A incidência do Diabetes Mellittus apresenta-se crescente no mundo todo, principalmente, devido à mudança no estilo de vida. A atividade física associada à alimentação balanceada é o tratamento mais indicado para o controle do diabetes, porém ainda há divergências nas recomendações e evidências científicas sobre a prescrição do exercício para indivíduos diabéticos. Esta pesquisa teve como objetivo comparar os efeitos fisiológicos do treinamento em esteira e do treinamento resistido na intensidade do limiar anaeróbio em indivíduos diabéticos tipo 2, com ênfase na monitorização contínua da glicose. Para isso, três grupos de diabéticos tipo 2 foram selecionados: um grupo foi submetido à seis semanas de treinamento em esteira na intensidade do limiar anaeróbio (18 sessões de 30 minutos), um grupo foi submetido à seis semanas de treinamento resistido na intensidade do limiar anaeróbio (10 sessões de seis exercícios) e um grupo foi controle. Foram analisadas as seguintes variáveis antes e após a intervenção: hemoglobina glicada, glicemia de jejum, frutosamina, cinética da glicose intersticial monitorizada continuamente, colesterol, triglicérides, intensidade do limiar anaeróbio em esteira, intensidade máxima do teste ergoespirométrico, consumo de oxigênio na intensidade do limiar anaeróbio, consumo máximo de oxigênio e volume do teste de fadiga. Também foram verificadas a frequência cardíaca, a percepção subjetiva do esforço e a glicemia casual antes, durante e após as sessões de treinamento. Foram encontradas diminuições significativas nas concentrações da glicemia de jejum e de frutosamina após o treinamento em esteira, diminuições significativas nas concentrações de triglicérides após o treinamento resistido e reduções significativas nos níveis de colesterol dos dois grupos de treinamento. O consumo de oxigênio na intensidade do limiar anaeróbio, bem como a intensidade do mesmo, aumentaram significativamente no grupo que treinou em esteira e o volume do teste de fadiga apresentou-se maior após os dois protocolos de treinamento. As médias das diferenças da frequência cardíaca e da percepção subjetiva do esforço iniciais e finais nas sessões de treinamento demonstram-se maiores no grupo de treinamento em esteira e as médias das diferenças entre a glicemia casual antes e após as sessões de treinamento apresentaram-se iguais para os dois grupos de treinamento. Não foram encontradas reduções significativas na área sob a curva da glicose monitorizada continuamente nos três grupos. Conclui-se que, para os protocolos de treinamento aplicados, o treinamento em esteira demonstrou-se mais eficaz para o controle glicêmico e para o aumento da capacidade aeróbia dos indivíduos diabéticos tipo 2. A monitorização contínua da glicose parece não ser um bom método para a verificação do controle glicêmico após treinamento físico se não for combinado ao controle alimentar. / The incidence of Diabetes Mellittus presents increasing worldwide, mainly due to the change in lifestyle. Physical activity associated with balanced diet is the best treatment to control diabetes, but there are still differences in recommendations and scientific evidence on the prescription of exercise for diabetics. This research aimed to compare the physiological effects of treadmill and resistance training in the intensity of anaerobic threshold in type 2 diabetic subjects with emphasis on continuous glucose monitoring training. For this, three groups of type 2 diabetic patients were selected: one group underwent six weeks of treadmill training on anaerobic threshold intensity (18 sessions of 30 minutes), one group underwent six weeks of resistance training intensity threshold anaerobic (10 sessions, six exercises) and one group was control. The following variables were analyzed before and after the intervention: glycated hemoglobin, fasting plasma glucose, fructosamine, interstitial glucose kinetics monitored continuously, cholesterol, triglycerides, anaerobic threshold intensity treadmill, maximum intensity of the cardiopulmonary exercise test, oxygen consumption in the intensity of anaerobic threshold, maximal oxygen consumption and volume of the fatigue test. The heart rate, perceived exertion and blood glucose levels were also checked before, during and after training sessions. Significant decreases were found in concentrations of fasting glucose and fructosamine after treadmill training, significant decreases in triglyceride concentrations after resistance training and significant reductions in cholesterol levels of the two training groups. The oxygen consumption at anaerobic threshold intensity and its intensity increased significantly in the group who trained on a treadmill and the volume of the fatigue test was higher after the two training protocols. The mean differences in heart rate and subjective perception of the initial and final effort in training sessions show up higher in the treadmill training and the mean differences between blood glucose levels before and after the training sessions had to be equal for the two groups of training. No significant reductions were found in the area under the curve of glucose monitored continuously in all three groups. We conclude that, for the training protocols applied , treadmill training has shown to be more effective for glycemic control and increased aerobic capacity of type 2 diabetic subjects. Continuous glucose monitoring does not seem to be a good method for the verification of glycemic control after physical training if not combined with diet control.

