La diabetes es una enfermedad que afecta la calidad de vida de las personas que la padecen, ya que una vez detectada no tiene cura, lamentablemente en el Perú muchas personas empeoran y fallecen por un inadecuado control de la enfermedad. Luego de realizar un análisis de mercado, se pudo distinguir las necesidades de los pacientes diabéticos, y validar que a nivel nacional no existen negocios de aplicaciones móviles en el cuidado de la salud, con ello se identificó la oportunidad de negocio, Total Diabetes, el cual es un modelo de negocio de aplicación virtual y página web que ofrece el desarrollo de una comunidad que da soporte a las personas que padecen la enfermedad, ya que no sólo ayuda a controlar el nivel de azúcar en la sangre, sino a fomentar hábitos y costumbres que ayuden a mejorar su estilo de vida. Con ello se pretende lograr mejorar los aspectos más relevantes tales como nutrición, concientización, accesibilidad a la atención, entre otros. En la etapa de evaluación de la deseabilidad se hicieron encuestas, las cuales validaron las hipótesis de calidad percibida, precio, frecuencia de compra y usabilidad. Asimismo, para evaluar la factibilidad se realizó un plan de mercadeo y simulaciones que permitieron validar el análisis financiero en diferentes escenarios, de los cuales lo más relevante es que el VAN Financiero es S/ 2’214,021.46, una TIR Financiera de 76.67% y el IR de 4.7. Finalmente, en relación a la rentabilidad social del proyecto, luego de realizar una proyección social financiera, se obtuvo un VAN social de S/ 8,601506.99, con lo cual se demuestra que Total Diabetes es una propuesta que genera valor a la sociedad. Lo cual está alineado de manera positiva con el ODS 3: Salud y bienestar, que espera impactar de manera positiva en la calidad de vida de los pacientes. / Diabetes is a disease that affects the quality of life of people who suffer from it, since once detected there is no cure, unfortunately in Peru many people worsen and die due to inadequate control of the disease. After carrying out a market analysis, it was possible to distinguish the needs of diabetic patients, and validate that at the national level there are no mobile application businesses in health care, thereby identifying the business opportunity, Total Diabetes, which It is a virtual application and web page business model that offers the development of a community that supports people who suffer from the disease, since it not only helps to control the level of sugar in the blood, but also to promote habits and customs that help improve your lifestyle. This is intended to improve the most relevant aspects such as nutrition, awareness, accessibility to care, among others. In the desirability evaluation stage, surveys were carried out, which validated the hypotheses of perceived quality, price, purchase frequency, and usability. Likewise, to evaluate the feasibility, a marketing plan and simulations were carried out that allowed validating the financial analysis in different scenarios, of which the most relevant is that the Financial NPV is S/ 2'214,021.46, a Financial IRR of 76.67% and the IR of 4.7. Finally, in relation to the social profitability of the project, after carrying out a financial social projection, a social NPV of S/ 8,601506.99 was obtained, which demonstrates that Total Diabetes is a proposal that generates value for society. This is positively aligned with SDG 3: Health and well-being, which is expected to have a positive impact on the quality of life of patients.

