Navegando por Assunto "Diabetes Mellitus"

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Cartilha educativa sobre cuidados com o uso de insulina injetável no tratamento do Diabetes Mellitus
(Universidade Federal do Pará, 2022-08-25) GOMES, Adriana dos Santos Mendes; SANTOS, Márcia Costa dos; http://lattes.cnpq.br/5450061620179886
Introduction: Diabetes Mellitus (DM) is a hormonal disorder characterized by persistent hyperglycemia resulting from a deficiency in the production and/or action of insulin. Currently, for the drug treatment of DM, we have two classes of injectable drugs: insulin and Glucagon-like peptide 1 (GLP-1) analogues, with insulin being the most used injectable drug today. Objectives: To create educational material on care with the injectable drug insulin aimed at patients with DM. Methodology: A bibliographic research was carried out in the MEDLINE, Pubmed and Scielo portals, which resulted in 2.920 publications and 29 scientific articles were registered. After analyzing the texts, the Educational Booklet on care with the use of the injectable drug insulin in the treatment of diabetes mellitus was prepared as a final product. It is a methodological development study, which refers to the elaboration, validation and evaluation of an instrument and research technique that can later be used by other people (POLIT; BECK, 2011). The booklet was edited using Office Word software free version 2021 and CorelDraw Graphics Suite X8 2021 and configured for printing on A4 sheet (210mm x 297 mm) in ―portrait‖ format. After delimiting the content of the booklet, the Flesch Reading Ease Index (IFLF) was applied in order to assess the ease with which a text can be read. After that, it was necessary to validate it, through the evaluation of a committee composed of content professor judges (JDC) and professional health care judges (JPSA). Results: The booklet addressed the following points about care with the use of insulin: types of insulin currently available, how to obtain it from SUS, what supplies are needed, how to carry out its application and care in the disposal of materials used. In the analysis of the booklet, the IFLF test revealed an index of 79.94 (%), being within the range of 70-80, which classifies the material as reasonably Easy. The judges carried out the validation of the educational material based on the evaluation of 3 aspects of the content: clarity of language, practical relevance and theoretical relevance. The global CVI (average of all grades) was calculated for the educational booklet, with values of 0.9 for clarity of language, 0.97 for practical relevance and 0.96 for theoretical relevance, indicating an excellent level of agreement between the judges. Conclusion: The educational material is presented with reasonably easy reading and presented good content validation, indicating that it is material of good understanding and content. It is hoped that this material will be well accepted, encourage education in DM, and serve as a practical guide for patients with diabetes in their daily lives and that it will develop skills and favor the autonomy and self-care of these individuals.
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Cartilha educativa sobre saúde óssea para pessoas que vivem com Diabetes Mellitus
(Universidade Federal do Pará, 2024-06-21) KHALED, Isabel Jane Campos Lobato; QUEIROZ, Natércia Neves Marques; http://lattes.cnpq.br/5359261920325026
Diabetes Mellitus has been linked to poorer bone health, leading to a higher risk of fractures in people living with diabetes. DM affects bone health in various ways. To prevent and manage bone problems in patients, some strategies need to be adopted, such as strict glycemic control, a diet with adequate intake of calcium and vitamin D, and physical exercises with an emphasis on strengthening activities. The educational approach values popular experiences and promotes the individual's autonomy in self-care. The aim of this study was to develop an educational booklet with the purpose of generating knowledge for the individual, using a descriptive-exploratory methodology to develop a lightweight health technology. The material was produced using easily understandable language and objective images.