A privação do sono pode comprometer a saúde, uma vez que é durante o ciclo sono/vigília que são produzidos alguns hormônios que desempenham papéis vitais no funcionamento de nosso organismo. Distúrbios do sono em diabéticos do tipo 2, constituem fatores de risco para o agravamento do diabetes, pois podem interferir no controle metabólico através da síndrome da resistência à insulina. A apnéia do sono, insônia, movimentos periódicos das pernas, a higiene do sono e consumo de substâncias psicoativas são citados em estudos, porém pouco explorados. Ferramentas vêm sendo utilizadas na investigação acerca do ciclo sono/vigília, dentre eles o diário de sono, a polissonografia e o Índice de Qualidade do Sono de Pittsburgh (PSQI). Este é composto por sete componentes, onde é avaliada a qualidade subjetiva do sono, latência do sono, duração, eficiência habitual, distúrbios do sono, uso de medicação para dormir e sonolência diurna. O presente estudo foi do tipo observacional-transversal. A qualidade do sono foi investigada em 50 diabéticos pertencentes a um Centro Educativo de Enfermagem para Adultos e Idosos. Para tal, os pacientes diabéticos do tipo 2, após assinatura do termo de consentimento, foram submetidos a uma avaliação cognitiva inicial, através do exame do estado mental, para descartar demência. Foi aplicado um instrumento que avalia a qualidade do sono, denominado Índice de Qualidade do Sono de Pittsburgh (PSQI) e um instrumento para levantar variáveis demográficas e clínicas. A maioria dos participantes era do sexo feminino, casados, com 4 anos de estudo em média, não trabalha e possui renda mensal de 2 salários mínimos. Em relação às variáveis clínicas, 38% apresentam tempo de diagnóstico de diabetes superior a dez anos, 70% são hipertensos, 36% apresentaram valores de Hemoglobina A1c>7%, 72% com nictúria, 85% IMC equivalente à obesidade e 22% usam medicação para dormir. Os componentes do PSQI foram detalhados separadamente e obtido o escore global, sendo que (26) 52% apresentaram escores que indicam qualidade do sono ruim. A relação dos escores obtidos no PSQI com algumas variáveis foi realizada, e identificamos que aqueles com tempo de diagnóstico superior a 10 anos e aqueles com hipertensão, possuíam pior qualidade do sono. A nictúria parece não ter corroborado para uma qualidade do sono ruim. Para aqueles com valores de Hemoglobina A1c >7%, a qualidade do sono foi pior. Entre os que usam medicação para dormir e os que apresentaram IMC normal, a qualidade do sono mostrou-se pior. Os achados desta investigação reforçam a relevância da temática, pois não existem instrumentos específicos para a avaliação do sono do diabético do tipo 2, informações precisas acerca das conseqüências da privação do sono em indivíduos diabéticos do tipo 2, dificultando afirmações acerca da qualidade do sono do diabético. / Lack of sleeping can jeopardize health, because it is during the sleeping/vigil cycle that some hormones, which perform vital roles in the functioning of our organism, are produced. Sleeping malfunctions in type 2 diabetics constitute risk factors to the aggravating of diabetes since they can interfere in the metabolic control through the insulin resistance syndrome. Sleeping apnea, insomnia, occasional leg movements, sleeping hygiene and psychoactive substances consuming are quoted in studies, but scarcely explored. Tools have been used in the sleeping/vigil cycle investigation, and among them there are the sleeping diary, polissonography and Pittsburgh Sleeping Quality Index (PSQI) This one is composed by seven components, where the subjective sleeping quality, sleeping, duration and habitual efficiency latency, sleeping malfunctions, use of sleeping pills and morning sleepiness are evaluated. The present study was observation-transversal type. Sleeping quality was carried in 50 diabetics belonging to an Educational Nursing Center for adults and the elderly. For such investigation the type 2 diabetic patients, after signing the agreement term documents, were submitted to an initial cognitive evaluation, through mental estate exam, so that dementia could be discarded. A tool to evaluate the sleeping quality called Pittsburgh