PROFILE OF TYPE 2 DIABETICS INSULIN-APPLICANTS FOLLOWED IN A MULTI HEALTH CENTER, SALVADOR, BAHIA, BRAZIL
Keywords:
Diabetes Mellitus, Type 2, Patient Care Team, Health Profile, InsulinAbstract
Objective: To describe the clinical and epidemiological profile of patients with insulin-inuming Type 2 Diabetes Mellitus followed by a multidisciplinary team in a Multicenter Health Unit in Salvador-BA, Brazil. Method: Epidemiological, cross-sectional, retrospective, descriptive study with patients treated in the Multicenter Health Unit from October/2017 to October/2019. The clinical and sociodemographic variables were collected from medical records and expressed in absolute and relative frequencies, mean and standard deviation (SD), in addition to median and interquartile range (IR). Results: We evaluated 163 patients with mean (SD) of age of 61.2 (± 10.6) years, with a predominance between 51 and 60 years (39.3%), 66.3% of which were female.The median time of diagnosis was 10 (3) years and 78.8% had been using insulin for less than 5 years. Half of the patients accepted their diabetic condition, 53.2% did not adequately correct hypoglycemic episodes, 68.1% glycated hemoglobin above the targets set by the Brazilian Diabetes Society and 59.9% had microalbuminuria. In addition, 96.3% did not exercise, 2.5% had an appropriate food profile, 71.0% were diagnosed with Systemic Arterial Hypertension, and 70.8% did not have the cholesterol fraction Low Density Lipoprotein (LDL) value in the goal established by the Brazilian Society of Cardiology. Conclusion: In this sample of insulin-applicant diabetic patients, most patients were female, had other comorbidities associated with DM, low adhering to hygienic dietary measures, elevation of glycated hemoglobin and signs of diabetic nephropathy.
Downloads
References
Muzy J, Campos MR, Emmerick I, da Silva RS, Schramm JM. Prevalência de diabetes mellitus e suas complicações e caracterização das lacunas na atenção à saúde a partir da triangulação de pesquisas. Cadernos de Saúde Pública. 2021;37(5) Available from: https://www.scielo.br/j/csp/a/B9Fhg54pjQ677YVx9g3mHwL/#
Montenegro Junior RM, Silveira MMC, Nobre IP, Silva CAB. A assistência multidisciplinar e o manejo efetivo do diabetes mellitus: Desafios atuais. Revista Brasileira em Promoção da Saúde. 2004;17(4):200-205.
Ferraz AE, et al. Atendimento multiprofissional ao paciente com diabetes mellitus no Ambulatório de Diabetes do HCFMRP-USP. Medicina. 2000;33(2):170-175.
Ali MK, Bullard KM, Saaddine JB, Cowie CC, Imperatore G, Gregg EW. Achievement of goals in U.S. diabetes care, 1999-2010. N Engl J Med 2013;368:1613-162.
Rawshani A, et al. Mortality and Cardiovascular Disease in Type 1 and Type 2 Diabetes. N engl j med. 2017;376(15):1407-1418. Available from: https://www.nejm.org/doi/full/10.1056/nejmoa1608664
Stellefson M, Dipnarine K, Stopka C. The Chronic Care Model and Diabetes Management in US Primary Care Settings: A Systematic Review. Prev Chronic Dis 2013;10:120180. DOI: http://dx.doi.org/10.5888/pcd10.120180
Antoine S-L, Pieper D, Mathes T, Eikermann M. Improving the adherence of type 2 diabetes mellitus patients with pharmacy care: a systematic review of randomized controlled trials. BMC Endocrine Disorders. 2014;14:53.
Costa MB, Castro AP. Abordagem interdisciplinar no tratamento do diabetes mellitus tipo 2: da teoria à prática. Extramuros. 2013;1(2):30-37.
Leite SA, et al. Enfoque Multidisciplinar ao Paciente Diabético: Avaliação do Impacto do “Staged Diabetes Management” em um Sistema de Saúde Privado. Arq Bras Endocrinol Metab. 2001;45(5):481-486.
Sociedade Brasileira de Diabetes. Diretrizes da Sociedade Brasileira de Diabetes 2019-2020. Brasil: Clannad Editora Científica; [2019?]. 491 p.
Batista MC, Priore SE, Rosado LEFPL, Tinôco SCC. Avaliação dos resultados da atenção multiprofissional sobre o controle glicêmico, perfil lipídico e estado nutricional de diabéticos atendidos em nível primário. Revista de Nutrição. 2005;18(2):219-228.
Macedo JL, Oliveira AS, Pereira CAS, Reis ER, Assunção MJSM. Perfil epidemiológico do diabetes mellitus na região nordeste do Brasil. Research, Society and Development. 2019;8(3). Available from: http://www.redalyc.org/articulo.oa?id=560662194028
Veloso J, Guarita-Souza LC, Lima Júnior E, Ascari RA, Précoma DB. Perfil clínico de portadores de Diabetes Mellitus em acompanhamento multiprofissional em saúde. Revista Cuidarte. 2020;11(3):e1059 DOI http://dx.doi.org/10.15649/cuidarte.1059.
