Self-care in adults with type 1 diabetes Mellitus
analysis of glycemic control
Keywords:
Blood glucose self-monitoring, Diabetes mellitus, type 1, Health promotion, Self-care skillsAbstract
Objective
Glycemic control is essential for reducing the risks of long-term complications in individuals living with type 1 diabetes mellitus. The study aimed to evaluate the relationship between glycemic control and demographic, economic, and clinical characteristics, and self-care behaviors for diabetes.
Method
A total of 107 people living with diabetes participated in the study. The participants completed an online self-report questionnaire containing clinical indicators and health care measures.
Results
The results showed that most participants did not have adequate glycemic control (based on glycated hemoglobin evaluation), especially due to difficulties in monitoring the disease and a lack of daily testing, as well as an increase in tobacco use. Low income, high body mass index, and low social class also predicted inadequate glycemic control.
Conclusion
It is recommended that health strategies sensitive to social inequalities and individual difficulties related to glycemic control be implemented to promote health.
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References
Alramadan, M. J., Afroz, A., Hussain, S. M., Batais, M. A., Almigbal, T. H., Al-Humrani, H. A., Albaloshi, A., Romero L., Magliano, D. J., & Billah, B. (2018). Patient-related determinants of glycemic control in people with type 2 diabetes in the gulf cooperation council countries: a systematic review. Journal of Diabetes Research, 2018, 9389265. https://doi.org/10.1155/2018/9389265
American Diabetes Association. (2022). Standards of medical care in diabetes-2022 abridged for primary care providers. Clinical Diabetes, 40(1), 10-38. https://doi.org/10.2337/cd22-as01
Associação Brasileira de Empresas de Pesquisa. (2019). Critério Brasil-2019. www.abep.org/criterioBr/01_cceb_2019.pdf
Azharuddin, M., Adil, M., Sharma, M., & Gyawali, B. (2021). A systematic review and meta-analysis of non-adherence to anti-diabetic medication: Evidence from low- and middle-income countries. International Journal of Clinical Practice, 75(11), e14717. https://doi.org/10.1111/ijcp.14717
Coutinho, W. F., & Silva Júnior, W. S. (2016). Diabetes Care in Brazil. Annals of Global Health, 81(6), 735-741. https://doi.org/10.1016/j.aogh.2015.12.010
Davison, K. A, Negrato, C. A, Cobas, R., Matheus, A., Tannus, L., Palma, C. S., Japiassu, L., Carneiro, J. R. I., Rodacki, M., Zajdenverg, L., Araújo, N. B. C., Cordeiro, M. M., Luescher, J. L., Berardo, R. S., Nery, M., Cani, C., Marques, M. C. A., Calliari, L. E., Noronha, R. M., ... Gomes, M. B. (2014). Relationship between adherence to diet, glycemic control and cardiovascular risk factors in patients with type 1 diabetes: a nationwide survey in Brazil. Nutrition Journal, 13(1), 1-11. https://doi.org/10.1186/1475-2891-13-19
Fortins, R. F., Lacerda, E. M. A., Silverio, R. N. C., Carmo, C. N., Ferreira, A. A., Felizardo, C., Nascimento, B. F., & Luescher, J. L., & Padilha, P. C. (2019). Predictor factors of glycemic control in children and adolescents with type 1 diabetes mellitus treated at a referral service in Rio de Janeiro, Brazil. Diabetes Research and Clinical Practice, 154, 138-145. https://doi.org/10.1016/j.diabres.2019.05.027
Gomes, M. B., Coral, M., Cobas, R. A., Dib, S. A., Canani, L. H., Nery, M., Freitas, M. C., Faria, M., Felício, J. S., Silva, S. C., Pedrosa, H., Costa e Forti, A., Rea, R. R., Pires, A. C., Montenegro Junior, R., Oliveira, J. E., Rassi, N., & Negrato, C. A. (2012). Prevalence of adults with type 1 diabetes who meet the goals of care in daily clinical practice: a nationwide multicenter study in Brazil. Diabetes Research and Clinical Practice, 97(1), 63-70. https://doi.org/10.1016/j.diabres.2012.02.008
