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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Navegando Programa de Pós-Graduação em Atenção e Estudo Clínico no Diabetes - PPGDIABETES/UFPA por Orientadores "TORRES, Natáli Valim Oliver Bento"
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Item Acesso aberto (Open Access) Construção de um protocolo de exercícios físicos para o atendimento a pessoas com diabetes mellitus tipo 2: revisão rápida(Universidade Federal do Pará, 2022-08-30) RIBEIRO, Andressa Karoline Pinto de Lima; TORRES, Natáli Valim Oliver Bento; http://lattes.cnpq.br/1927198788019996; https://orcid.org/0000-0003-0978-211XType 2 Diabetes Mellitus (DM2) accounts for 90-95% of all diabetes cases. This form covers individuals with relative insulin deficiency and peripheral insulin resistance. Physical exercise is an efficient therapeutic strategy for the treatment of people with DM2 as it contributes to glycemic control, as well as reducing cardiovascular risk factors, increasing physical fitness, contributing to body weight control and improving people's quality of life. Objective: Formulate a physical exercise protocol aimed at health professionals for the treatment and maintenance of glycemic control of adults with type 2 Diabetes Mellitus. Methodology: The study consists in the elaboration of the protocol from a rapid review in search of studies who investigated the effects of physical exercise on the glycemic control of adults with type 2 Diabetes Mellitus (DM2) to analyze which exercise parameters (modality, frequency, volume, intensity, interval and progression) are recommended to achieve better glycemic control in the population of interest. The PICOT strategy was adopted for the elaboration of the inclusion criteria of the studies and the PRISMA protocol for the writing of the manuscript. PubMed and LILACS databases were used. The study selection process took place through 4 steps: identification, selection by title and abstract, eligibility assessment and inclusion. Two authors independently extracted data on population, intervention and outcome from each study, and the extracted information was organized into tables. The methodological quality of each study was analyzed based on the PEDro scale (PROSPERO - CRD 42021262614). Results: From a total of 1152 articles, 17 studies met the inclusion criteria and were analyzed. A total of 1,141 (745 in exercise groups and 396 in sedentary control groups) people with T2DM were included. Regarding the type of study, 15 (88.2%) were randomized clinical trials and 2 (11.8%) were non-randomized clinical trials. The age of patients ranged from 45.6 to 61.7 years. The mean intervention time was 17 weeks, ranging from 9 to 48 weeks. Six studies 35.3% reported that no adverse events occurred during the intervention, two (11.8%) reported some event and nine (52.9%) did not present any information. The theoretical basis obtained from the rapid review and other studies supported the construction of a guidance protocol for professionals about physical exercise as a treatment for DM2 and management of glycemic control. The following elements were elaborated: frameworks of concepts, flowcharts and explanatory texts constructed with objective and easy-to-understand language as didactic tools in order to assist in the outpatient routine of professionals responsible for prescribing exercises in the management of patients treated at all levels of care of the Unified Health System (SUS). Discussion: Aerobic, resistance and combined training are associated with decreases in HbA1c, fasting glucose or postprandial glucose. however, combined training should be prioritized as they appear to have greater effects on glycemic control than either method alone. Conclusion: The protocol created from this review aims to offer professionals working at the various levels of health care in the SUS, updated, objective information, presented in a didactic way about physical exercise as a form of treatment for DM2. It is recommended that physical exercise protocols include both resistance and aerobic exercise, as their effects are greater on glycemic control than either method alone.Item Acesso aberto (Open Access) Exercício físico e controle glicêmico em pacientes com diabetes mellitus tipo 1: uma revisão rápida e proposta de material informativo e didático(Universidade Federal do Pará, 2022-08-28) OLIVEIRA, Adriana Alves; TORRES, Natáli Valim Oliver Bento; http://lattes.cnpq.br/1927198788019996; https://orcid.org/0000-0003-0978-211XDiabetes Mellitus (DM), which is characterized by a metabolic disorder that causes hyperglycemia in affected patients, is currently one of the major public health problems, as it affects more and more people around the world and generates increasingly high costs. . Among its classifications, there is Type 1 Diabetes Mellitus (DM1), which is the focus pathology of our study. DM1 may have an unknown or autoimmune origin, attacking the beta cells of the pancreas, which produce insulin, the hormone responsible for capturing glucose into the cells. As a result, glucose is not captured to generate energy, causing hyperglycemia in the body, in addition to not controlling hepatic gluconeogenesis. People who have DM1 can present different types of complications, whether micro (nephropathies, neuropathies, retinopathies) or macrovascular (coronary diseases and/or stroke), hence the importance of promoting adequate glycemic control in these patients, in order to prevent such complications. For this, several studies have shown that in addition to a balanced diet and drug treatment, it is important to include regular physical exercise in the routine of patients with this metabolic syndrome. Therefore, the objective of this work was to analyze the effects of physical exercises on the glycemic control of patients with DM1, through a quick review of the literature (PROSPERO nº CRD42021277762), to develop an informative booklet for professionals who work with such patients, in addition to the creation of didactic material for discussion on the introduction of physical exercises in the routine of people with type 1 Diabetes Mellitus (CAAE 39536920.5.0000.0017). Our review of the literature points out that, regardless of the modality practiced, performing physical exercises has several health benefits, such as reduced medication dosage, improved physical well-being, cardiovascular conditioning, improved insulin resistance, lipid profile, among others. others. From the theoretical basis through a quick review and reading of guiding positions and documents from societies, in addition to reading recent and relevant articles for the care of the person with diabetes, an informative booklet was built aimed at health professionals and didactic material for discussion about the introduction of physical exercises in the routine of people with type 1 Diabetes Mellitus. The booklet has two main parts: a first theoretical part, constructed in an objective and synthetic way, composed of information about diabetes, its pathophysiology, main complications and the effects of physical exercise on people with DM1, in addition to a flowchart to guide the decision on the indication and safety for the practice of physical exercises according to blood glucose and risk factors. The second part of the booklet was constructed in an illustrative way to configure itself as a didactic instrument for the discussion with health professionals about the necessary information and care, prior to the beginning of an exercise program, in order to guarantee patient safety. This second part was composed of dialogues between the character Bete (person with DM1) and the professional (Dr. Cinesia).