SCOPUS, Web of Science, LILACS y BDENF utilizando los términos controlados diabetes Mellitus, self care, insulin, health education, disposable equipment, medical wastedisposal y self administration y sus equivalentes en portugués, combinados con el operador booleano AND. Se incluyeron artículos originales publicados entre 2009 y 2019, en inglés, portugués y español, que respondieron a la pregunta orientadora: ¿cuál es la producción científica sobre la técnica de autoadministración de insulina en adultos con diabetes Mellitus en el contexto domiciliario en los últimos 10 años? Resultados: la muestra final estuvo formada por ocho artículos. Predominaron los estudios realizados en Brasil por enfermeros en el contexto de la atención primaria de salud. En cuanto a la técnica de auto aplicación de insulina, los resultados se agruparon en cuatro ejes: antes de la aplicación, técnica de preparación de insulina, aplicación y post aplicación. Se observaron acciones inadecuadas en todos los ejes, tales como: transporte, almacenamiento, auto aplicación, reutilización de agujas y disposición incorrecta. Tales deficiencias pueden resultar en procedimientos dolorosos, deterioro del control glucémico y complicaciones de salud para las personas con diabetes Mellitus. Conclusión: los resultados mostraron que la realidad de la insulina autoadministrada en adultos con diabetes Mellitus en el hogar puede modificarse a partir de la educación en salud brindada por enfermeros, además de ayudar a planificar acciones estratégicas para reducir dichos problemas.(AU)


Subject(s)
Humans , Adult , Self Care , Diabetes Mellitus/drug therapy , Medication Therapy Management , Insulin/administration & dosage , Primary Health Care , Health Knowledge, Attitudes, Practice , Health Education , Glycemic Control
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