Sleeping Quality Index (PSQI) and another one to bring out demographic and clinic variants were applied. The majority of the participants was feminine, married, an average of 4-year-school, non-working and with an average of 2 minimal wages. Relating to clinic variants, 38% presented diabetes diagnosis time of over 10 years, 70% are hypertensive, 36% presented Hemoglobin A1c >7% values, 72% with nycturia, 85% IMC equivalent to obesity and 22% use sleeping pills. The PSQI components were separately detailed and the global score was obtained showing that (26)52% presented scores which indicate bad sleeping quality. The scores relation obtained in the PSQI along with some variants was carried and it showed that patients with a diagnosis time over 10 years and those with hipertension have the worst sleeping quality. Nycturia doesn´t seem to be a reason for a bad sleeping quality. For those with Hemoglobin A1c values >7% presented a worse sleeping quality. Among the ones who use sleeping medicine and those who presented normal IMC, the sleeping quality was even worse. The findings of this investigation strengthen the thematic relevance because there are no specifics tools for the evaluation of the type 2 diabetics´ sleeping; precise information about the consequences of lack of sleeping in type 2 diabetic individuals, making it difficult to get an affirmation about the sleeping quality of the diabetic.

Made available in DSpace on 2019-03-30T00:14:34Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-12-14 / INTRODUCTION: The growth of the elderly population is a worldwide phenomenon, resulting from the improvement in general living conditions and considerable advances in science and technology. With this large contingent of elderly people incorporated into the Brazilian population, most of them present with chronic diseases and functional limitations. Studies have identified the existence of a connection between diabetes mellitus and the symptoms of depression. OBJECTIVE: To evaluate the relationship between diabetes mellitus and depressive symptoms in elderly people in the city of Fortaleza-CE. METHODS: Cross - sectional, descriptive and analytical study with quantitative approach. This study was carried out with elderly patients aged 60 years or older, users of the Primary Health Care Units of the Municipality of Fortaleza in 2016. Data collection was used to collect data on socio-demographic data, general health, oral discomfort and the Geriatric Depression - 15 (EDG-15). The analysis was performed using the calculation of prevalence ratios with respective 95% confidence intervals and the exact Fisher's and chi-square tests. RESULTS: A total of 288 elderly individuals with a mean of 71.4 ± 6.9 years and a predominance of the female gender participated in the study. There was a prevalence of 38.5% in the elderly with Diabetes mellitus and 29.6% in the EDG-15 scale. The Regional Health Coordination III obtained a higher prevalence of elderly people with Diabetes mellitus and with suspicion of depression. Regarding the socio-demographic characteristics, there was no statistical significance for the prevalence of DM. However, the symptoms of depression were statistically in the categories: marital status, gender, retirement, income and schooling. Statistical significance was also shown in the variables on the perception of current health status and in the last year. Most interviewees reported having depression as a diagnosis. Regarding the application of EDG-15, it predominated as a result: there is suspicion of depression. Prevalent people with diabetes and depressive symptoms that use seven or more medications and deny harmful habits. CONCLUSION: There was no statistical relevance of Diabetes mellitus with depressive symptoms among the elderly participants. In the light of the observed results, efforts should be made to implement and improve policies and practices for DM prevention and control, and early detection of depressive symptoms, helping health professionals to meet the challenge of ensuring healthy aging for the population. / INTRODUÇÃO: O crescimento da população de idosos é um fenômeno mundial, resultante da melhora nas