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A compreensão de diabéticos sobre as complicações com os pés e as implicações para o autocuidado
(Universidade Federal do Pará, 2013-10-30) PEREIRA, Odenilce Vieira; SANTANA, Mary Elizabeth de; http://lattes.cnpq.br/6616236152960399; https://orcid.org/0000-0002-3629-8932
The mellitus diabetes is a chronic disease that in recent years has contributed to the increased mortality in the world. The nurse stands out as a primary actor in diabetic care by performing nursing care at different levels of health care patient. The study aimed to describe the understanding of diabetic complications on his feet; identifying information submitted by nurses and examine factors that contribute to the incidence of vascular complications involving self-care. Descriptive qualitative research, developed in the months from May to July 2013, with thirty diabetic hospitalized at the University Hospital of Belém - Pará. Data were collected through semi-structured and subjected to thematic content analysis according to the model proposed by Bardin interview. All legal requirements have been rigorously considered. The study included seventeen women and thirteen men with a mean age of sixty . Most respondents had low level of education , ignorance and misinformation about diabetes which resulted in the realization of self-care. The data analysis allowed the learning of four core categories: discovery and control of diabetes, complications of diabetes and foot care; evidence that interfere with self-care of the feet; contributions of the healthcare team to practice self-care with their feet. The discussion was based on the theoretical framework that has supported the research and related theory of Orem Self Care. This research sought to emphasize inpatient hospital setting, as a characteristic for the curative treatment environment, however we believe that it can also be a place conducive to educational activities related to self-care and prevention for complications with the feet of diabetic patients.
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Construção de tecnologia educativa do tipo álbum seriado acerca dos cuidados com os pés de pessoas com Diabetes
(Universidade Federal do Pará, 2022-08-31) SILVA, Marcelina Ribeiro da; QUEIROZ, Natércia Neves Marques; http://lattes.cnpq.br/5359261920325026
Diabetes Mellitus represents a heterogeneous etiological group of metabolic disorders that have in common hyperglycemia and disorders in the metabolism of carbohydrates, proteins and fats, resulting from defects in the action and/or secretion of insulin. This etiological group is associated with several comorbidities such as cardiovascular diseases, stroke, chronic renal failure, peripheral neuropathy and diabetic skin wounds or ulcerations. In addition, chronic ulcerations are more frequent in the lower limbs, such as the feet, and predominantly among the elderly, affecting 15% and all patients with diabetes, of this total, 14 to 24% undergo lower limb amputations and, after that, approximately 59% of patients die within five years. Therefore, the objective is to build an educational technology such as an educational flipchart as a tool to support guidelines on foot care for diabetic people. For this, it was decided to carry out a study on the construction of educational technology, through research of methodological development with a qualitative approach. The methodological trajectory was structured in two stages, namely: Narrative Literature Review (Step 1) and Construction of the flipchart (Step 2). The album started with the creation of a cover, pre-textual information such as a catalog sheet, authors' metadata, presentation and detailed summary. In the textual part, texts and images were included on the concepts of the disease, epidemiological aspects, risk factors, prevention, signs and symptoms, complications, diabetic foot and foot care, in order to address the main issues that generate doubts among patients. Therefore, the construction of this flipchart for diabetic patients was conceived with an easy-to-understand language, with clear and concise texts and colored figures, in order to bring the reader/user of health closer to a technical-scientific didactic knowledge, mainly, so that the target audience has the autonomy to perform self-care. In this scenario, this teachingassistance tool should be used to assist health professionals in guiding patients treated in health services, for this, it is intended to submit the album to formal validation. Regarding the making of the illustrations, we sought to present a colored material with illustrative figures that referred to the general and specific aspects of the disease in question, especially regarding the care of the feet of diabetic people. In addition, the main points on the subject were addressed, as well as the objectives achieved, as there were discussions and reflections on the subject, there was the construction of educational technology and the description of the construction process. Finally, with this study, we intend to provide for people with diabetes instrument of guidance with foot care.
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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.
