RESUMEN
Grande parte dos pacientes em hemodiálise estão em idade laboral, acarretando um desafio na manutenção do seu trabalho. Realizou-se um estudo transversal em centros de hemodiálise no norte de Santa Catarina, entre dezembro de 2020 a fevereiro de 2021. Incluiu-se pacientes entre 18 e 55 anos em hemodiálise há mais de 3 meses. Avaliou-se aspectos relacionados ao trabalho, sua manutenção após início da hemodiálise e a qualidade de vida através do instrumento SF-36. A condição laboral foi avaliada com relação a qualidade de vida através de regressão logística. Dos 108 pacientes, a média de idade foi 43,34 ±8,88 anos, com mediana do tempo em diálise de 19 meses. Dos participantes, 78,9% estavam trabalhando seis meses antes do início da hemodiálise e 39,8% após 6 meses. Não houve diferença em relação ao sexo, idade e estado civil com relação ao trabalho antes ou após 6 meses do início da hemodiálise. Trabalhar foi associado a uma maior qualidade de vida, mesmo após ajuste para outras variáveis (OR=5,30; 95% IC 1,43-19,61, p=0,013). Conclui-se que existe importante queda da manutenção do emprego após início da hemodiálise. O estímulo a manutenção do trabalho pode favorecer uma melhor qualidade de vida nestes pacientes.
Most patients undergoing hemodialysis are of working age, and this poses a challenge in maintaining their jobs. A crosssectional study was carried out in hemodialysis centers in the north of Santa Catarina, between December 2020 and February 2021. Patients aged between 18 and 55 years old on hemodialysis for more than 3 months were included. Aspects related to work, remaining at their job after starting hemodialysis, and quality of life were evaluated using the SF-36 instrument. Their working situation was evaluated in relation to quality of life through logistic regression. Of the 108 patients, the mean age was 43.34 ± 8.88 years old, with a median time on dialysis of 19 months. Of the participants, 78.9% were working six months before starting hemodialysis and 39.8% were working 6 months after. There was no difference in terms of sex, age, and marital status with regards to work before or after 6 months of starting hemodialysis. Working was associated with a better quality of life, even after adjusting for other variables (OR=5.30; 95% CI 1.43-19.61, p=0.013). It is concluded that there is a significant drop in employment after starting hemodialysis. The stimulus to keep working can favor a better quality of life in these patients.
RESUMEN
ABSTRACT Objective: Insulin Icodec is a novel basal insulin analogue designed for once-weekly administration, therefore might propitiate reduction in the frequency of injections and facilitate treatment adherence. This study aimed to determine the glycemic control and safety profile of Insulin Icodec, compared with Glargine U100 in patients with diabetes mellitus type 2. Materials and methods: We performed a systematic review and meta-analysis of randomized controlled trials (RCT) data comparing Once-Weekly Insulin Icodec and Once-Daily Insulin Glargine U100 in patients with type 2 diabetes mellitus. PubMed, Embase, and Cochrane databases were searched for trials published up to May 14, 2022. Data were extracted from published reports and quality assessment was performed per Cochrane recommendations. Results: Three studies were included comprising 453 patients, 230 (50.77%) using Once-Weekly Insulin Icodec and 223 (49.22%) using Once-Daily Insulin Glargine U100. In the pooled data, Glycated Hemoglobin (MD -0.20% CI -0.33 to -0.07%; P=0.002) change from baseline demonstrated a significantly higher reduction in the Icodec group. Time with Glucose in Range (MD 6.60% CI 3.63 to 9.57%; P < 0.0001) and Insulin Dose Difference (MD 0.97UI CI 0.76 to 1.18UI; P < 0.0001) were higher in the Icodec group. There was no significant difference in fasting plasma glucose, body weight change, hypoglycemia or any adverse event evaluated. Conclusions: Once-Weekly Insulin Icodec was associated with a small reduction in Glycated Hemoglobin, as well as higher Time with Glucose in Range, with similar hypoglycemic adverse events, when compared with Once-Daily Insulin Glargine U100.