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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
81

Elucidating the lived experiences of hypoglycemia in patients diagnosed with diabetes mellitus : A general literature review / Belysning av de levda erfarenheter av hypoglykemi i patienter diagnostiserads med diabetes mellitus : En allmän litteraturstudie

McVicker, Kevin January 2024 (has links)
Background: Hypoglycemia is a common adverse effect to anti-hyperglycemic treatment for diabetes mellitus, it is characterized by a plasma glucose level of 79 mg/dl (3,9 mmol/l) or lower. Hypoglycemia has an abundance of symptoms, both neurogenic and neuroglycopenic which can result in loss of consciousness, seizure, and death if left untreated. General nurses have shown they are lacking in information regarding symptoms of hypoglycemia and as such experiences Aim: The aim of this study was to elucidate the lived experiences of hypoglycemia in patients diagnosed with diabetes mellitus. Method: A general literature review with an inductive approach. Results: The results of this study found that patients diagnosed with diabetes experienced challenges associated with hypoglycemia such as fear, particularly associated with nocturnal hypoglycemia. Patients diagnosed with diabetes also experienced helplessness, a lack of control, avoidance, restrictions and stress factors associated with hypoglycemia. Patients diagnosed with diabetes experienced hypoglycemic confidence primarily based on preventing recurrence and successful treatment, and for some through hope. Conclusion: The findings of this study indicate a need for nurses to understand the experiences patients diagnosed with diabetes have of hypoglycemia, to properly assist patients in health promotion and achieving a self-care balance. / Bakgrund: Hypoglykemi är en vanlig biverkning av anti-hyperglykemibehandling vid diabetes mellitus, hypoglykemi karakteriseras av ett plasmaglukosvärde på 79 mg/dl (3,9 mmol/l) eller lägre. Hypoglykemi har många symtom, båda neurogena och neuroglykopeniska som kan resultera i medvetslöshet, samt anfall och mortalitet om tillståndet är obehandlat. Generella sjuksköterskor har visat bristande kunskap gällande vanliga symtom vid hypoglykemi och patienters erfarenheter. Syfte: Syftet var att belysa levda erfarenheter av hypoglykemi hos patienter diagnostiserade med diabetes mellitus. Metod: En allmän litteraturstudie med induktiv ansats. Resultat: Denna litteraturstudie visar att patienter med diabetes har erfarenheter av svårigheter associerade med hypoglykemi som rädsla, särskilt rädsla för nattlig hypoglykemi. Patienter med diabetes upplevde hjälplöshet, bristande kontroll och undvikande, samt restriktioner och stressfaktorer associerade med hypoglykemi. Patienter med diabetes och hypoglykemi upplevde självförtroende främst relaterat till förhindrande av återfall, och för visa, genom hopp. Konklusion: Litteraturstudiens resultat indikerar att sjuksköterskor behöver förstå erfarenheter av hypoglykemi hos patienter med diabetes för att främja patienters hälsa och egenvårdsbalans.
82

Upplevelser och hantering av hypoglykemi : En kvalitativ studie med personer som har typ 1 diabetes och använder kontinuerlig glukosmätning