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A dança jazz como estratégia de cuidado ao adolescente com Diabetes Mellitus Tipo 1: um relato de caso
(Universidade Federal do Pará, 2024-02-26) DOURADO, Julyanna Nazareth da Silva; BENTO-TORRES, Natáli Valim Oliver; http://lattes.cnpq.br/1927198788019996; https://orcid.org/0000-0003-0978-211X
Diabetes Mellitus (DM) is a metabolic disorder associated with persistent hyperglycemia due to inadequate insulin production or reduced effectiveness of its mechanism of action. Type 1 Diabetes Mellitus (DM1), previously called “insulin-dependent diabetes” or “juvenile-onset diabetes,” accounts for 5 to 10% of DM cases. The DM1 complications can affect the living conditions of adolescents over the years and influence their quality of life. Physical exercise is a therapeutic tool for the treatment of people with DM1 and can improve insulin sensitivity and glycemic control, improving quality of life, mental health, and physical fitness. Dance is a low-explored option of physical exercise in the context of DM. In the present study, we report a single case study to investigate the potential of Jazz Dance as an intervention to achieve glycemic management, promote mental health, improve the physical fitness and quality of life of a 12-year-old female teenager with DM1, improve physical fitness and quality of life in an adolescent with DM1. The intervention program encompasses 24 Jazz classes twice a week, lasting 60 minutes, at moderate intensity (65 to 75% of maximum heart rate, Polar@). Pre- and post-intervention assessments (1 day after the choreographic presentation) include usual physical activity practice (Physical Activity Questionnaire for Adolescents PAQ-A), quality of life (Diabetes Quality of Life for Youths - DQOLY), symptoms of anxiety and depression (Depression, Anxiety and Stress Scale - Short Form - DASS-21), physical fitness (muscle strength of lower and upper limbs and indirect measure of cardiorespiratory fitness), and glycemic control (glycemia and glycated hemoglobin). Discursive textual analysis was also applied to assess the adolescent and her caregiver experiences (CAAE: 66423922.2.0000.0017/Approval number: 5.913.924). The results demonstrated a reduction in Fasting Glycemia (-16.02%), HbA1c (-4.00%), pre-test (-24.21%) and post-test (-9.56%) heart rate, depressive and anxious symptoms (-7.14%), and improved quality of life (3.61%). There was an increase in muscular strength in the upper limbs (20.00%), flight time, strength, and power in the lower limbs (0.27%; 1.62%; 1.70%, respectively). Despite limited evidence on the effect of dancing on people with DM, the data presented indicate the beneficial potential of Jazz in the care of adolescents with DM1, just as the report of the experience lived by the adolescent points to the positive impact of the intervention on her self-care routine and perceived quality of life. Despite the limitations of extrapolating our results to the teenage population with DM1, it is necessary to expand the research to include a more significant number of participants, as well as expand research on dance modalities as part of the treatment of DM1, aiming to quantify and qualify more precisely the potential adaptations and modifications provided to these people through dance.
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Desafios do Programa HIPERDIA e implicações para a enfermagem
(Universidade Federal do Pará, 2014-06-27) FERNANDEZ, Darla Lusia Ropelato; POLARO, Sandra Helena Isse; http://lattes.cnpq.br/7875594038005793; GONÇALVES, Lucia Hisako Takase; http://lattes.cnpq.br/6191152585879205; https://orcid.org/0000-0001-5172-7814
INTRODUCTION: The HIPERDIA Program was established in 2001 in primary care because of the severity of epidemiological Hypertension (HBP) and Diabetes Mellitus (DM), conditions that can lead to serious complications instilling limitations and suffering in the lives of their patients and their families. In this context, it is worth mentioning the importance of primary prevention of these diseases and their complications. Past more than a decade of implementation, it is worth to reflect on the impact on health conditions that the program has generated among its users. OBJECTIVES: To elucidate the principles, philosophy and the guiding policy of HIPERDIA Program of the Ministry of Health (MH); describe how the patient care works, by a health team of HIPERDIA Program; explore the life and health behaviors demonstrated by users of HIPERDIA after its insertion into the program. METHODOLOGY DESCRIPTION: This is a Case Study second Yin (2010) whose object of study was a HIPERDIA Program executed in a Basic Health Unit outskirts of Belém. Data were obtained through interviews with users, staff and managers of the program, in addition to direct field observation, consultation records and official documentation of MS. The data analysis was performed by the analytical strategy "Relying on Theoretical Propositions" and the analytical technique "Standard Combination". RESULTS: The deterioration of the HIPERDIA program management illustrated by deficiencies in infrastructure, supplies, medicines and weaknesses in the reference and counter reference network, excessive spontaneous demand that overloads the health team allocated insufficient in number and the context of poverty and urban violence in users living contribute to poor adherence to treatment regimen and limit the team in its interdisciplinary and integral action. Furthermore, the current model of care is grounded in traditional, based on consultations and prescriptions and that has not proved sufficient to fully meet the needs of care to people with chronic condition requiring long-term care by adopting lifestyles more consistent and healthy. FINAL THOUGHTS: Big challenges are drawn against the data emerged from this study and it involves governmental and intersectoral actions that promote improvements in the living conditions of the population which requires political will to investing the necessary resources. Notwithstanding this, the nurse can make a contribution by promoting cultural care and self-care actions, customizing the plan of action and bringing the responsibility of the user and their families in improving their health condition.
