Protocolo clínico para o atendimento de análogos de insulina às pessoas com diabetes mellitus na rede pública de saúde do município de Belém-Pará

Abstract

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.