Hansson, Jenny, Lundgren, Maria January 2024 (has links)
Introduktion: Typ 1-diabetes innebär ett betydande behov av egenvård, där hantering avhypoglykemi utgör en central del. För att underlätta denna egenvård ges patienter med typ 1-diabetes tillgång till kontinuerlig glukosmätning (CGM), där diabetessjuksköterskan spelar enviktig roll genom att erbjuda relevant undervisning och stöd. Syfte: Syftet med studien var att utforska upplevelser och hantering av hypoglykemi hospersoner med typ 1 diabetes som använder kontinuerlig glukosmätning. Metod: Kvalitativ intervjustudie med induktiv ansats valdes för att besvara syftet. Åttasemistrukturerade intervjuer genomfördes antingen på plats eller via telefon på två olikadiabetesmottagningar. Intervjuerna transkriberades ordagrant och analyserades med hjälp avkvalitativ innehållsanalys. Resultat: Analysen resulterade i tre huvudkategorier samt sex subkategorier, därhuvudkategorierna var: “Hypoglykemi- en del av vardagen”, “Hantering av hypoglykemi”och “Integrering av CGM i vardagen”. Det framkom att samtliga deltagare hade erfarenheterav hypoglykemi, och hade hittat olika strategier för att hantera detta. CGM upplevdes som enstor hjälp i vardagen samt vid hypoglykemihantering, och stödet från sjukvården samtnärstående var också väsentligt för att känna sig trygg i sin hantering. Slutsats: Deltagarnas varierande upplevelser av hypoglykemi resulterade i olika strategier förhantering i vardagen. Kontinuerlig glukosmätning utgör ett värdefullt stöd vid hanteringen avdiabetes och kan bidra till att upptäcka hypoglykemi innan den blir allvarlig. / Introduction: Type 1 diabetes is a disease that places great demands on self-care, wherehypoglycemia and its management are included. To help manage self-care, patients with type1 diabetes are offered continuous glucose monitoring (CGM), where the diabetes nurseshould offer relevant education and support. Aim: The aim of the study was to explore the experiences and management of hypoglycemiain people with type 1 diabetes using continuous glucose monitoring. Methods: Qualitative interview study with an inductive approach was chosen to answer thepurpose. Eight semistructured interviews were conducted on site or via telephone at twodifferent diabetes clinics. The interviews were transcribed verbatim and analyzed usingqualitative content analysis. Results: The analysis yielded three main categories and six subcategories. These maincategories included: "Hypoglycemia - a facet of daily life," "Management of hypoglycemia,"and "Integration of CGM in daily life." It was evident that all participants had experiencedhypoglycemia and had adopted various strategies to cope with it. CGM was experienced as agreat help in everyday life and in hypoglycemia management, and the support from thehealthcare system and relatives was also essential to feel confident in their management. Conclusion: The diverse experiences of hypoglycemia among participants have led to thedevelopment of various strategies for coping with hypoglycemia in their daily lives.Continuous glucose monitoring serves as a valuable tool in diabetes management and can aidindividuals with type 1 diabetes in detecting hypoglycemia before it becomes severe.
83

On severe hypoglycaemia in children and adolescents with Type 1 diabetes /

Nordfeldt, Sam, January 1900 (has links)
Diss. (sammanfattning) Linköping : Univ. / Härtill 6 uppsatser.
84

När blodsockret faller : – En studie om vikten av anhöriginformation och hur landsting kan informera om hypoglykemi med pathos.

Cronert, Mattias January 2016 (has links)
This is a study regarding the use of information aimed at relatives and close ones to people that is experiencing hypoglycemia due to their diabetes. And how the use of the classical rhetorical appeal pathos can be used to design such information, in order to emphasize the importance of knowing how to act when a person is experiencing the hypoglycemia state and how to make the information more relatable. This is a design study with and academic leap containing qualitative interviews with three participants. The problem studied is the information gap between people with diabetes and their surrounding family and friends. In this study the results show that the participants face danger in environments outside their home due to the lack of knowledge about diabetes and hypoglycemia symptoms. The focus of the study is understanding how people with diabetes type-1 experience hypoglycemia, so that I can inform about this subject in a manner and language that will reach the intended receiver. Done research shows that a low knowledge regarding diabetes is more than a fact, it’s a real problem within the field of information design and textdesign. Keywords: textdesign, hypoglycemia, diabetes, information design, human centered design, pathos
85