Huo, L., Deng, W., Shaw, J. E., Magliano, D. J., Zhang, P., McGuire, H. C., Kissimova-Skarbek, K., Whiting, D., & Ji, L. (2020). Factors associated with glycemic control in type 1 diabetes patients in China: A crosssectional study. Journal of diabetes investigation, 11(6), 1575–1582. https://doi.org/10.1111/jdi.13282
Johnston, L., Wang, G., Hu, K., Qian, C., & Liu, G. (2021). Advances in biosensors for continuous glucose monitoring towards wearables. Frontiers in Bioengineering and Biotechnology, 9, 1-17. https://doi.org/10.3389/fbioe.2021.733810
Knekta, E., Runyon, C., & Eddy, S. (2019). One size doesn’t fit all: Using factor analysis to gather validity evidence when using surveys in your research. Life Sciences Education, 18(rm1), 1-17. https://doi.org/10.1187%2Fcbe.18-04-0064
Ledesma, R. D., Valero-Mora, P., & Macbeth, G. (2015). The scree test and the number of factors: A dynamic graphics approach. Spanish Journal of Psychology, 18(e11), 1-10. http://dx.doi.org/10.1017/sjp.2015.13
Malta, D. C., Andrade, S. C., Claro, R. M., Bernal, R. T. I., & Monteiro, C. A. (2014). Evolução anual da prevalência de excesso de peso e obesidade em adultos nas capitais dos 26 estados brasileiros e no Distrito Federal entre 2006 e 2012. Revista Brasileira de Epidemiologia, 17(1), 267-276. https://doi.org/10.1590/1809-4503201400050021
Marques, R. D. M. B., Fornés, N. S., & Stringhini, M. L. F. (2011). Fatores socioeconômicos, demográficos, nutricionais e de atividade física no controle glicêmico de adolescentes portadores de diabetes melito tipo 1. Arquivos Brasileiros de Endocrinologia & Metabologia, 55, 194-202. https://doi.org/10.1590/S0004-27302011000300004
McLarty, R. P., Alloyce, J. P., Chitema, G. G., & Msuya, L. J. (2021). Glycemic control, associated factors, acute complications of Type 1 Diabetes Mellitus in children, adolescents and young adults in Tanzania. Endocrinology, Diabetes & Metabolism, 4, e00200. https://doi.org/10.1002/edm2.200
Moraes, C. M., Portella, R. B., Pinheiro, V. S., Oliveira, M. M. S., Fuks, A. G., Cunha, E. F., & Gomes, M. B. (2003). Prevalência de sobrepeso e obesidade em pacientes com diabetes tipo 1. Arquivos Brasileiros de Endocrinologia & Metabologia, 47(6), 677-683. https://doi.org/10.1590/S0004-27302003000600009
Moreira, E. D., Jr, Neves, R. C. S., Nunes, Z. O., Almeida, M. C. C., Mendes, A. B. V., Fittipaldi, J. A. S., & Ablan, F. (2010). Glycemic control and its correlates in patients with diabetes in Venezuela: Results from a nationwide survey. Diabetes Research and Clinical Practice, 87(3), 407-414. https://doi.org/10.1016/j.diabres.2009.12.014
Mourão-Júnior, C. A., Sá, J. R. D., Guedes, O. M. S., & Dib, S. A. (2006). Glycemic control in adult type 1 diabetes patients from a brazilian country city: Comparison between a multidisciplinary and a routine endocrinological approach. Arquivos Brasileiros de Endocrinologia & Metabologia, 50(5), 944-950. https://doi.org/10.1590/S0004-27302006000500018
Nguyen, A. L., Green, J., & Enguidanos, S. (2015). The relationship between depressive symptoms, diabetes symptoms, and self-management among an urban, low-income Latino population. Journal of Diabetes and its Complications, 29(8), 1003-1008. https://doi.org/10.1016/j.jdiacomp.2015.09.004
Nunes, R. R., Clemente, E. L. D. S., Pandini, J. A., Cobas, R. A., Dias, V. M., Sperandei, S., & Gomes, M. D. B. (2009). Confiabilidade da classificação do estado nutricional obtida através do IMC e três diferentes métodos de percentual de gordura corporal em pacientes com diabetes melitus tipo 1. Arquivos Brasileiros de Endocrinologia & Metabologia, 53(3), 360-367. https://doi.org/10.1590/S0004-27302009000300011
