Dissertações em Atenção e Estudo Clínico no Diabetes (Mestrado) - PPGDIABETES/UFPA

URI Permanente para esta coleçãohttps://repositorio.ufpa.br/handle/2011/17109

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Avaliação do crescimento linear em crianças com o diagnóstico de Diabetes Mellitus Tipo 1
(Universidade Federal do Pará, 2024-02-21) BARBOSA, Bruna Lopes; FELÍCIO, Karem Miléo; http://lattes.cnpq.br/5289063715182942
The Type 1 Diabetes Mellitus (T1DM) is characterized by the destruction of the ß-cells resulting in loss of endogenous insulin production. It is one of the most common presentations of youth-onset diabetes. The treatment needs multi-disciplinary approach and is based on intensive insulin therapy. The chronic hyperglycemia and severe insulin deficiency are known to be associated with impaired linear growth. The dysregulation of the GH-IGF-1 axis in T1DM is characterized by decreases in circulating IGF-1, GHR and GHBP, along with increases in GH and IGFBP-1. This study evaluated the influence of glycemic control in the linear growth of T1DM patients treated at Universitary Hospital João de Barros Barreto and compared the growth of these patients with the WHO`s reference. For that, a retrospective cohort study was made using data from medical records at the period between 5 and 19years old from 78 patients (40 females/ 38 males) following the criteria of age at the diagnosis £ 15 years old (females) and £ 17 years old (males). They were at diagnosis 8,6 years old, the duration of the disease was de15,4 years, glycated hemoglobin (HbA1C) 10,5 %. Among them, 58 patients (28 females/ 28 males) were achieved the final height (FH). The female’s FH was 156,2cm (Z score -1,11SDS) and the male’s FH was 166cm (Z score -1,45SDS). Only 19% were above the OMS`s media. But 26% had short stature. 9% were at Z≤ -3SDS. HbA1C ≥ 9,5% was related with worse FH. Each 1% of elevation in HbA1C was associated with a reduction of 2,23cm on FH, and 26% of FH variability were influenced by HbA1C level. The ones with HbA1C ³ 9% had significant stature loss compared to TH. In conclusion, the T1DM patients evaluated were shorter than the media of WHO`s charts, however the majority did not have short stature. HbA1C levels were negatively associated with stature loss compared to TH and final heigh. There was no correlation between FH and weight, insulin total dose, gender and diabetes duration.
Acesso aberto (Open Access)
Controle glicêmico e automonitorização da glicemia capilar: uma cartilha regionalizada para o paciente diabético
(Universidade Federal do Pará, 2022-02-04) CAVALCANTE, Regina do Socorro Oliveira Pinheiro; http://lattes.cnpq.br/0014255351015569; FELÍCIO, Karem Miléo; http://lattes.cnpq.br/5289063715182942
Diabetes mellitus is today a health problem worldwide, bringing serious micro and macrovascular complications when not properly treated; it is considered a difficult disease to control because its treatment requires changes in several aspects of the individual's life. Treatment consists of trying to maintain glycemic control, that is, maintaining blood glucose levels in the body in acceptable proportions; it requires discipline so that the medications are used correctly; changes in eating habits, maintaining a healthy diet, following an individual eating plan prescribed by a competent professional, and abandoning physical inactivity with the performance of regular physical activities. Glycemic control can be performed through periodic blood tests such as fasting blood glucose, glycated hemoglobin, and also through selfmonitoring, where the patient himself works by assessing his blood glucose levels daily and adjusting insulin amounts as instructed by his doctor. The self-monitoring techniques and parameters are passed on to the patient through Health Education, by the team responsible for their monitoring. Observing the importance of the diabetic patient maintaining glycemic control, aiming to prevent complications of the disease, we sought to carry out this study, which has as main objective, the production of a regionalized booklet for the patient containing the main guidelines on glycemic control and self-monitoring of capillary blood glucose, with easy-tounderstand language and illustrations that help them understand; the information was obtained through a literature review. It is intended to implement the booklet in primary health care, in Belém-PA, first with instructions on the subject to the health team that is working, so that the booklet is passed on to the user with appropriate information and clarifications.
Acesso aberto (Open Access)
Protocolo de manejo da úlcera do pé em portadores de Diabetes: diagnóstico, classificação e tratamento
(Universidade Federal do Pará, 2024-06-25) SILVA, Josyelle Liliam Ferreira; SILVA, Lilian de Souza D Albuquerque; http://lattes.cnpq.br/5441579181314766
Diabetes mellitus (DM) is a metabolic disease characterized by chronic hyperglycemia due to changes in insulin production and/or action. Foot ulcers in patients with diabetes represent one of the main chronic complications and are associated with high rates of morbidity and mortality. The aim of the present study is to formulate a protocol on the management of these ulcers. For this, an integrative literature review was carried out in the period from 2014 to 2024 in the databases of Google Scholar, Pubmed, Lilacs and Scielo. The main global guidelines on the subject were used, and the clinical characteristics, social profile and level of complexity of health care were taken into account in order to propose the best approaches. Didactic material was formulated with explanatory texts, tables and flowcharts to simplify the diagnosis, classification of ulcers and treatment of this condition. This clinical protocol serves as a tool for quick and upto-date consultation for any health professional who works with the care of these patients, to facilitate the management of this condition and simplify communication between the team involved in the care.
Acesso aberto (Open Access)
Protocolo de rastreio da Retinopatia Diabética
(Universidade Federal do Pará, 2023-04-14) SOUSA, Juliana Ferreira de; SANTOS, Márcia Costa dos; http://lattes.cnpq.br/5450061620179886
Diabetic Retinopathy (DR) is one of the main microvascular complications of Diabetes Mellitus (DM) that is mainly present in patients with a long time of the disease and with inadequate glycemic control. This study aims to create a clinical protocol for screening diabetic retinopathy. For this, a literature review was carried out with research in the PubMed, SciELO (Scientific Library Online) and LILACS (Latin American and Caribbean Literature in Health Sciences) databases. The terms “diabetic retinopathy”, “diabetes mellitus”, “screening” and “treatment” were used, with the following inclusion criteria: literature reviews, rapid reviews and systematic reviews, and exclusion criteria: repeated studies, case reports , letter to the editor, comments and studies not available in English and Portuguese. After reviewing the literature, a protocol was developed with guidelines for tracking diabetic retinopathy, with emphasis on flowcharts, charts and texts aimed at health professionals. Based on this study, a clinical protocol for tracking DR was developed, which is objective and clear and can help health professionals who assist patients with DM.

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