Programa de Pós-Graduação em Atenção e Estudo Clínico no Diabetes - PPGDIABETES/UFPA

URI Permanente desta comunidadehttps://repositorio.ufpa.br/handle/2011/17108

Navegar

Agora exibindo 1 - 20 de 32

Acesso aberto (Open Access)
Abordagem multiprofissional na assistência ao paciente com Diabetes Mellitus: uma revisão integrativa
(Universidade Federal do Pará, 2022-08-30) SANTOS, Grace Kelly Cabral dos; PIANI, Pedro Paulo Freire; http://lattes.cnpq.br/6434100473666705
Diabetes Mellitus (DM) as a chronic disease without visible symptoms at its beginning may have particular effects on the behavior of patients, as well as raising ways of how to approach the population in terms of regards its prevention. The symptomatological silence in the initial phase of the disease has repercussions on preventive behaviors and the chronicity of the disease, is an aspect that can favor the establishment of habits that become a patient's lifestyle or it can reduce care due to fatigue in following diets or guidelines, which implies another lifestyle in which guidelines about the disease are not the patient's priority. The component of subjectivity must be considered in any approach to disease in a health system that involves promotion, prevention, treatment and rehabilitation. Here, subjectivity is understood as individual processes that directly imply adherence to health treatment (GUIMARÃES; MENEGHEL, 2003). DM is a metabolic disorder characterized by hyperglycemia persistent, due to deficiency in insulin production or action, or in both mechanisms (SOCIEDADE BRASILEIRA DE DIABETES, 2019). DM is a rapidly growing public health problem throughout the world. world. By 2021, the International Diabetes Federation projected that 16% of world population between 20 and 79 years of age, living with diabetes. And the estimate for the year 2045, it will be approximately 783 million people with Diabetes (INTERNATIONAL DIABETES FEDERATION, 2021). In the Americas, estimates are that 62 million individuals live with DM, and these numbers tend to increase each year. To contain the advance of DM, there is a global agreement to reduce the number of DM and Obesity by the year of 2025 (PAHO, 2021a).
Acesso aberto (Open Access)
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)
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.
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 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)
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.
Acesso aberto (Open Access)
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.
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.
Acesso aberto (Open Access)
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.
Acesso aberto (Open Access)
Construção de um protocolo de exercícios físicos para o atendimento a pessoas com diabetes mellitus tipo 2: revisão rápida
(Universidade Federal do Pará, 2022-08-30) RIBEIRO, Andressa Karoline Pinto de Lima; TORRES, Natáli Valim Oliver Bento; http://lattes.cnpq.br/1927198788019996; https://orcid.org/0000-0003-0978-211X
Type 2 Diabetes Mellitus (DM2) accounts for 90-95% of all diabetes cases. This form covers individuals with relative insulin deficiency and peripheral insulin resistance. Physical exercise is an efficient therapeutic strategy for the treatment of people with DM2 as it contributes to glycemic control, as well as reducing cardiovascular risk factors, increasing physical fitness, contributing to body weight control and improving people's quality of life. Objective: Formulate a physical exercise protocol aimed at health professionals for the treatment and maintenance of glycemic control of adults with type 2 Diabetes Mellitus. Methodology: The study consists in the elaboration of the protocol from a rapid review in search of studies who investigated the effects of physical exercise on the glycemic control of adults with type 2 Diabetes Mellitus (DM2) to analyze which exercise parameters (modality, frequency, volume, intensity, interval and progression) are recommended to achieve better glycemic control in the population of interest. The PICOT strategy was adopted for the elaboration of the inclusion criteria of the studies and the PRISMA protocol for the writing of the manuscript. PubMed and LILACS databases were used. The study selection process took place through 4 steps: identification, selection by title and abstract, eligibility assessment and inclusion. Two authors independently extracted data on population, intervention and outcome from each study, and the extracted information was organized into tables. The methodological quality of each study was analyzed based on the PEDro scale (PROSPERO - CRD 42021262614). Results: From a total of 1152 articles, 17 studies met the inclusion criteria and were analyzed. A total of 1,141 (745 in exercise groups and 396 in sedentary control groups) people with T2DM were included. Regarding the type of study, 15 (88.2%) were randomized clinical trials and 2 (11.8%) were non-randomized clinical trials. The age of patients ranged from 45.6 to 61.7 years. The mean intervention time was 17 weeks, ranging from 9 to 48 weeks. Six studies 35.3% reported that no adverse events occurred during the intervention, two (11.8%) reported some event and nine (52.9%) did not present any