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Meu corpo dependente: representações sociais de pacientes diabéticos
(2010-06) SILVA, Sílvio Éder Dias da; PADILHA, Maria Itayra; RODRIGUES, Ivaneide Leal Ataíde; VACONCELOS, Esleane Vilela; SANTOS, Lucialba Maria Silva dos; SOUZA, Ralrizônia Fernandes; CONCEIÇÃO, Vander Monteiro da
This study aims at identifying social representations of diabetic clients on your body after the amputation, and analyze the relationship of these representations to the care of themselves. The research was a qualitative, exploratory, with the use of the social representations theory and case study method. The scenario was a hospital in the city of Belém, Pará, 20 subjects participated. The data collection techniques were: a free association of words and watch free. After examining three categories emerged: the healthy body - term health of living well, the body work - the perfection and beauty in daily life, The body amputated - the limitation caused by amputation; and the amputated body and its relation to the care of themselves. It is clear concern to recover the lost welfare.
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Percepções de portadores de diabetes sobre a doença: contribuições da Enfermagem
(2013-04) CHAVES, Miriam de Oliveira; TEIXEIRA, Mirian Rose Franco; SILVA, Sílvio Éder Dias da
This study aimed to identify the perceptions of patients concerning diabetes. This is a descriptive exploratory study with a qualitative approach, which was conducted with 32 subjects, in a hospital in the city of Belem-PA, Brazil. The thematic content analysis was used, from which four categories emerged: Diabetes control: nursing in the self-monitoring of blood glucose; The diabetic individual and nursing: an interaction with self-care; Nursing consultations provided to diabetic individuals: an intervention in the health-disease continuum; Diabetes and its complications: fear of loosing functioning. It was observed that patients start self-care driven by the fear of losing their health, that is, fear forces the patient to practice self-care. Nurses are directly linked to diabetes control as they start providing care and guidance for patients who self-monitor their disease.
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Potencial cicatrizante do extrato cetônico de Pentaclethra macroloba no processo de reparo de lesões excisionais na pele de camundongos diabéticos
(Universidade Federal do Pará, 2017-05-25) GOMES, Mauricio Ferreira; BASTOS, Gilmara de Nazareth Tavares; http://lattes.cnpq.br/2487879058181806
Diabetes Mellitus (DM), a disease that attracts the interest of many health professionals, is a chronic pathology that has become a public health concern in recent years. The disease is divided into diabetes type 1 and type 2 , which causes a dysfunction in insulin / glucose physiology. This deregulation causes significant alterations in some biological events, among them, the cicatrization process. The emergence of injury in to a normal person triggers a cascade of cellular and biochemical reactions Aiming to repair the injured tissue. In patients with diabetes, the repair is slower. Several mechanisms are described as important factors in the delay of the healing process in diabetics, among them, excessive production of reactive oxygen species (ROS), reduction of nitric oxide (NO), reduction of the response to growth factors (GFs) And proteins the insulin signaling pathway . The search for therapeutic forms that can help the tissue repair process is in great demand, Because the rate of people with diabetes is increasing over the years. Thus, it is aimed to find pharmacological alternatives for this aspect, in the present study the characterization of the pharmacological effect of the topical application of the ketone extract of the seed Pentaclethra macroloba (Pracaxi) on the tissue regeneration process in diabetic animals was performed. To evaluate the healing effect, an excisional cutaneous wound with biopsy punch was created in diabetic animals and were subsequently treated by topical application of the extract to evaluate the healing potential of the seed. The effect of the treatment was evaluated by some aspects, such as: wound contraction, Reepithelialization, quantity of inflammatory cells, tissue organization and formation of collagen in the extracellular matrix. The results showed that the pracaxi extract presented a healing effect in diabetic mice, stimulating the tissue reconstruction after skin lesions. In this way, the pracaxi becomes a possible alternative for the treatment of tissue lesions in diabetics because it stimulates the healing cascade promoting the best formation of the extracellular matrix.
