Navegando por Assunto "Type 2 Diabetes Mellitus"

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Abordagem nutricional em pessoas com Diabetes Mellitus Tipo 2: protocolo para nutricionistas da atenção primária à saúde
(Universidade Federal do Pará, 2023-12-13) QUEIROZ, Samara da Silva; CARVALHAL, Manuela Maria de Lima; http://lattes.cnpq.br/0708921042608519; HTTPS://ORCID.ORG/0000-0003-1397-0471; GOMES, Daniela Lopes; http://lattes.cnpq.br/0014255351015569
The nutritionist plays an important role in Primary Health Care (PHC) to promote Food and Nutritional Education (FNE) to users with DM2, aiming to achieve better glycemic management, mitigate complications arising from the disease and offer an improvement in the quality of life of these people. Therefore, this work aims to develop a protocol for nutritional management with a focus on DM2 to be used by nutritionists working in PHC. This is a methodological, developmenttype study, divided into three phases: bibliographical survey; preparation of illustrative material and validation of content, appearance and applicability of the material by expert judges and APS nutritionists. To prepare the protocol, an integrative review was carried out to define the content based on the needs found by PHC nutritionists. For validation, two instruments were used in electronic format: a form for content validation and another for apparent validation. The data obtained was compiled and stored in the Microsoft Office Excel version 2016 program. For data analysis, the Content Validity Index (CVI) was applied to the panel of experts. In the analysis of data judged by the target audience, items with a minimum level of agreement of 75% in positive responses were considered validated. This study is part of the project entitled “Creation and validation of protocols for associated interventions to control Diabetes Mellitus in primary health care” and all ethical aspects were respected, in accordance with Resolution 466/12, of the National Health Council. In validation content, the overall CVI average was 0.92, indicating an excellent degree of agreement among experts. Regarding validation with the target audience, a degree of agreement greater than 75% was obtained. At the end, the material was reviewed, adapting the protocol and creating illustrations. Given the above, it is concluded that the tool was validated, which attests to the effectiveness, relevance and applicability of the technology.
Acesso aberto (Open Access)
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.
Acesso aberto (Open Access)
Impactos do Diabetes Mellitus Tipo 2 na qualidade de vida da população amazônica: a importância da atuação da equipe multiprofissional
(Universidade Federal do Pará, 2024-08-01) TORRES, Luana Cristina Fiel; PIANI, Pedro Paulo Freire; http://lattes.cnpq.br/6434100473666705
In the diagnosis of Type 2 Diabetes Mellitus (T2DM), the individual produces insufficient insulin, and the group most affected by this disease are people over 30 years old, obese or overweight, caused by the result of the relationship between hereditary and environmental factors and/or associated with population aging and an unhealthy lifestyle, with low frequency of physical activity, obesity and inadequate diet. T2DM is a chronic disease associated with high morbidity and mortality and impaired Quality of Life (QoL) and represents a public health problem due to its increased incidence and prevalence. The objective of this research was to present the possible association between QoL and T2DM and the evidence regarding the impacts of factors such as the performance of the multidisciplinary team. For this purpose, a cross-sectional study was carried out with 30 patients, in which two scales were applied and analyzed: the “B-PAID” and the WHO Quality of Life (WHOQOL – Brief), from October 2023 to June 2024, at the Endocrinology outpatient clinic of the João de Barros Barreto University Hospital - Belém - PA, in addition to the sociodemographic survey such as gender, age group, race/ethnicity, municipality, team and complications of DM2. Through this study, a profile of participants was obtained, these being people of both genders, aged between 50-69 years, brown, who lived in Belém, had greater monitoring by the endocrinologist and the nurse and had as main complications hypertension and dyslipidemia. The results found after analyzing the climbs were that this participant profile had as risk factors their QoL, economic variables, physical pain as an impediment to performing their routine activities, the feeling of not having clear goals for their treatment; not knowing how to deal with complications resulting from DM2 and a future of possible worsening of these. Subsequently, the participants were divided into two groups: “participants accompanied by up to two professionals” and “participants accompanied by three or more professionals” and the result obtained was that the latter group had the possibility of greater success in their treatment and better quality of life.
Acesso aberto (Open Access)
A influência de polimorfismo de genes associados a remissão do Diabetes Tipo II, em pacientes operados de cirurgia bariátrica e metabólica pela técnica de by pass gástrico em Y-de-Roux
(Universidade Federal do Pará, 2024-09-26) BITAR, Daniel Fadul; KHAYAT, André Salim; http://lattes.cnpq.br/6305099258051586; https://orcid.org/0000-0002-3451-6369
Introduction: Obesity is the main risk factor for the development of type 2 diabetes mellitus (T2DM), characterized by a progressive loss of pancreatic function, resulting from genetic and environmental changes. Among the genetic changes are variants in key genes responsible for glycemic homeostasis, including GLP1R and TCF7L2. The genetic dysfunction of these genes decreases insulin secretion by β-pancreatic cells, influencing glycemic control. Objective: To evaluate the influence of genetic polymorphisms on the remission of type II diabetes in patients undergoing bariatric and metabolic surgery using the Roux-en-Y gastric bypass technique. Methodology: The research was approved by the ethics and research committee under number 6.158.558 and included a total of 70 patients who underwent bariatric surgery using the bypass technique. Two blood samples were collected, one for laboratory analyses (glucose, cholesterol, triglycerides, glycated hemoglobin, C-peptide) and another for genetic polymorphism analyses. Genomic DNA was extracted using the phenol-chloroform protocol and subsequently analyzed for quantification, purity, and integrity of the extracted samples. For polymorphism analysis, real-time PCR (RT-qPCR) was performed with specific Taqman probes on the ABI 7500 equipment. Statistical analyses were performed using the SPSS 29.0 program. Student's t-test and Spearman's correlation were used to evaluate clinical and biochemical factors. Fisher's exact test and Chi-square were used to analyze the correlation of the presence of variants. Significant values were considered with a p-value ≤ 0.05. Results: Regarding the rs10305420 polymorphism of the GLP1R gene, this variant decreases proportional weight loss over the years and increases glycated hemoglobin after bariatric surgery (p-value = 0.04). The rs7903146 polymorphism of the TCF7L2 gene influences glycated hemoglobin levels, increasing it after gastric bypass (p-value = 0.036). Conclusion: The rs10305420 variant of the GLP1R gene decreases proportional weight loss over the years and increases glycated hemoglobin A1C fraction; and the rs7903146 variant of the TCF7L2 gene in the presence of the T allele also influences the outcome of bariatric and metabolic surgery using the Roux-en-Y gastric bypass technique, increasing the glycated hemoglobin A1C fraction postoperatively and decreasing the remission of type 2 diabetes in patients undergoing this surgical procedure.
