No abstract

No abstract

Type 2 diabetes (T2DM) is a chronic disease that requires multidisciplinary patient-centered treatment. Although important, promoting self-care strategies is still a challenge. Methods: Patients with T2DM and poor glycemic control (HbA1c > 7.5%) were randomly assigned to participate in the Self-Care Multidisciplinary Workshop for Diabetes (MW) or usual care (UC). The MW consisted of 15-minute individual meetings with each T2DM providers (nurse, pharmacist, dietitian, physical educator and social worker) to approach diabetes self-care topics. It was offered in 3 different modules through 12 weeks aiming to bring knowledge and skills necessary for patients to improve their diabetes care. UC included 3 brief meetings in which printed educational folders were provided. Both groups maintained standard care at outpatient T2DM clinic with endocrinologists. Generalized estimating equation model was performed to assess HbA1c, Diabetes-related Quality of Life and Summary of Diabetes Self-Care Activities questionnaires variation from baseline to 12 months. Results: Ninety-six patients (59 ±9 years-old, 60% women, diabetes duration of 16 ±10 years, 62% medium-low/low socio-economic status, HbA1c 9.6 ±1.4%) were included. Variation from baseline of HbA1c [UC -0.52% (CI 95% -1.08 to 0.26) vs. MW -0.30% (CI 95% -1.05 to 0.45) p=0.072], healthful eating plan in the last 7 days (d) [UC -0.22 d (CI 95% -1.27 to 0.82) vs. MW -0.03 d (CI 95% -0.85 to 0.79) p=0.15] and foot exam in the last 7 d [UC 0.51 d (CI 95% -0.75 to 1.77) vs. MW 1.1 d (CI 95% -0.16 to 2.39) p=0.329] to 12 months were not different between groups. There was a decrease in worry about future effects of diabetes in MW [-0.46 (CI -0.81 to -0.12)], not found in UC [0.11 (CI -0.20 to 0.42) p=0.004]. Conclusion: A short-term MW reduced worry about diabetes but failed to improve glycemic control and self-care activities in long-standing T2DM patients of a low-income country. ClinicalTrials.gov Identifier: NCT03074383. Disclosure S. Piccoli Garcia: None. G.H. Telo: None. J. Schneiders: None. C. Blume: None. G. Berlanda: None. K. Sparrenberger: None. A.N. Gossenheimer: None. M.M. Madalosso: None. L.G. Bottino: None. A.S.O. Schein: None. A.C.P. Macedo: None. L. Helal: None. C. Christofoli: None. L.P. Santos: None. B.D. Schaan: None. Funding Fundo de Incentivo à Pesquisa e Eventos do Hospital de Clínicas de Porto Alegre

This is a retrospective report of the frequency of severe hypoglycemia and the association between common mental disorders and type 1 diabetes mellitus treated with insulin analogues. Patients with severe hypoglycemia compared with those without this complication had a higher prevalence of positive screening for common mental disorders (88% vs.77%, respectively, p = 0.03).

Objective: The aim of this study was to evaluate the frequency of hypoglycemia and the treatment satisfaction in patients with type 1 diabetes (T1D) using insulin analogues. Subjects and methods: This observational retrospective study included 516 adult patients with T1D from 38 cities in Southern Brazil. Demographics and clinical data were collected using a self-report questionnaire. Hypoglycemia was defined as an event based on either symptoms or self-monitored blood glucose < 70 mg/dL. Treatment satisfaction was evaluated using the Diabetes Treatment Satisfaction Questionnaire status version (DTSQs) and with a specific question with scores ranging from 0-10. Common mental disorders were assessed using the General Health Questionnaire (GHQ-12). Results: Overall, the mean age was 38 ± 14 years and 52% of the participants were women. The median diabetes duration was 18 years. The scores for insulin analogue treatment satisfaction were higher than those for previous treatments. DTSQ scores had a median value of 32 (interquartile range 29-35) and remained unchanged over time. The percentage of patients with hypoglycemia (including severe and nocturnal) was comparable across groups divided according to duration of use of insulin analogues. Most patients (n=395, 77%) screened positive for common mental disorders. Conclusions: Patient satisfaction with insulin analogue treatment was high and remained unchanged with time. Episodes of hypoglycemia also remained unchanged over time among patients using insulin analogues.