Programa de Pós-Graduação em Atenção e Estudo Clínico no Diabetes - PPGDIABETES/UFPA

URI Permanente desta comunidadehttps://repositorio.ufpa.br/handle/2011/17108

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Cartilha educativa para pessoas idosas que vivem com Diabetes Mellitus Tipo 2
(Universidade Federal do Pará, 2024-02-26) LOBATO, Alyne Maciel; SOUZA, Ana Carolina Contente Braga de; http://lattes.cnpq.br/0609863332556837
Diabetes Mellitus is a complex chronic condition characterized by hyperglycemia and metabolic dysregulations. Type 2 Diabetes Mellitus (DM2), the most common type of diabetes, is marked by the progressive and irreversible loss of insulin secretion by pancreatic β cells, associated with resistance to insulin action in peripheral tissues, resulting in a higher incidence and late diagnosis. Treatment requires a multifaceted approach, especially in older people, who face additional challenges due to aging. This includes lifestyle changes such as diet, exercise and medication administration, as well as the need for health education to promote treatment adherence and self-care. The DM2 approach demands a holistic view of the patient, considering the particularities of aging. Given the above, the study aims to develop an educational booklet for elderly people living with DM2, aiming to provide easyto-understand information, self-care guidelines and information records. The study is characterized as qualitative and descriptive, divided into two stages: the review of publications from the last five years (2018-2023) on the subject in the VHL, Scielo, Periódicos Capes and Pubmed databases and the development of an assistive technology in the format of primer. 725 results related to the theme proposed during the search were identified. Of these, 111 studies were selected to support the study in question. Among these, 17 studies were highlighted as main results and guided the discussion of the topics. Subsequently, the booklet was created, covering everything from the presentation of what type 2 diabetes is, to the self-care process and recommendations for elderly people. It is concluded, based on the conduct of this study, that the process of health education for the elderly population is essential. Consequently, it aims to strengthen self-care practices, increase adherence to medication therapy, promote lifestyle changes and raise awareness about the importance of preventing complications in elderly people living with DM2. Such measures aim to improve the overall quality of life of these individuals.
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Efeitos da suplementação de altas doses de colecalciferol sobre a excreção urinária de albumina em pacientes com Diabetes Mellitus Tipo 1
(Universidade Federal do Pará, 2022-08-26) SILVA, Lorena Regina Velasco Guimarães; SOUZA, Ana Carolina Contente Braga de; http://lattes.cnpq.br/0609863332556837
Diabetic kidney disease (DKD) is the leading cause of chronic kidney disease. The first clinical sign of this condition is microalbuminuria, currently called elevated urinary albumin excretion (UAE). Experimental and observational studies and clinical trials conducted in recent years suggest the effective role of vitamin D (VD) and its synergistic action with inhibitors of the renin-angiotensin-aldosterone system to counteract the worsening of DKD. The present study aimed to evaluate the effects of administration of high doses of cholecalciferol in the UAE of patients with type 1 diabetes (T1DM). For this, a clinical trial was carried out, in which patients with T1DM treated at the Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará (Belém, Brazil), were divided into two groups, according to baseline levels of 25-hydroxy-vitamin D - 25(OH)D - to receive cholecalciferol at doses of 10000 IU per day if 25(OH)D < 30 ng/ml and 4000 IU per day of cholecalciferol if 25(OH)D ≥ 30 ng/ml, for a period of 3 months. Before and after the intervention, patients underwent 24-hour microalbuminuria and isolated microalbuminuria collections. A total of 64 patients were included in this study, with a mean age of 27.9 ± 10.6 years and a mean duration of diabetes of 11.8 ± 7.9 years. There was a significant increase in 25(OH)D levels (26.7 ± 9 versus 55.1 ± 24.1 ng/mL, p <0.001) and a reduction in albuminuria in both methods evaluated, microalbuminuria in an isolated sample (urinary albumin:creatinine ratio) - UACR (62.5 ± 129.4 versus 55.6 ± 143.4 mg/g, p = 0.0027) and 24-hour urinary albumin excretion - 24-h UAE (76.4 ± 179.1 versus 58 ± 133.4 mg/ 24 h, p=0.002). The prevalence of DKD decreased from 37.5% at baseline to 25% after cholecalciferol supplementation. In patients classified as microalbuminuric (n=20) at the beginning of the study, in addition to a significant reduction in UAE assessed by 24-h UAE, reversion of microalbuminuria was observed in 40% of the patients in the sample (n=8). The results of the present study suggest that VD high-dose supplementation can promote a reduction in UAE in individuals with T1DM, especially in those in the early stages of DKD (microalbuminuric).