condições gerais de vida e avanços consideráveis na ciência e na tecnologia. Com esse grande contingente de idosos incorporados à população brasileira, grande parte deles apresentam-se com doenças crônicas e limitações funcionais. Estudos identificam a existência de uma conexão entre diabetes mellitus e os sintomas de depressão. OBJETIVO: Avaliar a relação entre diabetes mellitus e sintomas depressivos em pessoas idosas no Município de Fortaleza-CE. MÉTODOLOGIA: Estudo transversal, descritivo e analítico com abordagem quantitativa. Realizado com idosos com 60 anos ou mais, usuários das Unidades de Atenção Primária à Saúde do Município de Fortaleza em 2016. Foi utilizado para a coleta de dados, questionários versando sobre dados sócio demográficos, saúde geral, desconforto bucal e a aplicação da Escala de Depressão Geriátrica - 15 (EDG -15). A análise foi realizada utilizando o cálculo das razões de prevalências com respectivos intervalos de 95% confiança e os testes exato de Fisher e qui-quadrado. RESULTADOS: Participaram da pesquisa 288 idosos com média de 71,4 ± 6,9 anos e predomínio do gênero feminino. Houve prevalência de 38,5% de idosos com diabetes mellitus e 29,6% sugestivos de depressão pela escala EDG-15. A Coordenadoria Regional de Saúde III obteve maior prevalência de idosos com Diabetes mellitus e com suspeita de depressão. Relativo às características sócio demográficas, não houve significância estatística para a prevalência do DM. Entretanto os sintomas de depressão foi estatisticamente nas categorias: estado civil, gênero, aposentadoria, renda e escolaridade. Também foi demonstrado significância estatística nas variáveis sobre a percepção do estado de saúde atual e no último ano. A maioria dos entrevistados referiu ter depressão como diagnóstico. Quanto à aplicação da EDG-15, predominou como resultado: há suspeita de depressão. Preponderaram as pessoas diabéticas e com sintomas depressivos que utilizam sete ou mais medicações e que negam hábitos deletérios. CONCLUSÃO: Não houve relevância estatística de diabetes mellitus com os sintomas depressivos entre as pessoas idosas participantes. À luz dos resultados observados, esforços devem ser feitos para a implementação e o aprimoramento de políticas e práticas para prevenção e controle do DM, e detecção precoce dos sintomas depressivos auxiliando os profissionais de saúde no enfrentamento do desafio de assegurar um envelhecimento saudável à população.

O Diabetes mellitus gestacional (DMG) é uma séria condição que afeta muitas gestantes e traz muitos riscos tanto para a gestante, como para o feto. A recomendação é que se faça o rastreamento com teste oral de tolerância à glicose (TOTG) entre 24 e 28 semanas de gestação. O objetivo desse estudo é determinar a utilidade do teste de hemoglobina glicada (A1c) como teste diagnóstico de DMG, comparado com os critérios baseados na medida de glicemia. Métodos: este é um estudo de acurácia de teste diagnóstico. Nós avaliamos o metabolismo dos carboidratos através dos testes de TOTG e A1c em mulheres grávidas brasileiras atendidas nas visitas de pré-natal do Hospital de Clínicas de Porto Alegre (HCPA). Além dos testes de TOTG e A1c, foi analisada a história clínica das pacientes. O DMG foi definido de acordo com critério da American Diabetes Association (ADA) - um ou mais pontos alterados, glicemia de jejum, 1h ou 2h com concentrações de glicose plasmática ≥5.1, 10.0, ou 8.5 mmol/L, respectivamente-, ou de acordo com os critérios da Organização Mundial da Saúde (OMS) - glicemia de jejum ou 2h com concentrações de glicose plasmática ≥7.0mmol/L ou ≥7.8mmol/L, respectivamente. Presença de anemia, hemoglobinas variantes e doença renal crônica foram excluídas. Para avaliar o desempenho do teste de A1c foi utilizada a curva ROC (receiver operating characteristic curve). Resultados: um total de 262 mulheres grávidas (média de idade de 30 anos, média de idade gestacional de 26 semanas) foram avaliadas e 82 (31,3%) tiveram diagnóstico positivo (40 pelo critério da ADA e 42 pelo critério da OMS). Baseado na análise da curva ROC, considerando os critérios da ADA e OMS juntos e o TOTG como teste de referência, o ponto de corte para obter o melhor