Le traitement nutritionnel des épisodes d'hypoglycémie dans le diabète de type 1

Savard, Valérie 04 1900 (has links)
Les patients atteints de diabète de type 1 (DbT1) semblent sur-traiter leurs hypoglycémies par rapport aux recommandations des Lignes directrices Canadiennes en diabète. Objectifs : 1) Décrire les habitudes des patients DbT1 pour le traitement des hypoglycémies et estimer les impacts sur le profil de risque cardio-métabolique et 2) explorer les excursions glycémiques suite à un traitement d’hypoglycémie qui respecte les recommandations. Méthodologie (analyses secondaires) : Objectif 1 : 121 patients DbT1 ont complété un journal alimentaire et de glycémies de 48 h. Des variables cardio-métaboliques ont été mesurées et un questionnaire sur la peur des hypoglycémies a été complété. Objectif 2 : 57 patients DbT1 ont complété les bras contrôles de notre programme sur le pancréas artificiel (traitement des hypoglycémies standardisé). Les valeurs de glycémie étaient disponibles aux 5 minutes. Résultats : Projet 1 : Les patients ont fait en moyenne 1,45 hypoglycémies/jour et 73% sur-traitaient avec une consommation moyenne de glucides de 32 ± 24 g. Ce sur-traitement est associé avec un plus jeune âge et une peur des hypoglycémies plus importante, mais pas avec un profil de risque cardio-métabolique plus défavorable. Projet 2 : Dans 20% des cas, traiter une hypoglycémie avec 15 g de glucides était efficace pour ramener la glycémie ≥ 4,0 mmol/L en 15 minutes, le temps moyen étant de 24 ± 12 minutes. La proportion d’insuline basale, le temps depuis le dernier repas et la pratique d’activité physique sont les éléments qui semblent avoir le plus d’impact sur l’efficacité du traitement. Conclusion : L’éducation entourant le traitement des hypoglycémies a besoin d’être renforcée et d’autres études sont nécessaires afin de valider les recommandations. / Patients with type 1 diabetes mellitus (TIDM) seem to be overtreating their hypoglycemia, compared to the Canadian Clinical practice guidelines in diabetes. Objectives: 1) Describe T1DM patients’ habits of nutritional treatment of hypoglycaemia and observe the impact on cardio-metabolic risk profile, and 2) explore glycemic excursions following hypoglycemic treatment performed according to guidelines. Methods (secondary analysis): Objective 1: 121 T1DM patients completed a 48-hour food and glycemic record. Metabolic variables were measured and a self-administered questionnaire on fear of hypoglycemia was completed. Objective 2: 57 T1DM patients completed the control arm from our artificial pancreas program (standardized hypoglycemia treatment). Glycemia levels at a 5-minute interval were available. Results: Project 1: The daily mean of hypoglycemia events was 1.45/day, and 73% of patients over-treated with a mean carbohydrate daily intake of 32 ± 24 g. Overtreatment was associated with a younger age and a higher fear of hypoglycemia, but not with a worsen cardio-metabolic risk profile. Project 2: Rising glycemia to ≥ 4,0 mmol/L within 15 minutes using a treatment of 15g of carbohydrates was efficient in only 20% of the cases. Mean time of hypoglycemia recuperation was 24 ± 12 minutes. Basal insulin, elapsed time since the last meal, and physical activity seemed to have the most impact on hypoglycemia treatment efficiency. Conclusion: Education on treatment of hypoglycemia needs to be increased. Further studies validating recommendations are warranted.
86

Hipoglicemia e fatores de risco em pacientes críticos com controle glicêmico: estudo de coorte / Hipoglycemia and risk factors in critically ill patients with glycemic control: cohort study