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Protocolo clínico para o atendimento de análogos de insulina às pessoas com Diabetes Mellitus na rede pública de saúde do município de Belém-Pará
(Universidade Federal do Pará, 2024-02-29) NORONHA, Hirley Gabriel Reimão; SANTOS, Ândrea Kely Campos Ribeiro dos; http://lattes.cnpq.br/3899534338451625; https://orcid.org/0000-0001-7001-1483
Diabetes mellitus (DM) is a metabolic disorder that causes a persistent hyperglycemic state, related to inadequate insulin production and/or the ineffective mechanism of action of this hormone. DM1 is caused by the partial or total destruction of pancreatic beta cells, responsible for insulin secretion. DM2 arises from the combination of progressive resistance to the action of insulin, associated with the gradual loss of this hormone secretion. GDM occurs due to intolerance to carbohydrates in the diet that began during pregnancy, however, it does not meet the diagnostic criteria for Pre-Gestational DM. Approximately 6.9% of adults living in Belém-PA reported having some form of DM. DM treatment involves non-drug and drug measures. The multidisciplinary approach allows for better control of glycemic levels, ensuring a better quality of life. Drug treatment is carried out through a combination of oral antidiabetics with or without the addition of insulin therapy in DM2 and depends on hormonal insulin replacement in DM1. Exogenous insulin is currently available in the following formulations: long-acting, intermediate-acting, rapid-acting and ultrafast-acting. Insulin analogues are molecules where the amino acid structure is altered through genetic engineering and recombinant DNA technology, modifying the pharmacokinetic and pharmacodynamic properties compared to regular human insulins, while preserving the biological and stability properties of the insulin molecule. The present Clinical Protocol aims to standardize the care of long-acting and ultra-rapid insulin analogues in the public network of the city of Belém-PA, optimizing the treatment of patients with stable, unstable, or difficult-tocontrol DM, enabling the reduction of acute complications. and chronic diseases, improving patients’ quality of life.
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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 Controle Glicêmico do Diabetes Mellitus Tipo 1 e Tipo 2
(Universidade Federal do Pará, 2022-02-07) LEAL, Valéria Suênya Galvão; FELÍCIO, Karem Miléo; http://lattes.cnpq.br/5289063715182942
Diabetes Mellitus (DM) is a chronic and complex disease characterized by chronic hyperglycemia with great impact on morbidity and mortality, affecting different age ranges and the predominant types are type 1 DM (DM1) and type 2 DM (DM2). Additionally, there is a high prevalence and incidence worldwide and the trend is growing in adults as well as in children and adolescents, economically impacting the public health costs. In all forms of DM, there is a risk of developing microvascular complications (retinopathy, diabetes kidney disease, neuropathy) and macrovascular complications (peripheral arterial disease, cardiovascular and cerebrovascular diseases) that develop over the years due to off-target glucose levels. Therefore, the assessment and monitoring of blood glucose through glycated hemoglobin (HbA1c), fasting blood glucose (FG) and postprandial blood glucose (PPG), time on target, and glycemic variability are essential to prevent these complications, since they help in choosing the appropriate treatment to achieve the glycemic target stipulated by the current scientific societies. Despite these resources, there are still occurrences of uncontrolled glycemia among patients for various reasons, and insufficient achievement of glycemic goals. The objective of this study was to create a clinical protocol of glycemic control in a clear and didactic way in order to help health professionals in the management of patients with DM1 and DM2 through the elaboration of algorithms and explanatory texts, corroborating the achievement of glycemic goals. The protocol was produced in 3 stages. First, for an updated theoretical basis, a literature review was performed about the tools and ways to evaluate the glycemic control, the current glycemic goals, and the "power" of action of antidiabetic agents on HbA1c, FG, and PPG. This review was done by a rapid review of the literature in the PUBMED and LILACS databases with the terms "GLYCEMIC CONTROL", "GLUCOSE MONITORING", "GLYCEMIC VARIABILITY", "GLYCEMIC GOAL" and their correlates in Portuguese. Also, the guidelines of the major national and international diabetes scientific societies, four books, and relevant information from pertinent websites were included. This resulted in a total of 44 materials that were used as theoretical references for the development of this protocol. Based on these references, tables, charts, and didactic and objective flowcharts were elaborated. The main contributions of the protocol were the creation of the glycemic control goal tables for HbA1c, FG, and PPG; a table with the main antidiabetic drugs and their potential reduction; glycemic profile diaries of 4, 7, and 8 points; original flowcharts exemplifying the treatment and potential decrease of glycated hemoglobin for DM2 and DM1; and a flowchart for the management of glycemic control in special situations of physical exercise, disease situations, driving vehicles, and surgeries.