equilíbrio entre sensibilidade e especificidade (diagonal 100% a 100%) foi o valor de A1c de 31mmol/mol (5,3%). A sensibilidade e especificidade para este ponto de corte foi de 69,9% e 65,9%, respectivamente. Os pontos de corte de 40 mmol/mol (5.8%), 41 mmol⁄mol (5.9%) e 42 mmol⁄mol (6.0%) representaram especificidades de 96,1%, 96,6% e 98,3%, respectivamente. Conclusões: o teste de A1c apresenta baixa sensibilidade e alta especificidade para o diagnóstico de DMG, quando comparado com o critério tradicional. Nossos resultados mostraram que 39% dos casos de DMG foram diagnosticados usando o ponto de corte de A1c≥ 40 mmol/mol (5.8%). O teste de A1c, sozinho ou em combinação com o TOTG, talvez seja bastante útil no diagnóstico de DMG. / BACKGROUND: Gestational diabetes mellitus (GDM) is a potentially serious condition that affects many pregnancies and it carries risk for the mother and neonate. The current recommendation is to perform screening before 24 - 28 weeks of gestation by an oral glucose tolerance test (OGTT). The aim of this study is to determine the usefulness of glycated hemoglobin (A1c) as a diagnostic tool for GDM compared with the traditional criteria based on glycemia measurements. METHODS: This is a study of diagnostic test accuracy. We evaluated the status of carbohydrate metabolism by performing OGTT and A1c in Brazilian pregnant women attending prenatal visits at Hospital de Clínicas de Porto Alegre (HCPA). A1c, OGTT, and clinical history were analyzed. GDM was defined according to the American Diabetes Association (ADA) criteria (one or more fasting, 1-h, or 2-h plasma glucose concentrations ≥5.1, 10.0, or 8.5 mmol/L; respectively) or World Health Organization (WHO) criteria (fasting or 2-h plasma glucose ≥7.0mmol/L or ≥7.8mmol/L, respectively). Presence of anemia, variant hemoglobins and chronic renal disease were excluded. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of A1c. RESULTS: A total of 262 pregnant women (mean age 30 years, mean gestational duration 26 weeks) were enrolled and 82 (31.3%) were diagnosed with diabetes (40 by ADA criteria and 42 by WHO criteria). Based on ROC curve analysis, and considering OGTT as the reference criterion, the cut-off point obtained by the point with the best equilibrium between sensitivity and specificity (100%-to-100% diagonal) was A1c value of 31 mmol⁄mol (5.3%). The sensitivity and specificity for this cut-off 27 point were 69.9 % and 65.9 %, respectively. The cut-off points of A1c of 40 mmol/mol (5.8%), 41 mmol⁄mol (5.9%) and 42 mmol⁄mol (6.0%) presented specificities of 96,1%, 96,6% and 98,3%, respectively. CONCLUSIONS: A1c test presented low sensitivity and very high specificity for GDM diagnosis when compared with traditional criteria. Our results show that 39% of GDM cases would be diagnosed by using the cut-off point A1c≥ 40 mmol/mol (5.8%) alone. A1c test, alone or in combination with OGTT, may be a very useful diagnostic tool in GDM.

Magister Artium - MA / In South Africa 3.5 million people (estimated 6% of the total population) are diagnosed and living with diabetes. The majority of the diagnosed group suffer from Type 2 diabetes respectively. Described as a metabolic disorder, diabetes is also understood as an illness and disease and is usually handled through the intervention of biomedical perspectives, especially in the manner in which it is treated and managed. However, few ethnographies have interrogated how individuals living with diabetes in South Africa in negotiate between various medical/healing knowledge systems- both ‘alternative’ and biomedical. The study explores the area of Genadendal as a case study, using an ethnographic approach and a material semiotic approach (Mol, 2002) in relation to medical sense-making and treatments. I investigate the partial connections as discussed by Strathern (2004), between medical/healing knowledge systems, i.e. biomedical and herbal management through plant medicines, which inform diabetic realities. Ultimately, this study considers the various notions and understandings of diabetes, local knowledge, experiences of individuals with diabetes and the interfaces of different ways of knowing with each other.

