Multifactorial intervention for diabetes control among older users of insulin

Autores

  • Rafael Vaz Machry Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Departamento de Medicina Interna Universidade Federal do Rio Grande do Sul. Programa de Pós-Graduação em Endocrinologia Universidade Federal de Santa Maria. Centro de Ciências da Saúde. Departamento de Clínica Médica
  • Henrique Umpierre Pedroso Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Departamento de Medicina Interna
  • Luthiele Silva Vasconcellos Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Departamento de Medicina Interna
  • Rafaela Ramos Nunes Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Departamento de Medicina Interna
  • Cibelle de Abreu Evaldt Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Departamento de Medicina Interna
  • Eduardo Bardou Yunes Filho Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Departamento de Medicina Interna Universidade Federal do Rio Grande do Sul. Programa de Pós-Graduação em Endocrinologia
  • Ticiana da Costa Rodrigues Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Departamento de Medicina Interna Universidade Federal do Rio Grande do Sul. Programa de Pós-Graduação em Endocrinologia

DOI:

https://doi.org/10.11606/S1518-8787.2018052000144

Palavras-chave:

Aged. Diabetes Mellitus, prevention & control. Glycemic Index, drug effects. Hypoglycemic Agents. Insulin, administration & dosage. Blood Glucose Self-Monitoring. Clinical Trial.

Resumo

OBJECTIVE: To evaluate if the closer follow-up with the supply of insulin pens and the measurement of capillary blood glucose improve the management of older patients with type 2 diabetes without adequate glycemic control despite extensive therapy. METHODS: This is a prospective, non-randomized, quasi-experimental study. We have included 45 patients over 60 years old, from both sexes, with glycated hemoglobin (HbA1c) > 8.5% using oral hypoglycemic agents and insulin. The intervention consisted of monthly medical visits, with the provision of insulin pens and strips for blood glucose measurement. All patients received insulin pen, refills of Neutral Protamine Hagedorn and regular insulin, needles for the pen, blood glucose meter, and capillary blood glucose tests (three tests/day). Treatment was adjusted with the same endocrinologist monthly for six months. Glycated hemoglobin was measured at baseline and 12 and 24 weeks after intervention. RESULTS: Glycated hemoglobin at baseline was 10.34% (SE = 0.22%) and 8.54% (SE = 0.24%, p < 0.001) and 8.09% (SE = 0.21%, p < 0.001) at 12 and 24 weeks after intervention, respectively, with a significant reduction from baseline. CONCLUSIONS: More frequent medical visits, with treatment inputs including the use of insulin pens and self-monitoring, have improved glycemic control (reduction of 2.25% in HbA1C, on average, at 24 weeks of follow-up). Our data support a change in the management and medical behavior of older patients with chronically decompensated diabetes.

Publicado

2018-05-08

Edição

Seção

Artigos Originais

Como Citar

Machry, R. V., Pedroso, H. U., Vasconcellos, L. S., Nunes, R. R., Evaldt, C. de A., Yunes Filho, E. B., & Rodrigues, T. da C. (2018). Multifactorial intervention for diabetes control among older users of insulin. Revista De Saúde Pública, 52, 60. https://doi.org/10.11606/S1518-8787.2018052000144