La problemática abordada en el presente trabajo es la necesidad de disminuir el consumo de productos altos en azúcar, es decir, difundir en la población y motivar la alimentación saludable. La determinación de esta problemática se debió al alto y creciente número de personas que padecen de diabetes y celiaquía; enfermedades que deterioran la calidad de vida y que en algunos casos terminan causando la muerte. Dicha problemática se determinó mediante el método de entrevistas a personas afectadas directamente por las enfermedades ya mencionadas. Con la información obtenida de estas entrevistas se pudo definir el perfil del usuario que no solo consideraba a las personas afectadas por estas enfermedades sino también a personas sanas que buscan prevenir estas enfermedades. La propuesta que se planteó para solucionar esta problemática fue la de elaborar una barra energética a base de algarroba ya que esta planta tiene las propiedades de ser dulce y apta para los diabéticos. El producto también es apto para los celiacos dado que tampoco contiene gluten, buscando ser una alternativa de snack para ser consumida entre comidas y así evitar el consumo de productos con azúcar y gluten. Como parte de la evaluación de la propuesta se verificó que el producto cuente con la aceptación de los consumidores, para lo cual se hicieron experimentos donde los usuarios tuvieron la oportunidad de definir la presentación del producto como una barra energética con frutos secos. Así mismo, se evaluó la viabilidad económica donde se obtuvo un VAN positivo de S/. 3,334,607. Finalmente, debido al impacto positivo en la salud de las personas la propuesta impacta positivamente en los Objetivos de Desarrollo Sostenible (ODS) N° 3, N° 8 y N° 12, obteniendo un VAN social de S/. 3,167,540 o su equivalente en USD 846,031. / The problem covered in this study is the need to reduce the consumption of products high in sugar, that is, to promote healthy eating among the population and motivate it. The determination of this problem was due to the high and growing number of people suffering from diabetes and celiac disease; diseases that deteriorate the quality of life and in some cases end up causing death. This problem was determined by interviewing people directly affected by the aforementioned diseases. With the information obtained from these interviews it was possible to define the user profile that considered people affected by these diseases and also healthy people who seek to prevent these diseases. The idea that was proposed to solve this problem was to elaborate a bar based on carob, since this plant has the properties of being sweet and suitable for diabetics. The product is also suitable for people with celiac disease, given that it does not contain gluten, seeking to be an alternative snack to be consumed between meals and thus avoid the consumption of products with sugar and gluten. As part of the evaluation of the project, was verified that the product has the acceptance of consumers, for which experiments were conducted where users had the opportunity to define the presentation of the product as an energy bar with nuts and dried fruits. The economic viability was also evaluated and a positive NPV of S/. 3,334,607. Finally, due to the positive impact on people's health, the project has a positive impact on the Sustainable Development Goals (SDGs) N° 3, N° 8 and N° 12, obtaining a social NPV of S/. 3,167,540 or its equivalent in USD 846,031.

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No. of bitstreams: 1 Maria Aparecida Barbosa Rego.pdf: 1503924 bytes, checksum: 9f582589bf54cbb5312f49882238f735 (MD5) Previous issue date: 2004-12-16 / As a nurse of the Family Health Program we observe that diabetes bearers of the town of Nova Aurora State of Goias did not manage to reduce their glycemic levels even when receiving educational orientation Facing this issue this research was developed with the means of: analyzing an educational process for health along with diabetes bearers applying an approach between the theoretical assumptions of Paulo Freire and the methodological references from the Arch of Maguerez which was adapted by Bordenave e Pereira and analyze the results of the glycated hemoglobin before and after the implementation of the educational plan It is an action research with a quanti qualitative approach This study was approved by the Ethics Research Committee from the Federal University of Goias Nineteen people participated in the educative action and seventeen in the glycated hemoglobin test all diabetes bearers who signed a term of free and clarified assent and were informed concerning the intervention proposal An educative action was accomplished in six meetings The dosage of glycated hemoglobine occurred at the beginning of the educative action and five months after the end of it The results of this examination were analyzed by means of Student s t-Test The speeches of the group during the educative process were recorded and analyzed in accordance with Laurence Bardin In the light of reality the emergent categories related themselves to: feeding confrontation and feelings of success and frustration towards the illness The themes diet hypoglicemia / hyperglicemia and the physiopathology of the Diabetes mellitus were chosen as key points to be theorized In the stage of theorization of the diet categories emerged such as dependency on the