Thesis (M Med (Family Medicine))--University of Limpopo, 2010. / The number of diabetic patients will continue to rise even in rural settings and the burden of this disease will continue to take its effect on the limited resources of these communities. The effect of such burden will be more pronounced if we are to add the various complications associated with substandard management of diabetes mellitus. The first step in assessing the level of care we give to this category of patients is to measure their level of adherence, in an effort to expose the pitfalls on both the side of the patients and on the side of the health care provider. The aim of the study is to assess the level of adherence to treatment among type2 diabetic patients in Matlala district hospital; Limpopo Province. This cross-sectional study used the convenience method of sampling with the aid of a tested, structured questionnaire, to obtain data from respondents between December 2009 and March 2010, a period of 4 months. The excel computer program was used for data capturing. Percentages and numbers were used for interpretation and cross tabulation was used to determine association. The result of the study indicated that 137 {70%} of the respondents adhere to diabetes treatment. There were two demographical characteristics that are significantly associated with non adherence: age {p=0.028} and employment status {p=0.018}. Of those respondents that keep their appointments, 98% are adherent to treatment. When considering reasons for poor adherence; 29% of respondents stated that the clinic did not have their pills, 16% stated that they forgot to take their medication and 14% stated that they travelled to visit ix and did not take enough pills with them. On the reasons for poor adherence to lifestyle: 29% of the respondents said that they were too old, 22% stated no specific reason, 13% struggled to motivate themselves and 10% simply forgot what to do. Most, 68%, of the respondents that adhere to the recommended use of medication agreed that they take it at meal time, 14% set a reminder, 8% employed the assistance of a treatment supporter and other respondents used other means to remember. The study revealed an above average level of adherence in my setting and it will be logical to assess whether this corresponds to the metabolic control expected of good adherence. More is needed to be done on the reasons why our patients do not adhere to both medication and lifestyle changes and each stake holder needs to address their short comings.

Thesis (M Med(Family Medicine))--University of Limpopo (Medunsa Campus) 2010. / Aim & Objectives Aim: To explore the lay beliefs of type 2 diabetic patients seen at Prince Mshiyeni Memorial Hospital. Objectives: To understand lay beliefs of effective life long management of type 2 diabetes patients and consequently to make recommendations of improving management of diabetes in conjunction with the findings of the study. Methodology Study Design: An exploratory study from a qualitative perspective using free attitude interviews as a data collection technique. Setting: Prince Mshiyeni Memorial Hospital a district hospital located in Umlazi in the outskirts of Durban, South Africa. Study Population: All type 2 diabetic patients above the age of 40 on treatment for 18 months or more. Ten respondents were purposively selected using maximum variation sampling strategy. Participants were asked individually to give an account of their beliefs and experience in the management of diabetes. All interviews were tape recorded, transcribed verbatim, and analyzed to identify emerging themes. Results The interpretative thematic analysis generated the following main themes: 1) Combination therapy 2) Modern versus Traditional 3) The bitter stuff 4) Traditional healers and alternative remedies viii 5) Stress: Physical, financial, emotional, psychosocial strain 6) Spiritual believes: Religious and Traditional 7) Eating right food and loose weight Conclusions This study has described most lay beliefs about the management of type 2 diabetes in this setting. The research has identified that type 2 diabetic patients seen at Prince Mshiyeni Memorial Hospital in Umlazi South of Durban held different diabetes management beliefs based on their respective initial symptom perception and beliefs, their illness origin and healing beliefs, their spiritual and traditional beliefs and values and to a significant extent, the beliefs of spouses or life partner in couples and of family members. These findings have challenged the functionality of the health care in its capacity to respond to the population expectations based on their ethnic, spiritual and cultural background.