Acesso aberto (Open Access)
Protocolo de tratamento medicamentoso no Diabetes Mellitus Tipo 2
(Universidade Federal do Pará, 2022-04-30) JANAÚ, Luísa Corrêa; QUEIROZ, Natércia Neves Marques de; http://lattes.cnpq.br/5359261920325026; FELÍCIO, João Soares; http://lattes.cnpq.br/8482132737976863
Type 2 diabetes mellitus (DMT2) is a disease of high global prevalence, affecting millions of people worldwide. It is responsible for a range of complications, both microvascular (retinopathy and nephropathy) and macrovascular (peripheral arterial disease, atherosclerosis and cerebrovascular diseases) that have a great impact on the quality of life of affected patients and that demands high costs from the public health network. In order to avoid these complications in patients with T2DM, it is essential to maintain glycemic control through individualized treatment, considering both clinical and socioeconomic aspects, essential for good adherence and, consequently, adequate control of glycemic parameters. In view of this, the objective of this thesis was to elaborate a clinical protocol for the treatment and glycemic control of DMT2. For this, a rapid review was carried out in the Pubmed and LILACS databases, searching for references with a high level of scientific evidence. There were also used guidelines from the main national and international diabetes scientific societies, as well as the expertise and publications by the research group in endocrinology and diabetes of the Federal University of Pará in the area. This resulted in a total of 195 publications (7 of which were authored by the group) included as a theoretical reference for the elaboration of the protocol. Based on this, explanatory texts, 10 concept tables and 6 didactic and objective flowcharts focused on individual characteristics of diabetics were generated in order to aid general and specialist physicians in the management of patients treated at the 3 levels of care of the Brazilian Unified Health System, aimed at preventing complications and reducing public spending. The strengths of the protocol were: the creation of a flowchart linking the diagnostic criteria to the glycemic targets for each test; initial treatment flowchart based on blood glucose levels at the time of diagnosis; flowchart with low-cost medication options for socially vulnerable patients; and creation of an insulin therapy flowchart incorporating the findings of the PARADIGM study, authored by the group.
Acesso aberto (Open Access)
Vitamina D, qualidade de vida e alto risco de depressão em indivíduos com Diabetes Mellitus Tipo 2 e Doença Renal Diabética: um estudo transversal
(Universidade Federal do Pará, 2024-02-23) REIS, Melissa de Sá Oliveira dos; FELÍCIO, João Soares; http://lattes.cnpq.br/8482132737976863
Clinical Depression is highly prevalent in patients living with Diabetic Kidney Disease (DKD) and Diabetes Mellitus 2 (DM2) and is related to high morbidity and mortality, in addition, Health-Related Quality of Life (HRQoL) is also potentially impacted in these patients. Vitamin D (VD) deficiency has been associated with depression and worse HRQoL in patients with DRD. This study aims to investigate the association between vitamin D levels, HRQOL and depression in patients with DRD who are not receiving dialysis treatment. To this end, this was a cross-sectional study, which included 51 patients with DM2 and DRD, not on dialysis and with severely elevated albuminuria, treated at the João de Barros Barreto University Hospital. To measure depressive symptoms (SD), the Beck Depression Inventory (BDI) was used and HRQoL was analyzed using the EQ-5D-5L instrument. Additionally, the Glomerular Filtration Rate estimate was calculated by CKD-EPI Refit. Result: The prevalence of depression was 46.9% and was strongly associated with quality of life levels assessed by the EQ-5D. Impacting both domains and utility indices (Domain “Pain and discomfort” 0.7±0.8 vs 1.1±0.8, p<0.05; Utility index “United States” 0.89 [0.78-1] vs 0.71[0.60-0.84], p<0.05). Worse quality of life was even associated with the severity of depression. With regard to DV, it directly impacted HRQoL, but no direct association was found between DV and depression. Models with simple logistic regression showed that patients with peripheral neuropathy (PN) had a six times greater risk of experiencing depression (OR 6.56, R²=0.12, p<0.05). Additionally, the duration of DM2 was also important, with each year of illness increasing the risk of depression by 12% (OR 1.135, R²=0.18, p<0.05). The data suggested that depression has a high prevalence in patients with T2DM and DRD and is strongly associated with low levels of HRQoL. HV impacted quality of life, but was not directly associated with the prevalence and severity of depression.