information. The theoretical basis obtained from the rapid review and other studies supported the construction of a guidance protocol for professionals about physical exercise as a treatment for DM2 and management of glycemic control. The following elements were elaborated: frameworks of concepts, flowcharts and explanatory texts constructed with objective and easy-to-understand language as didactic tools in order to assist in the outpatient routine of professionals responsible for prescribing exercises in the management of patients treated at all levels of care of the Unified Health System (SUS). Discussion: Aerobic, resistance and combined training are associated with decreases in HbA1c, fasting glucose or postprandial glucose. however, combined training should be prioritized as they appear to have greater effects on glycemic control than either method alone. Conclusion: The protocol created from this review aims to offer professionals working at the various levels of health care in the SUS, updated, objective information, presented in a didactic way about physical exercise as a form of treatment for DM2. It is recommended that physical exercise protocols include both resistance and aerobic exercise, as their effects are greater on glycemic control than either method alone.
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)
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.
Acesso aberto (Open Access)
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).
Acesso aberto (Open Access)
Exercício físico e controle glicêmico em pacientes com diabetes mellitus tipo 1: uma revisão rápida e proposta de material informativo e didático
(Universidade Federal do Pará, 2022-08-28) OLIVEIRA, Adriana Alves; TORRES, Natáli Valim Oliver Bento; http://lattes.cnpq.br/1927198788019996; https://orcid.org/0000-0003-0978-211X
Diabetes Mellitus (DM), which is characterized by a metabolic disorder that causes hyperglycemia in affected patients, is currently one of the major public health problems, as it affects more and more people around the world and generates increasingly high costs. . Among its classifications, there is Type 1 Diabetes Mellitus (DM1), which is the focus pathology of our study. DM1 may have an unknown or autoimmune origin, attacking the beta cells of the pancreas, which produce insulin, the hormone responsible for capturing glucose into the cells. As a result, glucose is not captured to generate energy, causing hyperglycemia in the body, in addition to not controlling hepatic gluconeogenesis. People who have DM1 can present different types of complications, whether micro (nephropathies, neuropathies, retinopathies) or macrovascular (coronary diseases and/or stroke), hence the importance of promoting adequate glycemic control in these patients, in order to prevent such complications. For this, several studies have shown that in addition to a balanced diet and drug treatment, it is important to include regular physical exercise in the routine of patients with this metabolic syndrome. Therefore, the objective of this work was to analyze the effects of physical exercises on the glycemic control of patients with DM1, through a quick review of the literature (PROSPERO nº CRD42021277762), to develop an informative booklet for professionals who work with such patients, in addition to the creation of didactic material for discussion on the introduction of physical exercises in the routine of people with type 1 Diabetes Mellitus (CAAE 39536920.5.0000.0017). Our review of the literature points out that, regardless of the modality practiced, performing physical exercises has several health benefits, such as reduced medication dosage, improved physical well-being, cardiovascular conditioning, improved insulin resistance, lipid profile, among others. others. From the theoretical basis through a quick review and reading of guiding positions and documents from societies, in addition to reading recent and relevant articles for the care of the person with diabetes, an informative booklet was built aimed at health professionals and didactic material for discussion about the introduction of physical exercises in the routine of people with type 1 Diabetes Mellitus. The booklet has two main parts: a first theoretical part, constructed in an objective and synthetic way, composed of information about diabetes, its pathophysiology, main complications and the effects of physical exercise on people with DM1, in addition to a flowchart to guide the decision on the indication and safety for the practice of physical exercises according to blood glucose and risk factors. The second part of the booklet was constructed in an illustrative way to configure itself as a didactic instrument for the discussion with health professionals about the necessary information and care, prior to the beginning of an exercise program, in order to guarantee patient safety. This second part was composed of dialogues between the character Bete (person with DM1) and the professional (Dr. Cinesia).
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 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.
Acesso aberto (Open Access)
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.
Acesso aberto (Open Access)
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.