Crespo, Jeiel Carlos Lamonica 04 November 2014 (has links)
Introdução: No âmbito da assistência ao paciente crítico, ainda persiste uma intensa e controversa discussão acerca da dificuldade da manutenção da normoglicemia, especialmente a fim de evitar episódios hipoglicêmicos. A hipoglicemia consiste em importante evento adverso e fator limitante para o controle glicêmico (CG) ideal. Objetivo: Este trabalho teve por objetivo analisar a hipoglicemia e os fatores associados em pacientes críticos. Método: Coorte retrospectiva conduzida com pacientes críticos internados nas unidades de terapia intensiva, e clínica semi-intensiva do Hospital Universitário da Universidade de São Paulo. A amostra foi composta por 106 adultos, que apresentaram CG, por, pelo menos, 48 h, e cujo seguimento foi de 72 h. A variável dependente foi hipoglicemia (70mg/dl) e independentes foram idade, dieta, uso de insulina, catecolaminas, hemodiálise, carga de trabalho de enfermagem e SAPSII. Na análise dos dados utilizaram-se os testes t de student, Exato de Fisher e regressão logística, com significância de p 0,05. Resultados: A incidência de hipoglicemia 70mg/dl foi de 14,2%. A média de idade foi 63,3 anos, com internação clínica em 67% dos casos, cerca de 40% dos pacientes tinham diabetes mellitus 39% insuficiência renal e 8% insuficiência hepática. A hipoglicemia foi associada a média da glicemia (p=0,013) variabilidade glicêmica (p=0,000), uso de catecolaminas (p=0,040), óbito na UTI (p=0,008). Foram fatores de risco a ausência de dieta via oral, OR 5,11; IC 1,04 -25,10, e a realização de hemodiálise OR 4,28; IC 1,16-15,76. O intervalo de medida glicêmica mais frequente foi de 6/6h, com poucas medidas em horários de troca de turno de trabalho e no período das 4 h às 7 h. A correlação entre medidas glicêmicas prescritas e realizadas foi de 0,880 (p=0,000). Conclusão: A hipoglicemia persiste como evento adverso no contexto das unidades críticas. A prescrição do CG, com maior ênfase na monitorização nos grupos de risco, ou seja, nos pacientes submetidos a hemodiálise e aqueles que não recebem dieta VO, pode ajudar a prevenir episódios hipoglicêmicos / Introduction: Within the context of critical patients care, there remains an intense and controversial discussion over the difficulty of maintaining normoglycemia, especially to avoid hypoglycemic episodes. Hypoglycemia is an important adverse event and a limiting factor for an ideal glycemic control (GC). Objective: This study aimed to analyze the factors associated to hypoglycemia in critically ill patients. Methods: Retrospective cohort study conducted in critically ill patients from intensive and semi-intensive care units, of the University Hospital University of São Paulo. The sample consisted of 106 adults who had GC, for at least 48 h, and whose follow-up was 72 h. The dependent variable was hypoglycemia (70mg / dl) and independent variables were age, diet, insulin, catecholamines, hemodialysis, nursing workload and SAPSII. In the data analysis we used Students t and Fishers Exact tests and logistic regression, with significance of p 0,05. Results: The incidence of hypoglycemia 70mg / dl was 14.2%. The average age was 63.3 years, 67% were clinical patients, about 40% had diabetes mellitus, 39% had renal failure and 8% liver failure. Hypoglycemia was associated with mean blood glucose (p = 0.013) glycemic variability (p = 0.000), use of catecholamines (p = 0.040), and death in the ICU (p = 0.008). Risk factors were the absence of oral diet, OR 5.11; CI 1.04 -25.10, and hemodialysis OR 4.28; CI 1.16 to 15.76. The most frequent range of glucose measurement was 6 / 6 h, with few readings in the hours of the nursing work shift change, and from 4 h to 7 h am. The correlation between prescribed and performed glucose measurements was 0.880 (p = 0.000). Conclusion: Hypoglycemia persists as an adverse event in the context of critical units. Prescription of GC, with greater emphasis on monitoring in risk groups, namely, patients undergoing hemodialysis and those not receiving VO diet, can help prevent hypoglycemic episodes
87

18-22 metų merginų, sergančių 1 tipo cukriniu diabetu, greitosios adaptacijos aerobiniams ėjimo krūviams ypatumai / 18-22 years girl, with type 1 diabetes, quick load adaptations aerobic walking workload characteristics