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Protocolo de diagnóstico e tratamento da Doença Renal do Diabetes
(Universidade Federal do Pará, 2024-02-09) FERREIRA, Neylane Kely Vasconcelos; FELÍCIO, João Soares; http://lattes.cnpq.br/8482132737976863
Diabetes mellitus (DM) affects millions of people worldwide and represents an important public health problem, being associated with several complications, among which diabetic kidney disease (DRD) stands out. DRD is part of the group of microvascular complications that represent the main cause of chronic kidney disease (CKD) in patients entering dialysis programs. In adults, DRD occurs in 20–40% of people with diabetes, and its presence significantly increases cardiovascular risk and healthcare costs. The objective of this study is to create a protocol on DRD, generating behavior algorithms to guide health professionals at all levels of care through a literature review on updates in pathophysiology, diagnosis and treatment. The study was carried out through an integrative literature review, based on searches in the PubMed and LILACS databases, with the terms “DIABETIC KIDNEY DISEASE” AND “DIAGNOSIS”; “DIABETIC KIDNEY DISEASE” AND “TREATMENT”; “DIABETIC KIDNEY DISEASE” AND “DIAGNOSIS” AND “TREATMENT” and their correlates in Portuguese. Repeated studies, case reports, letters to the editor, comments and studies not available in English or Portuguese were excluded. The present work also included observational and descriptive studies, literature reviews and systematic reviews. In addition, the study is based on data from work carried out by the endocrinology and diabetes research group at the Federal University of Pará. After reviewing the literature, the selected information served as the basis for the construction of a clinical protocol regarding screening, diagnosis, and treatment of diabetes kidney disease. The clinical applicability of our protocol consists of providing a tool, not only for the specialist, but for the general practitioner in primary, secondary and tertiary care, with the aim of enabling effective care for patients with diabetic kidney disease. Thus, the adoption by specialist or general medical professionals of a “PROTOCOL FOR DIAGNOSIS AND TREATMENT OF DIABETES KIDNEY DISEASE” appears as a promising resource in the approach to individuals affected by this comorbidity.
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Protocolo de diagnóstico e tratamento da hipertensão arterial sistêmica no Diabetes Mellitus
(Universidade Federal do Pará, 2024-02-23) OLIVEIRA, Cássio Antônio Bezerra de; QUEIROZ, Natércia Neves Marques de; http://lattes.cnpq.br/5359261920325026; FELÍCIO, João Soares; http://lattes.cnpq.br/8482132737976863
Hypertension is a chronic disease that often accompanies diabetes mellitus and the relationship between the two is complex. Like diabetes, it is an important cardiovascular risk factor and microvascular complications, such as nephropathy and retinopathy, and has higher health costs than diabetes itself. The treatment of hypertension in diabetes has been widely debated and there is still a need to reach a consensus on treatment goals and strategies. The objective of the present study was to develop a clinical protocol on the diagnosis and treatment of hypertension in diabetes mellitus whose main foundation was its applicability in the Brazilian public health system, focusing on medical adherence to recommendations, the impact of applying the evidence in primary and secondary care, and the evolution of health quality in these scenarios. To this end, an integrative literature review was carried out, selecting health articles based on the quality of evidence located in the PUBMED database and published in the last 20 years (2004-2024). Five researchers were responsible for selecting those with the best quality of evidence. National and international guidelines and works published by the UFPA diabetes clinical research group were also used. In the end, 106 articles were selected as theoretical references for preparing the protocol. The results were synthesized in the form of a clinical protocol containing concise texts and teaching resources (27 tables, 3 flowcharts and 1 figure) that will guarantee safety in clinical decision-making in primary and secondary health care settings, configuring a practical guide on the topic in question.
