Autocuidado em adultos com diabetes Mellitus tipo 1: análise do controle glicêmico

Campos, Gracielie da Silva; Brust-Renck, Priscila Goergen; Gonçalves, Tonantzin Ribeiro

Acessibilidade / Reportar erro

Brasil

Estudos de Psicologia (Campinas)

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

RESEACH REPORT | Health Psychology • Estud. psicol. 41 • 2024 • https://doi.org/10.1590/1982-0275202441e220120 copiar

Autocuidado em adultos com diabetes Mellitus tipo 1: análise do controle glicêmico

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo

Objetivo

O controle glicêmico é essencial para diminuir os riscos de complicações em longo prazo de pessoas vivendo com diabetes mellitus tipo 1. O objetivo do estudo foi avaliar a relação entre controle glicêmico e características demográficas, econômicas, clínicas, e comportamentos de autocuidado para a diabetes.

Método

Participaram da pesquisa 107 pessoas vivendo com diabetes. Os participantes responderam um questionário de autorrelato online com indicadores clínicos e de cuidado com a saúde.

Resultados

Os resultados mostraram que a maioria dos participantes não possuía controle glicêmico adequado (baseado na avaliação de hemoglobina glicada), especialmente aqueles com dificuldade de monitorar a doença e pelas falhas em realizar a testagem diária e aumento do uso de tabaco. O controle glicêmico inadequado também foi predito pela baixa renda, índice de massa corporal elevado e baixa classe social.

Conclusão

Recomenda-se implementar estratégias em saúde sensíveis às desigualdades sociais e dificuldades individuais relacionadas ao controle glicêmico para promover a saúde.

Palavras-chave
Automonitorização da glicemia; Diabetes mellitus tipo 1; Promoção da saúde; Habilidades para autocuidado

Variables		Total	Adequate	Inadequate	p-value^a a Mann-Whitney test for equality of means.
Variables		Median (P25-P75)
BMI		24.0 (21.4-24.0)	23.0 (20.9-27.6)	25.1 (22.8-28.2)	0.113
Age		30.00 (24-36)	30.00 (2-36)	29.5 (23-36)	0.840
Age at diagnosis		14.00 (9-20)	14.0 (8-19)	15.5 (11-21.7)	0.188
		n (%)			p-value^b b Fisher’s Exact test for qualitative comparison.
Sex (female)		90 (84.1)	49 (77.8)	41 (93.2)	0.035
Marital status (married/common-law marriage)		54 (50.5)	33 (52.4)	21 (47.7)	0.696
Have children (yes)		33 (30.8)	20 (31.7)	13 (29.5)	0.835
Skin color (white)		82 (76.6)	49 (77.8)	33 (75.0)	0.818
Education (higher education and above)		84 (78.5)	49 (77.8)	35 (79.5)	1.000
Employed (yes)		65 (60.7)	43 (68.3)	22 (50.0)	0.071
Average personal income in minimum-wage salaries					0.002
	No income	28 (26.2)	13 (20.6)	15 (34.1)
	Less than 1 MG to 2 MG	41 (38.3)	19 (30.2)	22 (50.0)
	3 MG or more	38 (35.5)	31 (49.2)	7 (15.9)
Social class					0.001
	A	11 (10.3)	10 (15.9)	1 (2.3)
	B	64 (59.8)	42 (66.7)	22 (50)
	C	31 (29.9)	11 (17.5)	21 (47.7)

Self-care indicators	Total	Adequate	Inadequate	p-value^a a Fisher’s Exact test for qualitative comparison.
Tested insulin 4 times or more (last week)	73 (68.22)	51 (80.95)	22 (50)	0.001
Tested glucose 4 times or more (last week)	73 (68.22)	51 (80.95)	22 (50)	0.001
Had a hemoglobin A1c test (frequency in the last 12 months)	102 (95.33)	58 (92.06)	44 (100)	0.066
Had a medical check-up for T1DM control (last 12 months)	103 (96.26)	59 (93.65)	44 (100)	0.115
Has not delayed insulin doses (last 30 days)	38 (35.51)	32 (50.79)	6 (13.64)	0.000
Has a positive perception of T1DM control (12 months)	51 (47.66)	42 (66.67)	9 (20.45)	0.000
Used insulin as prescribed, not exceeding dosage (last 30 days)	65 (60.75)	41 (65.08)	24 (54.55)	0.185
Has other health problems	39 (36.45)	17 (26.98)	22 (50)	0.013
Experienced a hypoglycemic episode (12 months)	46 (42.99)	25 (39.68)	21 (47.73)	0.265
Has other chronic diseases (in addition to T1DM)	25 (23.36)	15 (23.81)	10 (22.73)	0.543
Participates/participated in a T1DM group or association	53 (49.53)	33 (52.38)	20 (45.45)	0.306
Received support in T1DM care during childhood	78 (72.9)	45 (71.43)	33 (75)	0.428
Consulted other doctors (last 12 months)	18 (16.82)	8 (12.7)	10 (22.73)	0.136
Carries a T1DM medical identification	54 (50.47)	35 (55.56)	19 (43.18)	0.144
Carries food in case blood glucose levels gets too low	92 (85.98)	57 (90.48)	35 (79.55)	0.094
Smoked cigarettes (last week)	5 (4.67)	2 (3.17)	3 (6.82)	0.667
Was hospitalized or went to the emergency room due to diabetic ketoacidosis	14 (13.08)	5 (7.94)	9 (20.45)	0.056

