Navegando por Assunto "Diabetes Mellitus Tipo 1"

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Adesão ao tratamento por pacientes portadores de diabetes tipo 1 e tipo 2: efeitos do treino de discriminação de dicas internas e externas
(Universidade Federal do Pará, 2003-03-01) BRANDÃO, Washington Luiz de Oliveira; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723; TOURINHO, Emmanuel Zagury; http://lattes.cnpq.br/5960137946576592
The present study aims to compare the results of discriminatioll training of symptoms and actions related to the treatment of Type I and Type 2 diabetes, evaluating the effectíveness of these trainings for the estimation of glicemic levels and adherence to the treatment. A countless number of surveys carried on in the Health psychology field has the goal of improving the treatment to diabetic patients. Part of these surveys use a procedure caUed general blood glucose selfmonitoring which is based on skills such as observation, checking and registering the relevant aspects in the treatment of diabetes such as: (a) glícemic leveI (GL); (b) symptoms (internal cues - 1C); and (c) actions related to the treatment such as medication, nourishment and physical activity (external cues - EC). The studieshave shownthat general blood glucose.self-monitoring helps the patients to improve the levei of discrimination ofthe glicemic a1terations. This 1iterature is not clear about defining which is the best cue to the used to improve the discrimination of the glicemic levels and states that the development of this skill does not enhance the adherence to the treatment. This study was made of three distinct phases: (a) Baseline and introdutory interview; (b) Trainings interviews; (c) Devolutive final interview. The training phase is divided ln two parts - Internal Cues (IC) and External Cues (EC). During the training phases the participants estimated and assigned a cause to the glicemic leveI on their blood stream measured by a memory-containing reflectometer in the interviews. During in the EC, the participantes also received a feedback from the researcher about the report of the directions followed, based on the directions given by medical advice and compiled from medical registers ofthe patients. 1ts rate of adherence (RA) was measured in the two first phases. The training interviews were conducted at 'the participant's home, in the intervals of 3 days, during which the participants registered the events which took place during corresponding phase. The results showed that independently of the type of training which was accomplished, the participants estimated their glicemic levels based on external cues. The symptoms related to 1Cphase were not always associated to glicemic leveI measured. The participants with diabetes Type 1 reached a higher degree of precision on their estimations during the EC training. The majority of participants had higher degree of the adherence to the treatment when they stared by the EC training. The results suggest that: (a) the reports of the symptoms are not the best indication to evaluate glicemic leveI and adherence of treatment; (b) the best type of training to enhance the adherence to the treatment is the one which involves external cues
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Associação entre saúde mental e hábitos alimentares em indivíduos com Diabetes Tipo 1 durante o distanciamento social pela pandemia de COVID-19 no Brasil
(Universidade Federal do Pará, 2021-07-02) AINETT, Waléria do Socorro de Oliveira; GOMES, Daniela Lopes; http://lattes.cnpq.br/0014255351015569
Social distancing was considered by the World Health Organization (WHO) as the strategy to combat the COVID-19 pandemic, in order to prevent the spread of the disease, but this strategy caused a series of changes in people's social lives, including disabled persons. Type 1 Diabetes Mellitus (T1DM). Changes in mental health are often associated with diabetes, which can result in lower adherence to treatment and worse outcomes related to the management of the disease. Considering that the context experienced during social distancing can affect the mental health and eating habits of individuals with T1DM, the present study aimed to evaluate the association between mental health and eating habits of individuals with T1DM during social distancing by COVID-19 in Brazil. This was a cross-sectional study carried out in July 2020 using an online form. Sociodemographic and economic data, mental health perception through the adapted DSM-5 Level 1 Symptoms Scale - adult - were used, in addition to data on eating habits, through the consumption pattern of fruits, vegetables, sweets, ultra-processed foods, cooking habits, number of daily meals, change in food and water use. The results showed that participants who perceived moderate and severe symptoms of depression and anxiety had a positive association with increased food consumption in general, especially sweets and ultra-processed foods, such as snacks (snacks and cookies), as well as having a positive association with reduced fruit consumption and reduced cooking habits. Individuals with lower perceptions of symptoms of depression and anxiety showed a negative association with bad eating habits. It was evidenced that situations of social distancing, such as the one caused by the COVID-19 pandemic, can affect the mental health of individuals with T1DM, in this way, greater perceptions of symptoms of depression and anxiety can cause changes in consumption and food choices, affecting self-care and adherence to nutritional therapy recommended for this population.