Jakaitė, Jurgita 20 June 2012 (has links)
Hipotezė: 1 tipo cukriniu diabetu sergančių merginų vegetacinių sistemų rodiklių pokyčiai krūvio metu bus didesni, nei šokėjų ir nesportuojančių. Tikslas: Įvertinti 18-22 1 tipo cukriniu diabetu sergančių merginų, greitosios adaptacijos aerobiniams ėjimo krūviams, ypatumus. Tiriamieji: 10 šokėjų, 12 nesportuojančių sveikų merginų, ir 12 sergančių 1 tipo cukriniu diabetu merginų. Tyrimo metodai: 1. Kūno kompozicija 2. dujų analizė 3. pulsometrija 4. biocheminė kraujo analizė 5. standartinis šešių minučių ėjimo krūvis bėgtakiu 6. matematinė statistika. Tyrimo organizavimas: Tyrimas atliktas 2011-2012 metais. Tyrime dalyvavo 34 merginos, kurios buvo suskirstytos į 3 grupes: I grupę sudarė 1 tipo cukriniu diabetu sergančios merginos (n=12), II grupę šokėjos (n=10), III grupę nesportuojančios sveikos merginos (n=12). Tiriamosios buvo 18-22 metų amžiaus. Tiriamosios, atvykusios į Lietuvos kūno kultūros akademijos sporto fiziologijos labaratorija, buvo supažindintos su tyrimu. Prieš tyrimą tiriamosioms buvo atlikta kūno sudėties analizė su „Tanita TBF-300-A “ svartyklėmis. “Tanita TBF-300-A” svarstyklėmis buvo nustatyta tiriamųjų: kūno masė, KMI (kūno masės indeksas), riebalų masė (%), riebalų masė (kg). Visos tyrime dalyvavusios merginos atliko 6 minučių standartinį ėjimo testą bėgtakiu VIASYS LE 200 CE (Vokietija) pagal (1 tyrimo protokolą). 6 minučių standartinio ėjimo testo metu buvo atliktas tiesioginis MDS nustatymas dujų analizatoriumi „Oxycon Mobile“ (Jaeger, Vokietija)... [toliau žr. visą tekstą] / Hypothesis: We thought that type 1 diabetic girls vegetative system parameters during exercise will be higher than the dancers and untrained. The aim of the study: To evaluate the type 1 diabetic quick adaptation of aerobic walking loads, characteristics Subjects: 10 dancers, 12 untrained healthy women, 12 patients with type 1 diabetic women. The methods of the study: 1. Body composition 2. gas analysis 3. pulsometry 4. biochemical blood analysis 5. standard 6-minute treadmill walk test 6. mathematical statistics. The organization of the study: The study was conducted from 2011 to 2012 years. The study included 34 women were divided into 3 groups: group I consisted of type 1 diabetic girls (n = 12), group II dancers (n = 10), III group of healthy untrained girls (n = 12). The participants were between 18-22 years of age. Before the study subjects was performed body composition analysis with Tanita TBF-300-A."Tanita TBF-300-A subjects were found on scales: body weight, BMI (body mass index), fat mass (%), fat mass (kg).All the girls participated in the study, carried out a standard 6-minute treadmill walk test VIASYS LE 200 CE (Germany) in accordance with (1 TABLE). Standard 6-minute walk test was carried out directly by the gas analyzer MDS "Oxycon Mobile (Jaeger, Germany). Total 6-minute walk test in a standard treadmill VIASYS LE 200 CE (Germany) and recovery time using a portable system Oxycon Mobile has been recorded in gas exchange rates of oxygen consumption (VO2)... [to full text]
88

The prevalence and nutritional causes of hypoglycaemia in patients with end-stage renal failure (ESRF) on maintenance haemodialysis (MHD) at Kenyatta National Hospital Nairobi, Kenya

Kariuki, Anastacia Wanjiku 03 1900 (has links)
Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--University of Stellenbosch, 2008. / BACKGROUND: Although hypoglycaemia is a known complication of haemodialysis, there is little information about its prevalence among patients on maintenance haemodialysis. OBJECTIVE: To determine the prevalence of hypoglycaemia in patients on maintenance haemodialysis in Kenyatta National Hospital (Nairobi, Kenya) and to identify potential nutritionrelated causes of hypoglycaemia. METHODS: A cross-sectional, descriptive and observational study design was followed. Patients who had been on chronic maintenance haemodialysis for 3 months or longer were included in the study which was carried out from May 8 through to June 30, 2006. Random blood glucose levels were determined at baseline, 15 minutes, 30 minutes and 45 minutes, and at hourly intervals thereafter until the end of the dialysis session. The prevalence of hypoglycaemia (a blood glucose level less than 3.9 mmol/L) was then determined for the duration of haemodialysis. The relationship between minimum blood glucose levels and dietary intake, anthropometric status, primary diagnosis, co-morbid and socio-demographic factors, prescribed medication and dialysis related factors was determined. RESULTS: Among the 51 haemodialysis patients who participated in the study, the prevalence of hypoglycaemia was 16% (n=8). Eight percent (n=4) of these patients were however already hypoglycaemic on initiation of dialysis. Dietary intake of niacin ((r=0.31; p=0.02), riboflavin (r=0.30; p=0.03) and vitamin B6 (r=0.30; p=0.03) showed a significant relationship with blood glucose levels. The relationships between hypoglycaemic episodes and insulin administration (p=0.06), and between blood glucose levels and BMI (r=0.25; p=0.08 and protein intake (r=0.26; p=0.07) approached significance. There was no significant relationship between blood glucose levels and the duration of haemodialysis (p=0.942), hours of haemodialysis (p=0.27) and the dialysate solution used (p=0.12). CONCLUSIONS: Hypoglycaemia was present in 16% of patients on maintenance haemodialysis. Potential nutritional parameters which may have contributed to lower blood glucose levels in this study include a lower dietary intake of niacin, riboflavin, and vitamin B6. Lower protein intake and lower BMI was marginally associated with low blood glucose levels.
89