Valle T, Koivisto VA, Reunanen A, Kangas T, Rissanen A. Glycemic control in patients with diabetes in Finland. Diabetes Care. 1999; 22(4):575-579
Wong J, Tabet E. The introduction of insulin in type 2 diabetes mellitus. Aust Fam Physician. 2015 May;44(5):278-83.
Reach G, Pechtner V, Gentilella R, Corcos A, Ceriello A. Clinical inertia and its impact on treatment intensification in people with type 2 diabetes mellitus. Diabetes Metab. 2017;43(6):501-511.
Malerbi DA, Franco LJ. Multicenter study of the prevalence of diabetes mellitus and impaired glucose tolerance in the urban Brazilian population aged 30-69 yr. The Brazilian Cooperative Group on the Study of Diabetes Prevalence. Diabetes Care 1992;15(11):1509-16.
Bertolin DC, Pace AE, Cesarino CB, Ribeiro RCHM, Ribeiro RM. Psychological adaptation to and acceptance of type 2 diabetes mellitus. Acta Paul Enferm. 2015;28(5):440-446. Available from: https://www.scielo.br/j/ape/a/zSpBWRpWxDdcGzKGszb6Qnb/?lang=pt#
Cunha GH, Fontenele MSM, Siqueira LR, Lima MAC, Gomes MEC, Ramalho AKL. Insulin therapy practice performed by people with diabetes in Primary Healthcare. Rev Esc Enferm USP. 2020;54: e03620. Available from: https://www.scielo.br/j/reeusp/a/7LxJJWBfwgQ7n5wb6Sxdkft/?lang=pt
Souza AM, Pereira RA, Yokoo EM, Levy RB, Sichieri R. Alimentos mais consumidos no Brasil: Inquérito Nacional de Alimentação 2008-2009. Rev Saúde Pública. 2013;47(1Supl):190-199.
Rossaneis MA, Andrade SM, Gvozd R, Pissinati PSC, Haddad, MCL. Fatores associados ao controle glicêmico de pessoas com diabetes mellitus. Ciência & Saúde Coletiva. 2019;24(3):997-1005.
Almeida DC, Araújo ST, Negreiros FDS, Aguiar MIF, Moreira TR, Crispi APP. Complicações micro e macrovasculares em pessoas com Diabetes Mellitus tipo 2 em atendimento ambulatorial. Rev Rene. 2017;18(6):787-793.
International Hypoglycaemia Study Group. Glucose concentrations of less than 3.0 mmol/L (54 mg/dL) should be reported in clinical trials: a joint position statement of the American Diabe- tes Association and the European Association for the Study of Diabetes. Diabetes Care 2017;40:155-157
Conduta Terapêutica no DIABETES TIPO 2: Algoritmo SBD 2018. Disponível em:http://www.diabetes.org.br/publico/images/2018/posicionamento-oficial-sbd-tratamento-do-dm2-versao-final-e-definitiva-10-mai-2018.pdf/. Acesso em: 14 junho 2018.
Torres HC, Pace AE, Chaves FF, Velasquez-Melendez G, Reis IA. Avaliação dos efeitos de um programa educativo em diabetes: ensaio clínico randomizado. Rev Saúde Pública. 2018;52(8).
Secretária Municipal de Saúde de Fortaleza. Diretrizes clínicas: Diabetes Mellitus. Brasil: [publisher unknown]; 2016.
Barroso WKS, et al. Diretrizes Brasileiras de Hipertensão Arterial – 2020. Arq Bras Cardiol. 2021;116(3):516-658. Available from: https://abccardiol.org/article/diretrizes-brasileiras-de-hipertensao-arterial-2020/.
American Diabetes Association. Older Adults: Standards of Medical Care in Diabetes—2021. Diabetes Care. 2021;44(Supplement1):S168-S179 Available from: https://care.diabetesjournals.org/content/44/Supplement_1/S168.
Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985;100(2) Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1424733/.
Meneguci J, Santos DAT, Silva RB, Santos RG, Sasaki JE, Tribess S et al. Comportamento sedentário: conceito, implicações fisiológicas e os procedimentos de avaliação. Motri. 2015; 11(1):160-174. Disponível em:http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-107X2015000100016&lng=pt. https://doi.org/10.6063/motricidade.3178.
Downloads
Published
How to Cite
Issue
Section
License
Copyright
Submission of originals to Práticas e Cuidado: Revista de Saúde Coletiva (Practices and Care: Journal of Public Health - PC-RESC) implies the transfer of publication rights by the authors. The copyright for manuscripts published in this journal belongs to the authors, with PC-RESC retaining rights over the first publication. The authors may only use the same results in other publications if they explicitly indicate PC-RESC as the original publication medium.
Creative Commons License
Except where otherwise specified, the terms of a Creative Commons Attribution-ShareAlike 4.0 International License apply to the material published in this journal, which permits unrestricted use, distribution, and reproduction in any medium, provided the original publication is correctly cited.
This magazine is licensed under a License 