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Avaliação da qualidade de vida de pacientes com Diabetes Mellitus tipo 1: dados do primeiro estudo multicêntrico no Brasil
(Universidade Federal do Pará, 2013) SOUZA, Ana Carolina Contente Braga de; FELÍCIO, João Soares; YAMADA, Elizabeth Sumi; http://lattes.cnpq.br/8482132737976863; http://lattes.cnpq.br/7240314827308306
The type 1 diabetes mellitus type 1 (T1DM) is the most common endocrine disease of childhood and adolescence and it negatively impacts the quality of life (QOL). The EuroQol is an instrument that assess the health state. It has been used in most global multicenter studies in diabetes and it has been shown to be an extremely useful and reliable tool. The aim of this study is to evaluate the QOL of patients with T1DM in Brazil, a country of continental proportions, by analyzing the EuroQol. For this purpose, we performed a retrospective and cross-sectional study, which analyzed questionnaires from patients with T1DM, answered in the period of December 2008 to December 2010 in 28 research centers in 20 cities of the four regions (Southeast, North-Northeast, South and Midwest). We also collected data about chronic micro and macrovascular complications and lipid profile. The assessment of quality of life by EuroQol shows that the average score assigned to general health is markedly lower than those found in two other T1DM population studies conducted in Europe (EQ – VAS from Germany, Netherlands and Brazil were 82.1 ± 14, 81 ± 15 and 72 ± 22, respectively). The EuroQol shows that the North-Northeast region has the best index in the assessment of the overall health status compared to the Southeast and lower frequency of self-reported anxiety -depression, compared to other regions of the country (North-Northeast = 1.53 ± 0.6, Southeast = 1.65 ± 0.7, South = 1.72 ± 0.7 and Midwest = 1.67 ± 0.7, p <0.05). Additionally, several known variables (age, duration of diabetes, physical activity, HbA1c, fasting glucose, and presence of chronic complications correlated with QOL (r = -0.1, p <0.05, r = -0.1, p <0.05, r = -0.1, p <0.05, r = -0.2, p <0.05, r = -0.1, p <0.05 and r = -0.1, p <0.05, respectively). This is the first population study to evaluate the quality of life of patients with type 1 diabetes in the south hemisphere. Our data indicates poorer quality of life of patients with T1DM in Brazil when compared to data from European countries. Although we found an inferior diabetes duration and lower presence of microvascular complications in the North -Northeast region compared to other regions, our data suggests the existence of additional factors responsible for better QOL and lower presence of anxiety-depression found in this region. More studies are necessary to identify these possible factors.
Acesso aberto (Open Access)
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)
Caracterização da adesão ao acompanhamento nutricional por adultos com Diabetes Mellitus Tipo 1 durante a pandemia de COVID-19 no Brasil
(Universidade Federal do Pará, 2024-02-23) TOMPSON, Amanda Cristina Cunha; GOMES, Daniela Lopes; http://lattes.cnpq.br/0014255351015569
Diabetes Mellitus (DM) is a chronic disease with complex treatment, therefore, it is believed that adherence to nutritional treatment has been impaired during the Covid-19 pandemic. Maintaining nutritional care online is a strategy to improve adherence to healthy eating, which improves glycemic control and prevents clinical complications of DM. The objective of this study was to characterize adherence to nutritional monitoring of adults living with DM1 during the COVID- 19 pandemic in Brazil. This is a descriptive and analytical cross-sectional study, carried out in July 2020. An online form was used to collect sociodemographic and economic data, characteristics of nutritional monitoring and eating habits, as well as social distancing of adults diagnosed with DM1 residents in Brazil. Pearson's Chi-Square test was applied, with adjusted residual analysis, considering a statistical significance level of p<0.05. Of the 472 participants, 86.02% were female, 62.50% lived in the capital or metropolitan region and 32.42% had a family income between 3 and 5 minimum wages. When evaluating nutritional monitoring, 62.08% did not undertake and maintained non-adherence to nutritional monitoring during the pandemic, 4.66% of participants maintained nutritional monitoring online and 2.12% maintained these consultations in person. Having better education (p=0.048) and income (p=0.009) was associated with maintaining online nutritional monitoring. A positive association was found between adequate consumption of fruits (p=0.001) and vegetables (p=0.049) and maintaining online or in-person and online nutritional monitoring. There was a positive association between starting face-to-face nutritional monitoring and consuming less food via delivery (p=0.024). Maintaining or starting to follow-up in person or online was associated with adhering to carbohydrate counting (p=0.047). Adhering to telenutrition consultations is an innovative and complementary alternative to DM healthcare.
Acesso aberto (Open Access)
Cartilha nutricional para pessoas com Diabetes Mellitus Tipo 1
(Universidade Federal do Pará, 2022-08-29) SOUZA, Laysa Lira de; QUEIROZ, Natércia Neves Marques; http://lattes.cnpq.br/5359261920325026
Diabetes is a chronic condition that is related to an insufficient production of insulin or an occasional deficient insulin production is diabetes in glycemic metabolism. Type 1 Diabetes Mellitus (T1D) predominantly consists of an injury to the body's own insulin-producing cells; in this case, most of them are those planned during childhood and childhood insulin to survive. The treatment of T1D involves insulin therapy, food education and physical activity, and progress has been made. Diabetes education programs are essential tools for improving metabolic control and patient inclusion in their treatment. Therefore, the objective of this study is the elaboration of a nutritional education booklet for people living with type 1 diabetes mellitus, in order to assist in the treatment. For this, educational material such as a booklet on nutrition education for people with type 1 diabetes mellitus was prepared. Through a methodological development research with a qualitative approach. The approach was structured in two stages: the first stage was the bibliographic survey that took place between the months of September 2021 to July 2022, in the databases and virtual libraries LILACS, SciELO, MEDLINE, and PUBMED, 7 relevant references were added to the topic addressed in the booklet and 5 most recent guidelines and positions from the Brazilian Society of Diabetes seeking references with a high level of scientific evidence. The second stage consisted in the elaboration of the booklet, based on the scientific content obtained through the previous stage. The material was produced using an easy-tounderstand language and objective images. Comprising information about diet in T1D, carbohydrate counting strategies, elaboration of tables in the identification of food groups in the search to offer autonomy and information about food in T1D. And after the preparation of the material, the objective is to validate it, through considerations of selected judges with expertise in the subject.