Frequência de hipoglicemia e satisfação dos pacientes que recebem análogos de insulina para o tratamento do diabetes mellitus tipo 1 no Estado do Rio Grande do Sul

Berlanda, Gabriela January 2018 (has links)
Introdução: O controle glicêmico estrito com múltiplas injeções diárias de insulina é o foco do tratamento para diabetes mellitus tipo 1 (DM1), mas geralmente está associado a um aumento no número de episódios de hipoglicemia, e o estresse de conviver com esse evento pode estar associado a prejuízos para a saúde mental do paciente. Embora os análogos de insulina de ação prolongada tenham propriedades farmacológicas para imitar o perfil fisiológico de insulina, a literatura não é unânime em demonstrar esse efeito em comparação à insulina humana. No Brasil, apenas alguns estados, incluindo o Rio Grande do Sul (RS), fornecem análogos de insulina para pacientes com DM1. O objetivo deste estudo foi avaliar a frequência de hipoglicemias e a satisfação dos pacientes com DM1 que recebem análogos de insulina de curta e longa ação após sua introdução no Rio Grande do Sul (RS). Materiais e métodos: Estudo transversal, retrospectivo, realizado com pacientes adultos com diabetes tipo 1, residentes de 38 cidades do estado do Rio Grande do Sul, que recebiam análogos de insulina via Secretaria Estadual de Saúde. Os dados clínicos e demográficos foram avaliados por formulário auto-respondido, a satisfação dos pacientes com o tratamento através do Questionário de satisfação com o tratamento do diabetes (DTSQs) e os transtornos mentais comuns (TMC) através do Questionário sobre saúde geral (QSG-12). Resultados: Um total de 507 pacientes foram incluídos, com idade média de 38,6±13,7 anos, 52% feminino, com duração do DM 18 [IQR25-75 = 11-25] anos e 36,8% com ensino superior completo. A pontuação mediana de satisfação com o tratamento (DTSQs) foi de 32 [IQR25-75 = 29 -35]. A satisfação dos pacientes não reduziu a longo prazo. A taxa de pacientes com hipoglicemias, incluindo grave e noturna, não alterou com o tempo de uso dos análogos de insulina. Apesar de taxas altas de hipoglicemias e com a maioria dos pacientes com triagem positiva para transtornos mentais comuns os pacientes mantiveram altos escores de satisfação com o tratamento, o que não reduziu em longo prazo como em outras intervenções em doenças crônicas. / Introduction: Strict glycemic control with multiple daily insulin injections is the focus of treatment for type 1 diabetes (T1D), but it is usually associated with an increase in the number of hypoglycemia episodes, and the stress of living with this event may be associated with damages to the mental health of the patient. Although long-acting insulin analogues have pharmacological properties to mimic physiologic insulin profile, literature is not unanimous in showing this effect in comparison to human insulin. In Brazil, only some states, including Rio Grande do Sul (RS), provide insulin analogues for T1D patients. The purpose of this study was to evaluate the frequency of hypoglycemia and the satisfaction of T1D patients who receive short and long acting insulin analogues after their introduction in RS. Methods: A cross-sectional, retrospective study was conducted with adult patients with T1D, residents of 38 cities in Rio Grande do Sul state, who received insulin analogues via the State Department of Health. Demographic and clinical data was evaluated through a self-responded questionnaire; satisfaction, analyzed using the Diabetes Treatment Satisfaction Questionnaire (DTSQs), and Common Mental Disorders (CMD), analyzed using the General Health Questionnaire (QSG-12). Results: A total of 507 T1D patients were included, with a mean age of 38.6 ± 13.7 years, 52% female, with diabetes duration of 18 (11-25) years and 36.8% with complete higher education. The medium score of satisfaction with the treatment (DTSQs) was 32 [IQR25-75 = 29 -35]. Patient satisfaction was not reduced in the long term. The rate of patients with hypoglycemia, including severe and nocturnal hypoglycemia, was not changed with the time use insulin analogues. Although high rates of hypoglycaemia and with most patients with positive 14 screening for common mental disorders patients maintained high satisfaction scores with treatment, which did not reduce in the long term as in other interventions in chronic diseases.
90