health professional and autonomy / independence on the choice of one s food For the themes hypo / hyperglicemia the categories focused on the educational and liberating approach and the cognitive control that they had over these themes From the theorization of the physiopathology of the Diabetes mellitus the exposed categories were: absence of knowledge and knowledge at the common sense Changes of the subjects at the stage of solution hypothesis were observed when they elaborated educational posters which evidenced two categories: preventive measures of specific health promotion for the group and early diagnosis directed towards the community The application to the reality was accomplished through the accounts of the DM bearers as to changes in their abilities and attitudes and the attainment of autonomy and independence conquered through the control of cognitions the resultant actions of the educational practice were: the construction of teaching material which made it possible to share their knowledge with the group and the community; the capacity to establish an association between their previous knowledge to the acquired scientific knowledge during the educational intervention; changes of abilities and in the capacities of confrontation of the illness besides the changes in the alimentary habits As to the referent results of the glycated hemoglobine the t-Test shows an statistically significant difference with the reduction of the plasmatic levels of the dosed element The present research evidenced that educative action was capable to contribute to the construction of significant knowledge and for the attainment of autonomy and independence of the DM bearers facing their health problem and reduction in the index of glycated hemoglobine / Enquanto enfermeira do Programa Saúde da Família percebemos que os portadores de diabetes do município de Nova Aurora-GO não conseguiram reduzir seus níveis glicêmicos mesmo recebendo orientações educacionais Para o enfrentamento deste problema desenvolvemos esta pesquisa com objetivos de: analisar um processo de educação para a saúde junto a portadores de diabetes utilizando uma aproximação entre os pressupostos teóricos de Paulo Freire e metodológicos do Arco de Maguerez adaptado por Bordenave e Pereira e analisar os resultados de hemoglobina glicada antes e após a implementação do plano educativo Trata-se de uma pesquisa ação com abordagem quanti-qualitativa Este estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Goiás Participaram dezenove pessoas da ação educativa e dezessete do teste de hemoglobina glicada todas portadoras de diabetes que assinaram o termo de consentimento livre e esclarecido e foram informados acerca da proposta de intervenção Realizou-se a ação educativa em seis encontros A dosagem de hemoglobina glicada ocorreu no início da ação educativa e cinco meses após o término da mesma Os resultados deste exame foram analisados mediante teste T de Student As falas do grupo durante o processo educativo foram gravadas e analisadas de acordo com Laurence Bardin Na observação da realidade as categorias emergentes se relacionavam à alimentação ao enfrentamento e aos sentimentos de êxito e frustração frente à doença Os temas dieta hipoglicemia / hiperglicemia e a fisiopatologia do DM foram eleitos como pontos-chave a serem teorizados Na etapa de teorização da dieta surgiram as categorias: dependência do profissional de saúde e autonomia / independência para a escolha de seus alimentos Para os temas hipo / hiperglicemia as categorias focavam a abordagem educacional e libertadora e o domínio cognitivo que detinham acerca destes temas A partir da teorização da fisiopatologia do DM as categorias evidenciadas foram: a ausência de conhecimento e o conhecimento em nível do senso comum Observaram-se mudanças dos sujeitos na fase de hipóteses de solução quando construíram cartazes educativos que evidenciavam duas categorias: medidas preventivas de promoção da saúde específicas para o grupo e promoção da saúde e diagnóstico precoce direcionado à comunidade A aplicação à realidade foi efetivada mediante relatos dos portadores de DM quanto às mudanças em suas habilidades e atitudes e o alcance da autonomia e independência conquistadas por meio do domínio de conhecimentos As ações resultantes da prática educacional foram: construção de material educativo que possibilitou compartilhar saberes com o grupo e a comunidade; a capacidade de estabelecer associação de seus conhecimentos prévios aos conhecimentos científicos adquiridos durante a intervenção educacional; mudanças nas habilidades e atitudes de enfrentamento da doença além da mudança nos hábitos alimentares Quanto aos resultados referentes a hemoglobina glicada o test t mostra diferença estatisticamente significativa com diminuição dos níveis plasmáticos do elemento dosado A presente pesquisa evidenciou: que a ação educativa foi capaz de contribuir para a construção de conhecimentos significativos para o alcance da autonomia e independência dos portadores de DM frente a seu problema de saúde e diminuição no índice de hemoglogina glicada