Variables	Factors
Variables	1	2	3	4	5
Tested insulin 4 times or more in the last week	0.95	0.01	0.14	0.06	0.04
Tested glucose 4 times or more in the last week	0.95	0.01	0.14	0.06	0.04
Had a hemoglobin A1c test (frequency in the last 12 months)	0.07	0.88	-0.06	0.04	0.00
Had a medical check-up for T1DM control (last 12 months)	-0.04	0.84	-0.06	0.13	-0.04
Has not delayed insulin doses (last 30 days)	0.16	-0.05	0.75	-0.10	0.15
Has a positive perception of T1DM control (12 months)	0.29	0.04	0.68	-0.19	-0.04
Used insulin as prescribed, not exceeding dosage (last 30 days)	-0.17	-0.13	0.67	0.33	-0.13
Has other health problems	0.11	0.14	-0.22	0.70	-0.04
Experienced a hypoglycemic episode (12 months)	-0.13	-0.13	0.02	0.68	0.10
Has other chronic diseases (in addition to T1DM)	0.18	0.21	0.12	0.48	-0.10
Participates/participated in a T1DM group or association	0.02	0.15	0.03	-0.08	0.75
Received support in T1DM care during childhood	0.03	-0.21	-0.01	-0.07	0.63
Consulted other doctors in the last 12 months	-0.34	0.19	0.04	0.31	0.48
Carries a T1DM medical identification	0.26	-0.35	-0.05	0.19	0.44
% Explained Variance	17.62	13.90	11.08	9.49	9.14

Variables	B	SE	Wald	OR	95% CI
Intercept	-0.58	0.26	5.16	0.56
Factor 1: Daily testing	-0.85	0.25	11.30^* * p < 0.05.	0.43	0.26 - 0.70
Factor 2: Medical care	0.64	0.39	2.70	1.90	0.88 - 4.08
Factor 3: T1DM Control	-1.16	0.28	17.52^ p < 0.001.	0.31	0.18 - 0.54
Factor 4: Other health problems	0.55	0.25	4.88^* * p < 0.05.	1.73	1.06 - 2.82
Factor 5: Support from others	-0.09	0.24	0.12	0.92	0.57 - 1.48

Variables		B	SE	Wald	OR	95% CI
Intercept		-6.50	2.11	9.45^ p < 0.001.	0.002
Sex (male)		-0.01	0.84	0.0001	0.99	0.19 -5.09
Education (incomplete higher education and above)		1.09	0.62	3.07^†	2.96	0.88 -9.99
Employed (yes)		-0.79	0.72	1.220	0.45	0.11 -1.85
Personal income (> = 3MW)
	No income	1.63	0.89	3.40^† † p < 0.10.	5.12	0.90-28.97
	Less than 1 MW to 2 MW	1.53	0.63	5.88^* * p < 0.05.	4.61	1.34-15.88
BMI		0.20	0.07	8.16^ p < 0.001.	1.22	1.07-1.41
Social class (C/D/E)
	A	-3.18	1.33	5.72^* * p < 0.05.	0.04	0.003-0.56
	B	-1.40	0.55	6.58^ p < 0.001.	0.25	0.08-0.72
Age at diagnosis		0.05	0.03	2.110-	1.05	0.98-1.12

Programa de Pós-Graduação em Psicologia, Pontifícia Universidade Católica de Campinas Editora Splendet, Pontifícia Universidade Católica de Campinas, Campus I, Rua Prof. Dr. Euryclides de Jesus Zerbini, 1516, Pq. Rural Fazenda Santa Cândida, Telefone: (55 19) 3343-7223. - Campinas - SP - Brazil
E-mail: psychologicalstudies@puc-campinas.edu.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence to: T. R. GONÇALVES. E-mail: tonanrib@yahoo.com.br.