Okido, A. C. C., Almeida, A. D., Vieira, M. M., Neves, E. T., Mello, D. F. D., & Lima, R. A. G. (2017). As demandas de cuidado das crianças com Diabetes Mellitus tipo 1. Escola Anna Nery, 21(2), e20170034. https://doi.org/10.5935/1414-8145.20170034
Peduzzi, P., Concato, J., Kemper, E., Holford, T. R., & Feinstein, A. R. (1996). A simulation study of the number of events per variable in logistic regression analysis. Journal of Clinical Epidemiology, 49(12), 1373-1379. https://doi.org/10.1016/s0895-4356(96)00236-3
Pettus, J. H., Zhou, F. L., Shepherd, L., Preblick, R., Hunt, P. R., Paranjape, S., Miller K. M., & Edelman, S. V. (2019). Incidences of severe hypoglycemia and diabetic ketoacidosis and prevalence of microvascular complications stratified by age and glycemic control in U.S. adult patients with type 1 diabetes: A real-world study. Diabetes Care, 42(12), 2220-2227. https://doi.org/10.2337/dc19-0830
Peyrot, M., Barnett, A. H., Meneghini, L. F., & Schumm-Draeger, P. M. (2012). Factors associated with injection omission/non-adherence in the Global Attitudes of Patients and Physicians in Insulin Therapy study. Diabetes, Obesity and Metabolism, 14, 1081-1087. https://doi.org/10.1111/j.1463-1326.2012.01636.x
Rodrigues, T. C., Pecis, M., Canani, L. H., Schreiner, L., Kramer, C. K., Biavatti, K., Macedo, B., Esteves, J. F., & Azevedo, M. J. (2010). Caracterização de pacientes com diabetes mellitus tipo 1 do sul do Brasil: complicações crônicas e fatores associados. Revista da Associação Médica Brasileira, 56(1), 67-73. https://doi.org/10.1590/S0104-42302010000100019
Sand, P., Blom, M. D., Forsander, G., & Lundin, C. S. (2018). Family dynamics when a child becomes chronically ill: impact of type 1 diabetes onset in children and adolescents. Nordic Psychology, 70(2), 97-114. https://doi.org/10.1080/19012276.2017.1362990
Sheleme, T., Mamo, G., Melaku, T., & Sahilu, T. (2020). Glycemic control and its predictors among adult diabetic patients attending Mettu Karl referral hospital, southwest Ethiopia: A prospective observational study. Diabetes Therapy, 11, 1775-1794. https://doi.org/10.1007/s13300-020-00861-7
Sociedade Brasileira de Diabetes. (2021). Diretrizes da Sociedade Brasileira de Diabetes - 2021. https://diretriz.diabetes.org.br/data/2021/
Šoupal, J., Petruželková, L., Grunberger, G., Hásková, A., Flekač, M., Matoulek, M., Mikeš, O., Pelcl, T., Škrha, J., Jr, Horová, E., Škrha, J., Parkin, C. G., Svačina, Š., & Prázný, M. (2020). Glycemic outcomes in adults with T1D are impacted more by continuous glucose monitoring than by insulin delivery method: 3 years of follow-up from the COMISAIR study. Diabetes Care, 43(1), 37-43. https://doi.org/10.2337/dc19-0888
Watkins, M. W. (2018). Exploratory factor analysis: a guide to best practice. Journal of Black Psychology, 44(3), 219-246. https://doi.org/10.1177/0095798418771807
World Health Organization. (2018). Health inequities and their causes. https://www.who.int/news-room/factsin-pictures/detail/health-inequities-and-their-causes
World Health Organization. (2011). Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus. http://www.who.int/diabetes/publications/report-hba1c_2011.pdf
Ziegler, R., Heidtmann, B., Hilgard, D., Hofer, S., Rosenbauer, J., Holl, R., & DPV-Wiss-Initiative. (2011). Frequency of SMBG correlates with HbA1c and acute complications in children and adolescents with type 1 diabetes. Pediatric Diabetes, 12(1), 11-17. https://doi.org/10.1111/j.1399-5448.2010.00650.x
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