Frequência de hipoglicemia e satisfação dos pacientes que recebem análogos de insulina para o tratamento do diabetes mellitus tipo 1 no Estado do Rio Grande do Sul

Berlanda, Gabriela January 2018 (has links)
Introdução: O controle glicêmico estrito com múltiplas injeções diárias de insulina é o foco do tratamento para diabetes mellitus tipo 1 (DM1), mas geralmente está associado a um aumento no número de episódios de hipoglicemia, e o estresse de conviver com esse evento pode estar associado a prejuízos para a saúde mental do paciente. Embora os análogos de insulina de ação prolongada tenham propriedades farmacológicas para imitar o perfil fisiológico de insulina, a literatura não é unânime em demonstrar esse efeito em comparação à insulina humana. No Brasil, apenas alguns estados, incluindo o Rio Grande do Sul (RS), fornecem análogos de insulina para pacientes com DM1. O objetivo deste estudo foi avaliar a frequência de hipoglicemias e a satisfação dos pacientes com DM1 que recebem análogos de insulina de curta e longa ação após sua introdução no Rio Grande do Sul (RS). Materiais e métodos: Estudo transversal, retrospectivo, realizado com pacientes adultos com diabetes tipo 1, residentes de 38 cidades do estado do Rio Grande do Sul, que recebiam análogos de insulina via Secretaria Estadual de Saúde. Os dados clínicos e demográficos foram avaliados por formulário auto-respondido, a satisfação dos pacientes com o tratamento através do Questionário de satisfação com o tratamento do diabetes (DTSQs) e os transtornos mentais comuns (TMC) através do Questionário sobre saúde geral (QSG-12). Resultados: Um total de 507 pacientes foram incluídos, com idade média de 38,6±13,7 anos, 52% feminino, com duração do DM 18 [IQR25-75 = 11-25] anos e 36,8% com ensino superior completo. A pontuação mediana de satisfação com o tratamento (DTSQs) foi de 32 [IQR25-75 = 29 -35]. A satisfação dos pacientes não reduziu a longo prazo. A taxa de pacientes com hipoglicemias, incluindo grave e noturna, não alterou com o tempo de uso dos análogos de insulina. Apesar de taxas altas de hipoglicemias e com a maioria dos pacientes com triagem positiva para transtornos mentais comuns os pacientes mantiveram altos escores de satisfação com o tratamento, o que não reduziu em longo prazo como em outras intervenções em doenças crônicas. / Introduction: Strict glycemic control with multiple daily insulin injections is the focus of treatment for type 1 diabetes (T1D), but it is usually associated with an increase in the number of hypoglycemia episodes, and the stress of living with this event may be associated with damages to the mental health of the patient. Although long-acting insulin analogues have pharmacological properties to mimic physiologic insulin profile, literature is not unanimous in showing this effect in comparison to human insulin. In Brazil, only some states, including Rio Grande do Sul (RS), provide insulin analogues for T1D patients. The purpose of this study was to evaluate the frequency of hypoglycemia and the satisfaction of T1D patients who receive short and long acting insulin analogues after their introduction in RS. Methods: A cross-sectional, retrospective study was conducted with adult patients with T1D, residents of 38 cities in Rio Grande do Sul state, who received insulin analogues via the State Department of Health. Demographic and clinical data was evaluated through a self-responded questionnaire; satisfaction, analyzed using the Diabetes Treatment Satisfaction Questionnaire (DTSQs), and Common Mental Disorders (CMD), analyzed using the General Health Questionnaire (QSG-12). Results: A total of 507 T1D patients were included, with a mean age of 38.6 ± 13.7 years, 52% female, with diabetes duration of 18 (11-25) years and 36.8% with complete higher education. The medium score of satisfaction with the treatment (DTSQs) was 32 [IQR25-75 = 29 -35]. Patient satisfaction was not reduced in the long term. The rate of patients with hypoglycemia, including severe and nocturnal hypoglycemia, was not changed with the time use insulin analogues. Although high rates of hypoglycaemia and with most patients with positive 14 screening for common mental disorders patients maintained high satisfaction scores with treatment, which did not reduce in the long term as in other interventions in chronic diseases.

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