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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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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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Efeitos de regras sobre comportamentos de cuidados com os pés em pessoas com diabetes
(Universidade Federal do Pará, 2011-11-18) NAJJAR, Enise Cássia Abdo; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723; ALBUQUERQUE, Luiz Carlos de; http://lattes.cnpq.br/5261537967195189
The amputation of lower limbs is one of the Diabetes Mellitus (DM) complications caused by diabetes foot. Simple preventive measures focused on foot care behavior care are significant help in prevention against diabetes foot. Due to the high severity and prevalence of diabetes foot, several studies have been made aiming to identify variables which contribute to improve adhesion to preventive measures concerning foot care of diabetes patients. However, it has not yet become clear which factors contribute to establish and maintain foot care behavior. The proposal of this study was to identify variables which contribute to establish and maintain foot care behavior, thus contributing to avoid diabetes feet in people with diabetes. The thesis is divided into three studies: the first one, transversal descriptive, was characterized as a baseline for the other two, which were experimental. The research was developed in a basic health unit in the city of Belém, Pará Brazil. The first study investigated: the rules (orientations) related to foot care presented to patients with diabetes by health professionals of the Hiperdia; the behavioral repertoire of 54 participants with diabetes on foot care; the state of feet health care of participants with diabetes. The second study investigated the effect of rules in the establishment and maintenance of foot care behavior in people with diabetes, manipulating, or not, the presentation of questions on foot care; and, if the patient were receiving foot examinations. The third one investigated, on 16 patients, the effects of rules in the establishment and maintenance of foot care behavior of people with diabetes, when: (a) reports that rule following of foot care produced social reinforcement; (b) the patients were presented with rules which explained why foot care rules should be followed; (c) they were presented rules that specified justifications on why foot care rules should be followed, and the report on following foot care rules produced a social reinforcement; (d) report on foot care rule following did not produce social reinforcement and the rules presented did not have the justifications for foot care. Results from Study 1 indicated that the presentation of instructions on foot care by health professionals is insufficient, the behavioral repertoire of foot care is precarious, and there is possibility of risks in developing diabetes foot among the patients. In general, the manipulations carried out on both Study 2 and 3 favored an increase of new behavior on foot care in the participants’ behavioral repertoire. These data suggest that foot care rule following depends on: (a) contact with aversive consequences caused by following or not of rules; (b) the presentation of questions which favor behavior self-destruction; (c) the presentation of social reinforcement; (d) the presentation of justifications to the emission of behavior; (e) combined presentation of justifications for the emission of behavior and the consequences for the behavior emitted; (f) exposition to a greater number of favorable conditions to rule following; (g) pre-experimental historic of rule following; and, (h) monitoring of rule following behavior by health professional.
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Protocolo de abordagem nutricional no Diabetes Mellitus Tipo 1 no estado do Pará para profissionais de saúde
(Universidade Federal do Pará, 2022-08-26) TEIXEIRA, Marcela Rassy; GOMES, Daniela Lopes; http://lattes.cnpq.br/0014255351015569
The main objective of this dissertation is to develop a nutritional therapy protocol in Type 1 Diabetes Mellitus for professionals. This is a methodological study, which is a product of the Postgraduate Program in Attention and Clinical Study in Diabetes - PPGDIABETES of the Federal University of Pará - UFPA. With the title of "Creation and validation of protocols for associated interventions for the control of Diabetes Mellitus in Primary Health Care", from the João de Barros Barreto University Hospital (HUJBB) - UFPA, approved by the Research Ethics Committee of the HUJBB (opinion number 4. 481,093) and carried out in 2021, which aims to build and evaluate intervention tools by pilot test. A literature review was carried out, with a search for current and relevant topics for clinical practice, using this information to build the protocol that was later submitted to the pilot test and evaluated by two nutritionists specializing in the area of diabetes mellitus, to adjust appearance and content. . As a result, algorithms, tables and charts were developed to guide the nutritional approach protocol that includes the following variables: summary of diagnostic criteria and glycemic goals, stages of readiness for behavior change, anthropometric assessment, proposal of food diaries, recommendations nutritional supplements, proposal of therapeutic steps for the use of technology in diabetes, dietary strategies and updating of a Carbohydrate Count Table adapted to the North region. It is concluded that the present protocol can be considered for outpatient follow-up and in food and nutrition education activities for patients with type 1 diabetes mellitus, in order to support professionals during clinical practice.