Thesis (Family Medicine)) -- University of Limpopo, 2010. / Background In the Vanga Health Zone, diabetic patients have idea that diabetes is due to witchcraft, which idea can interfere with the prevention and management of their disease. The purpose of this study was to determine the profile of patients diagnosed with type 2 diabetes mellitus at Vanga Hospital, Democratic Republic of Congo (DR Congo). Methods A cross-sectional study was designed with use of a questionnaire to a systematic sample of type 2 diabetic patients attending the diabetic clinic of Vanga hospital for at least six months and resident at Vanga health zone. Results Only 2.1 % of the participants believe in a scientific cause for diabetes; 53.5 % of them do not think that their disease is due to the fact that they crossed over a path where some ritual was performed and, 89.2 % of the participants believe that God deserted the person who suffered from diabetes and expect that prayer will rectify the disease. The majority of participants (65.6 %) had poor glycaemic control. Correlation analysis has shown that glycaemia level was not significantly associated with sociodemographic characteristics or health belief factors. Conclusion The majority of patients at the Vanga diabetic clinic have a greater need for management strategies to improve their glycaemic control. Keywords: type 2 diabetes mellitus, health beliefs, knowledge, sub-Saharan Africa, rural

Magíster en Psicología Infanto-Juvenil / La presente investigación pretende contribuir al conocimiento de factores psicológicos (desarrollo psicosocial y autoestima), familiares (salud mental del cuidador, funcionamiento familiar y criticismo) y salud mental (trastorno depresivo y sintomatología ansiosa) de niños diabéticos tipo 1 entre 8 y 12 años, que residen en la V Región. Metodología: Se seleccionó aleatoriamente una muestra de 23 niños que presenta diabetes mellitus tipo 1 incluyendo a su cuidador principal y se comparó salud mental, factores psicológicos y familiares con un grupo control, además se identificaron factores asociados a sintomatología ansiosa y depresiva en niños insulinodependientes. Como método de evaluación se empleo cuestionarios, los que fueron aplicados a los niños y sus cuidadores. Resultados: Los niños diabéticos en comparación con el grupo control presentaron un menor desarrollo psicosocial y nivel de autoestima. Los cuidadores de niños diabéticos mostraron más dificultades de salud mental, observándose más disfunción familiar y criticismo en las familias de niños insulinodependientes. Los niños diabéticos exhibieron más sintomatología ansiosa, sin apreciarse diferencias en la presencia de trastorno depresivo. La sintomatología depresiva en el niño diabético se asocio en forma muy significativa a su autoestima y funcionamiento familiar. La sintomatología ansiosa (como rasgo) se correlacionó en forma muy significativa con autoestima, salud mental del cuidador y funcionamiento familiar. Al realizar modelos de regresión lineal múltiple se encontró que el 75,9% de la sintomatología depresiva se explica por el nivel de autoestima y desarrollo psicosocial del niño diabético. En ansiedad rasgo el 61% del comportamiento de la variable se encuentra explicado por la autoestima del escolar. Conclusión: La diabetes puede contribuir a la iniciación, desarrollo y mantención de dificultades emocionales en el niño y su familia, observándose que la autoestima es una variable explicativa de la sintomatología ansiosa y depresiva en el niño diabético

This qualitative study was designed to gain an insight into the ways in which adolescents and young adults managed ?self? in their day - to - day diabetes management. It also examined the effect that illness self representations had on that management. A grounded theory approach using a symbolic interactionist framework was adopted based on 27 in- depth semi structured interviews with adolescents and young adults with diabetes. Respondents described the effects of diabetes management on the physical, emotional, social and related selves. They also described their various illness self representations. It often took an inordinate amount of work for the respondents to manage their diabetes. This ?management? work could be related to problems with their physiological control, emotional stressors, the need to be socially interactive, differing priorities or relational issues. Certainly even the most resilient respondents experienced periods of vulnerability and needed to nurture the ?self? The study generates new knowledge which builds upon the existing body of knowledge relating to the management of self in adolescents and young adults in the context of T1DM. The study established that whilst some health professionals are sensitive and cognizant of the needs of adolescents and young adults with diabetes, there is room for improvement in the way in which health professionals understand the complexities involved in diabetes management for adolescents and young adults / Doctor of Philosophy (PhD)