Glycemic control in diabetes mellitus in patients assisted by a university hospital in the state of Piauí (Brazil)

Abstract

Objectives: To investigate glycemic control in outpatient clinics at a university hospital, as well as to correlate HbA1c with fasting glucose and post-prandial glycemia, in order to assess which variable best correlates with an HbA1c. Methods: This is a descriptive cross-sectional study, with data that were collected from electronic medical records, from the random consultation of the medical of the blood glucose measurement. To check glycemic control, the parameters defined by the Brazilian Diabetes Society (2017-2018) were used: fasting glucose <100 mg / dL, HbA1c <7% and postprandial glucose <160 mg / dL. A statistical analysis was performed with the aid of the SPSS® program (version 13.0), adopting p <0.05 as the level of statistical significance. Results: 250 medical records were applied, with the average age of the participants being 60.1 ± 12.9 years (87 men and 163 women). A fasting glycemia was altered beyond the recommended in 80.8% of the individuals evaluated, HbA1c in 45.2% of the cases and 66% of the participants in the study possessed postprandial glycemia in addition to the recommended goals. The correlation between HbA1c/fasting blood glucose (rs= 0.74) and HbA1c/postprandial blood glucose (rs = 0.60) was, respectively, strong and moderate. Conclusions: With this study, it was possible to verify that a significant portion of the limits of use did not have good glycemic control. The correlation between fasting glucose and HbA1c confirmed that HbA1c is the best parameter for monitoring blood glucose levels in diabetes mellitus. In addition, the fasting blood glucose / HbA1c correlation showed greater strength in the postprandial blood glucose / HbA1c correlation.

Poor glycemic control and associated factors in diabetic people attending a reference outpatient clinic in Mato Grosso, Brazil

“…Diabetics face barriers imposed by insulin therapy itself, such as repetitive injections and the respective discomfort, lack of supplies (materials) or access to home care, difficulty in maintaining regularity and adherence to therapy (food, medication and physical activity), as well as understanding the disease and its consequences that also interfere with glycemic control. (17) Still, it is noteworthy that the use of insulin revolutionized the treatment of the disease and the benefits arising from its regular, systematic and appropriate use provided better quality of life for diabetic patients.…”

“…Individuals aged 40 to 60 years with longer duration of the disease (>10 years) constitute a greater proportion of patients with poor glycemic control compared to those of different age groups. (16)(17)(18)(19)(20)(21)(22) This is a more recent reality, because although historically, poor glycemic control used to be more prevalent in older adults, nowadays, there is a higher incidence of diabetes in young people. (9) With the transformation of lifestyles and the approach to new care resources, there has been an increase in the longevity of this group and premature deaths of younger people resulting from exposure to risk factors (obesity, hypoactivity, alcoholism and smoking, another factor that can be attributed is the misuse of technologies in the contemporary world, added to the unavailability of time to perform physical activities, self-medication and others).…”