Submitted by JACIARA CRISTINA ALMEIDA DO AMARAL (jaciaramaral@ufpa.br) on 2018-07-19T17:24:02Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_PerfilSocioComportamental.pdf: 937565 bytes, checksum: 7cacebf5a187d19e5d3866c2552f416b (MD5) / Approved for entry into archive by JACIARA CRISTINA ALMEIDA DO AMARAL (jaciaramaral@ufpa.br) on 2018-07-19T17:24:35Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_PerfilSocioComportamental.pdf: 937565 bytes, checksum: 7cacebf5a187d19e5d3866c2552f416b (MD5) / Made available in DSpace on 2018-07-19T17:24:35Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_PerfilSocioComportamental.pdf: 937565 bytes, checksum: 7cacebf5a187d19e5d3866c2552f416b (MD5) Previous issue date: 2015-10-13 / Introdução: O Diabetes Mellitus tipo1 na infância e adolescente está despertando atenção pelo aumento do número de casos, estando entre endocrinopatias mais comuns nesta faixa etária. Objetivo: Traçar o perfil sócio comportamental e clínico de pessoas diabéticas do tipo 1 menores de 15 anos que fazem acompanhamento no ambulatório do Hospital Universitário João de Barros Barreto, Referência em Diabetes do Estado do Pará. Centro de Referência em Endocrinologia e Diabetes do Estado do Pará. Métodos: Trata-se de um estudo descritivo, prospectivo, com abordagem quantitativa. As variáveis analisadas foram dados sociodemográficos, comportamental, antropométricos, conhecimento do diabetes e dificuldades encontradas no tratamento dos pacientes. Os dados obtidos por meio do preenchimento de questionário, respondido pelo responsável da criança ou adolescente, na faixa etária de até 15 anos de idade com diagnóstico de diabetes mellitus tipo 1. Foi observado que as crianças apresentaram nível de glicemia dentro da normalidade (71,43%), enquanto que entre os adolescentes predominou glicemia alterada (75%). Não foi evidenciado influencia ao sexo, a escolaridade e a renda familiar, quando relacionada à glicemia. Na análise comportamental a frequência e a prática de atividade física, não demonstrou ser um fator que interferiu no controle da glicemia. Quanto a prescrição da dieta, a maioria reconhece ser o nutricionista como o responsável por esta conduta (70%), a dificuldade financeira foi apontada como principal fator que impede seguir essa dieta (26,67%), e o principal critério adotado por esta clientela é a não ingestão de açucares e doces (63,33%), quando nos reportamos ao lanche ingerido na escola predominou aquele produzido e levado de casa (53.33%). Quanto à insulinoterapia uso mais frequente foi análogo de insulina de curta e longa duração (46,67%). A causa do diabetes a reconhecem ser pelo déficit de insulina (45,24%). A nefropatia foi relatada apenas em um paciente (3,33%), e a maioria já consultou oftalmologista (60%). A média do nível de glicemia entre as crianças foi 167,43, e adolescentes 177,50. Conclusão: O crescimento de casos de DM1 é uma preocupação mundial para a Saúde Pública. As dificuldades se estendem desde o conhecimento sobre a fisiopatologia até a necessidade de mudanças de hábitos de vida, que acontece através de um processo de educação que inicia nas consultas de rotina e se estende ao trabalho de grupo, objetivando melhor controle glicêmico e de complicações diabéticas, proporcionando melhor qualidade de vida a essa clientela. / Introduction: Diabetes mellitus type 1 at children and adolescents is awakening attention to the increasing number of cases, is the most common endocrine disease at this age group. Objective: To describe the profile of type 1 diabetic patients under 15 who do monitoring at Reference Center of Endocrinology and Treatment Methods for Diabetes in State of Pará: This was a descriptive analytical, prospective study with a quantitative approach. The variables analyzed were sociodemographic, behavioral, anthropometric data, diabetes knowledge and difficulties encountered in the treatment of patients. All data required for the analysis was obtained by questionnaire filling, answered by the parents or people in charge of the child or adolescent aged up to 15 years of age diagnosed with type 1 diabetes mellitus at the clinic of the University Hospital João de Barros Barreto, reference in Pará for diabetes Treatment. Results: We observed 30 patients; children had blood glucose level within the normal range (71.43%), while the teenager with altered glycemia (75%). No relation was found between glucose indices and sex, education or family income. The behavioral analysis regarding frequency and physical activity in this study did not prove a factor that interfered with controlled blood glucose or not. About the diet therapy, a major part of interviewed recognizes that nutritionist is the professional is responsible for prescribing (70%), financial issue is appointed as the most difficult factor to follow such a diet (26.67%), the main criteria for this diet is not eating sugar and sweets (63.33%). School snacks are made and brought from home (53.33%). Insulin therapy more frequently is the analogue insulin short and long term (46.67%). Regarding the cause of diabetes, insulin deficit is the principal (45.24%). Nephropathy had been report in only one patient (3.33%). Many of them have already checked ophthalmologist (60%) as a preventive measure. The average blood glucose level among children was 167.43, 177.50 and adolescents. Conclusion: The increase of cases of DM1 is a global concern for public health. The difficulties come since the knowledge of the pathophysiology until lifestyle changes needing, which starts at process of education during the routine clinical practice and reaches the working group, aiming to better glycemic control and better quality life to this clientele.

