A dança jazz como estratégia de cuidado ao adolescente com Diabetes Mellitus Tipo 1: um relato de caso

Abstract

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.