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Protocolo de diagnóstico e tratamento da Neuropatia Diabética
(Universidade Federal do Pará, 2024-02-09) VIEIRA, Jocyelle Nascimento; FELÍCIO, João Soares; http://lattes.cnpq.br/8482132737976863
Diabetic neuropathy (DN) is currently the most frequently observed chronic complication of diabetes mellitus (DM) and, at the same time, the most underdiagnosed, affecting up to half of these patients, depending on the diagnostic methodology used. It generally affects individuals with a long duration of the disease (>10 years), however, it may be present at diagnosis in patients with DM2 or manifest early, within the first five years of the disease, in patients with DM1. Additionally, once diagnosed, DN is usually irreversible, but its appropriate management in patients with early diagnosis increases the possibility of regression and stabilization of the disease, considerably delaying and preventing the onset of complications. The objective of this work was to create a protocol for diagnosing and treating diabetic neuropathy in an objective and didactic manner, with a focus on helping general practitioners and specialists, both in primary and tertiary care. The protocol was prepared using the integrative literature review method, which was divided into 6 phases. The first phase consisted of preparing the guiding question to define the studies to be included and then an integrative review was carried out in the PUBMED and SciElo databases with the terms “NEUROPATHY”, “TREATMENT”, “DIAGNOSIS”, “NEUROPATHY DIABETIC” and its counterparts in Portuguese. Guidelines from the main national and international diabetes scientific societies, one book and relevant information from relevant websites were also included. After data collection and analysis, 106 materials were used as theoretical references for the preparation of this protocol. This resulted in the construction of didactic and objective tables, charts and flowcharts. The clinical applicability of the study consists of providing a tool, not only for the specialist, but for the general practitioner at different levels of health care, with the aim of enabling effective care for individuals with DN. Thus, the main contributions of the protocol were the development of a total of 20 didactic and visual tools aimed at the prevention, tracking, diagnosis and treatment of DN. 5 flowcharts, 4 charts and 2 tables are authored by the author.
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Protocolo de rastreio e tratamento da dislipidemia no paciente adulto com Diabetes Mellitus
(Universidade Federal do Pará, 2023-05-15) PALÁCIOS, Amanda de Oliveira Góes; FELÍCIO, João Soares; http://lattes.cnpq.br/8482132737976863
Diabetes mellitus (DM) is a highly prevalent metabolic disease that keep rising, and its main cause of mortality is atherosclerotic cardiovascular diseases. Classically, besides the concomitance with other comorbidities that increase this risk, DM presents a dyslipidemic triad also favorable to this outcome: increased triglycerides, reduced HDL-c, and formation of small and dense LDL-c molecules. Aiming to guide the appropriate treatment of dyslipidemia in diabetic patients, it is necessary to prepare a scientific material that addresses the subject in a didactic manner, based on current scientific evidence and adapted to the reality of the Brazilian population. The protocol developed fulfills this purpose and, for this, it was carried out an integrative review of the literature in the PubMed database. As a result, flowcharts, tables, and figures were elaborated to guide the drug treatment of hypercholesterolemia and hypertriglyceridemia according to established goals after defining the cardiovascular risk. The stratification of this risk was intentionally made through criteria that would make this assessment feasible regardless of the use of calculators or other means, giving autonomy to the professional performing it. The material aims to serve from primary to tertiary care and is indicated for general practitioners and specialists.
Acesso aberto (Open Access)
Protocolo nutricional no Diabetes Mellitus Tipo 2
(Universidade Federal do Pará, 2022-08-29) PALHETA, Rayelly Cíntia Ataíde; GOMES, Daniela Lopes; http://lattes.cnpq.br/0014255351015569; FELÍCIO, João Soares; http://lattes.cnpq.br/8482132737976863
Type 2 diabetes mellitus (T2DM) is a disease with high prevalence worldwide, representing about 90 to 95% of all diabetes mellitus (DM) cases, resulting from increased peripheral insulin resistance associated with a deficient insulin secretion, which may remain undiagnosed for years. Nutritional care in T2DM is essential in the treatment of the disease, being able to improve glycemic control and to reduce glycated hemoglobin in a range of 1% to 2%. Therefore, it is essential to know nutritional strategies to patients with diabetes, in order to reach an adequate glycemic control through individualized treatment. Thus, this work objectives to develop a nutritional protocol based on a rapid review in Pubmed and LILACS databases, searching for up-to-date references with a high level of scientific evidence, in addition to the guidelines of the main scientific national and international diabetes societies. We also rely on the authors' clinical experience and publications on nutritional therapy in T2DM, in order to create didactic and objective flowcharts for glycemic, lipid and blood pressure control, as well as for weight loss in T2DM, which aim to help health professionals in the approaching of these patients, as for the primary health care scenarios, as well as for the secondary and tertiary levels.