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Protocolo de classificação e diagnóstico do Diabetes Mellitus
(Universidade Federal do Pará, 2022-05-02) SILVA, Ariel Regina Silva da; SOUZA, Ana Carolina Contente Braga de; http://lattes.cnpq.br/0609863332556837
Diabetes mellitus (DM) is characterized as a metabolic disorder of multiple etiology that results in persistent hyperglycemia due to failure in insulin action and/or secretion. According to the World Health Organization (WHO), the American Diabetes Association (ADA) and the Brazilian Society of Diabetes (SBD), DM is classified according to etiology into four clinical classes: type 1 DM (T1DM), type 2 DM (T2DM), other specific types of DM (caused by different etiologies) and gestational DM. To diagnose DM and its types, it is necessary to associate clinical data (clinical history, personal and family history, signs, symptoms, physical examination) with the results of laboratory tests: fasting glucose, glycated hemoglobin A1C, oral test glucose tolerance test (OGTT) and/or specific antibody dosage (anti insulin, anti-GAD, antiislet, etc.), among others. The present work aimed to produce a protocol for clinicians and specialists on the classification and diagnosis of DM. Using a rapid review methodology, recent and relevant publications on the topic were selected in two databases: National Center for Biotechnology Information (NCBI/PUBMED) and Scientific Electronic Library Online (SCIELO). The selection was performed based on the evaluation of pre-determined inclusion and exclusion criteria, by a panel of two researchers with expertise in the area. The clinical protocol was elaborated focusing on the classification and diagnosis of DM, presented through didactic texts, easy to be understanding and in a language suitable for health professionals. Visual elements such as figures, charts and flowcharts were added to the material to highlight the most important information about the main types of DM, including the most specific and/or rare (LADA, MODY, neonatal diabetes mellitus, etc.), to assist the health professional to perform the early diagnosis of DM and identify the probable etiology of the disease. The reduction in the delay in recognizing the disease and causes may imply changes in the therapy and prognosis of the condition, in addition to directing family counseling for affected patients.
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Protocolo de rastreio e diagnóstico do Diabetes Mellitus Gestacional
(Universidade Federal do Pará, 2022-08-31) SOUZA, Larissa Mayane Reis Barros de; SOUZA, Ana Carolina Contente Braga de; http://lattes.cnpq.br/0609863332556837
Gestational diabetes mellitus (GDM) is associated with severe adverse perinatal outcomes and unfavorable short- and long-term health consequences for both mother and child. Due to the increasing prevalence of GDM worldwide, the impact and importance of this medical condition in prenatal care is growing. There is no consensus on the best forms of diagnosis for GDM, different criteria are adopted worldwide which currently often leads to a late diagnosis. The aim of this study is to develop an objective and didactic clinical protocol to help general practitioners and specialists on the diagnosis of GDM, in both primary and tertiary care. The study was carried out using the method of rapid literature review, which occurred through searches in the PUBMED and Scielo databases, with the terms "GESTATIONAL DIABETES MELLITUS CLASSIFICATION", "GESTATIONAL DIABETES DIAGNOSIS", "GESTATIONAL DIABETES RISK ALGORITHM", “ALGORITHM OF COMPLICATIONS OF GESTATIONAL DIABETES MELLITUS” and its correlates in english. Repeated studies, case reports, letters to the editor, comments and studies not available in English or Portuguese were excluded. Observational, descriptive studies, literature reviews, meta-analyses and systematic reviews were included. 107 publications were carried out for this protocol, which resulted in 11 flowcharts, 9 figures and 4 tables, in addition to explanatory texts, presented in 8 topics: categorization of hyperglycemia in pregnancy (pre-gestational diabetes, overt diabetes and GDM), maternal physiology, risk factors in GDM, maternal and fetal complications, screening and diagnosis of GDM, investigation of diabetes mellitus in the puerperium and practical examples for diagnosis of GDM. This project resulted in the creation of a practical instrument, which allows medical professionals carry out the diagnosis between the different forms of hyperglycemia in pregnancy, better understanding of the pathophysiology, risk factors and maternal-fetal complications of GDM, and therefore, assist professionals in the screening and and diagnosis, in situations of total/ partial financial viability and/or technical availability, regarding both GDM and diabetes mellitus in the puerperium, in order to promote early therapeutic intervention when applicable.

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