La diabetes es una enfermedad silenciosa que degrada progresivamente la salud de las personas y tiene diversos orígenes; sin embargo, los principales desencadenadores son la mala alimentación y la vida sedentaria. En el Perú, existen más de 1 millón de personas con diabetes Tipo 2 y otro millón que lo padece sin ser diagnosticado. De la población diagnosticada, el 27% no respeta el tratamiento indicado, de acuerdo con la Encuesta Demográfica y de Salud Familiar (2016). El panorama se agrava con la carencia de personal calificado y de centros de atención combinado con el diagnóstico anual de aproximadamente 23,000 nuevos casos de acuerdo al Ministerio de Salud (2018); y con la llegada del SARS- CoV-2, el control de la salud de las personas con diabetes se ha dificultado por la poca accesibilidad a medicamentos e instrumentos de medición. Por ello, después de pasar por un proceso de Design Thinking y Lean Startup, se plantea un ecosistema digital para las personas con diabetes Tipo 2, en donde puedan conseguir servicios de nutricionistas y entrenadores especializados, encontrar información relevante sobre la diabetes, adquirir instrumentos de medición a un menor precio y encontrar una comunidad con la cual interactuar. Desarrollando así un modelo de negocio robusto y sostenible que genera valor, con un VAN de S/.1’046,711 aproximadamente y con tiempo de retornó de la inversión de 2.12 años, y con un VAN social de S/.5’240,447 que permite impactar positivamente a 18,250 personas durante los 5 años. Asimismo, se validó la factibilidad con la prueba de Montecarlo obteniendo como resultado una probabilidad de éxito en el 70.36%, obteniendo como resultado un VAN promedio S/. 579,746, con una TIR de 64.9% y un Payback de 2.9 años, de esta manera avala la sostenibilidad del modelo de negocio de Miski. / Diabetes is a silent disease that progressively worsen patient’s health and having has main triggers following a poor diet and having a sedentary life. In Peru, there are more than 1 million people with Type 2 diabetes and another million that have not been diagnosed. According to the Demographic and Family Health Survey (2016), 27% of the diagnosed people do not respect the treatment. The panorama is heighten by the lack of qualified personal and health care centers and the annual diagnosis of approximately 23,000 new cases according to the Ministry of Health (2018). SARS-CoV-2 has also complicated the control of diabetes, as it made it difficult to access medicines and glucose measuring instruments. For this reason, after going through a process of Design Thinking and Lean Startup, a digital ecosystem was developed for people with Type 2 diabetes; where they can obtain personal nutritionists and specialized trainers services, find relevant information on diabetes, acquire measuring instruments at a lower price and interact with a community. Thus, thriving a robust and sustainable business model that generates value, with a financial NPV of approximately S/.1'046,711 that has an investment return of 2.12 years, and with a social NPV of S/. 5'240,447, which impacts positively on 18,250 people during the 5 years. Likewise, the feasibility was validated with montecarlo test, obtaining as a result a probability of success of 70.36%. It is important to mention that an average NPV S/. 579,746 with a TIR of 64.4% and a payback of 2.9 years, thus endorsing the sustainability of Miski ́s business model.