Acesso aberto (Open Access)
Retinopatia em pacientes hipertensos e/ou diabéticos em uma unidade de saúde da família
(Universidade Federal do Pará, 2014-04) ALVES, Aline Pinto; SANTOS, Reny Wane Vieira dos; ALMEIDA SOBRINHO, Edmundo Frota de; ROCHA, Sheila Patrícia Lopes; LOCH, Ana Cláudia Nóbrega
Purpose: To identify the prevalence of abnormal ophthalmoscopy in patients with systemic hypertension (SH) and / or diabetes mellitus (DM) in a Family Health Unit (FHU). Method: was performed a individual study, observational, primarily descriptive and crosssectional of a sample of a cohort of 50 patients with hypertension and / or diabetic enrolled in the program HIPERDIA in a FHU of the city of Ananindeua – Para, between the months of september and november 2009. Results: ophthalmoscopy was performed in 46 patients and 27 (58.7%) had some alteration. When performing a specific analysis (excluding the findings of arteriolar narrowing and venous engorgement) were changes in 18 (39.1%), 45.5% with DM and SH, 40% with DM and 36% with SH. Conclusion: The high prevalence of the changes in ophthalmoscopy found in this study demonstrates that effectiveness as a screening method in the context of primary health care, justifying that use. corroborates also the importance of primary care in the prevention of diabetic and hypertensive retinopathy, through periodic control of patients at high vascular risk as the population studied.
Acesso aberto (Open Access)
O uso da planta “pata–de–vaca” (Bauhinia Forficata) no tratamento do diabetes mellitus: um estudo na feira do Ver–o–Peso em Belém–Pará, Amazônia, Brasil
(Universidade Federal do Pará, 2021-12-14) SILVA, Bruna Leticia Rosário da; SILVA, Iracely Rodrigues da; http://lattes.cnpq.br/5393264898435715; OLIVEIRA, Euzébio de; http://lattes.cnpq.br/1807260041420782; https://orcid.org/0000-0001-8059-5902
The Ver–o–Peso fair, located in Belém do Pará, is considered the largest open market in Latin America. There, a large number of plant species with varied medicinal properties are for sale, being used by residents of the city of Belém and metropolitan region for the treatment of numerous diseases. Despite this, many plants have not yet been scientifically identified/registered or patented by the pharmaceutical industry for their various uses and medicinal properties, which have been used, often for centuries, through traditional knowledge and ways. This work aims to characterize the forms of therapeutic/medicinal uses of the plant species known as “pata-de-vaca” (Bauhinia Forficata), in the treatment of Diabetes Mellitus, in the urban region of Belém do Pará, also verifying what they are. the active principles of this plant species that influence its effectiveness for the treatment of this disease. The research has a qualitative methodological approach, carried out through field research, using as data collection instruments, the application of free listing, interviews with key informants, application of forms/questionnaires, direct observation, audio recording of respondents and photographic records of the studied plant. The results of this research show that the urban region of the city of Belém do Pará has a large framework of traditional knowledge about medicinal plants and is very familiar with the practices employed in the use of medicinal plants that are used for health care. With that, the conclusion of this work, which in this case the research focus was the Bauhinia Forficata, showed that this plant has great commercialization and revealed efficacy when used for the treatment of Diabetes Mellitus. The findings also contributed to the recognition and appreciation of local knowledge and practices on the "pata-de-vaca" (Bauhinia Forficata) that are present in the urban region, and are being applied/used for treatment and consequent promotion of quality of life of diabetic patients.