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Results of glycated hemoglobin during treatment with insulin analogues dispensed in the public health system of Federal District in Brazil

Background: Diabetes treatment requires specialized multi-professional teams, supplies for blood glucose monitoring and training for self-injections of human insulin or insulin analogues. The State Health Secretariat of the Federal District (SHS-FD) has dispensed insulin analogues by means of clini...

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Main Authors: Leite, Eliziane Brandão, Pedrosa, Hermelinda Cordeiro, Casulari, Luiz Augusto
Format: Artigo
Language: Inglês
Published: BioMed Central 2021
Subjects:
Diabetes
Insulina
Hemoglobina glicada
Tratamento
Online Access: https://repositorio.unb.br/handle/10482/40950
https://doi.org/10.1186/s13098-015-0061-0
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spelling ir-10482-409502021-05-19T19:09:53Z Results of glycated hemoglobin during treatment with insulin analogues dispensed in the public health system of Federal District in Brazil Leite, Eliziane Brandão Pedrosa, Hermelinda Cordeiro Casulari, Luiz Augusto Diabetes Insulina Hemoglobina glicada Tratamento Background: Diabetes treatment requires specialized multi-professional teams, supplies for blood glucose monitoring and training for self-injections of human insulin or insulin analogues. The State Health Secretariat of the Federal District (SHS-FD) has dispensed insulin analogues by means of clinical validated protocols since 2004. However, data on outcomes of follow-up are still unknown. Objective: To evaluate the results of glycated hemoglobin (HbA1c) among diabetic patients treated with insulin analogues. Methods: It is a retrospective cohort study involving data of type 1(DM1) and type 2 diabetes (DM2) patients 18 years old and above who were registered to participate at the insulin analogues dispense program of the SHS-FD. Evaluation of criteria of insulin treatment continuity was based on HbA1c values achieved in the follow-up period: in the target, <7 %, patients between 18 and 65 years old; <8 % for those above 65 years old; out of target, when values were superior these cut off points for both age groups; and minimum 0.5 % reduction of two HbA1c values during follow-up. Results: Two hundred and fifteen formularies were analyzed: Type 2 patients (63.7 %) and female sex were the most prevalent (63.7 %), (p < 0.05). Mean age and SD were 41.5 ± 23.5 years among DM1 and 60.5 ± 28.5 in those with DM2. HbA1c in the target was found in 26 %, 48 % were out of target and 26 % achieved 0.5 % minimum reduction in HbA1c value (p < 0.05). The main clinical characteristics associated with HbA1c found to be in the target were older age (>65 years), more than three medical appointments in the follow-up and lower mean HbA1c in the patient selection for inclusion criteria in the dispense program (p < 0.05). Conclusion: The low number of patients using insulin analogues in the target group, considered to be in good control, implies the need to reevaluate both level of patients self-care knowledge and glucose monitoring prior their inclusion in the insulin analogue dispense program. Reinforcement and training of health professional teams in enrollment procedures should be on mandatory basis to avoid protocol failure or deviations. 2021-05-19T19:09:53Z 2021-05-19T19:09:53Z 2015 Artigo LEITE, Eliziane Brandão; PEDROSA, Hermelinda Cordeiro; CASULARI, Luiz Augusto. Results of glycated hemoglobin during treatment with insulin analogues dispensed in the public health system of Federal District in Brazil. Diabetology and Metabolic Syndrome, v.7, n.66, 2015. DOI: 10.1186/s13098-015-0061-0. Disponível em: https://dmsjournal.biomedcentral.com/articles/10.1186/s13098-015-0061-0. Acesso em: 17 maio 2021. https://repositorio.unb.br/handle/10482/40950 https://doi.org/10.1186/s13098-015-0061-0 Inglês Acesso Aberto (CC BY) - © 2015 Leite et al. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. application/pdf BioMed Central
institution REPOSITORIO UNB
collection REPOSITORIO UNB
language Inglês
topic Diabetes
Insulina
Hemoglobina glicada
Tratamento
spellingShingle Diabetes
Insulina
Hemoglobina glicada
Tratamento
Leite, Eliziane Brandão
Pedrosa, Hermelinda Cordeiro
Casulari, Luiz Augusto
Results of glycated hemoglobin during treatment with insulin analogues dispensed in the public health system of Federal District in Brazil
description Background: Diabetes treatment requires specialized multi-professional teams, supplies for blood glucose monitoring and training for self-injections of human insulin or insulin analogues. The State Health Secretariat of the Federal District (SHS-FD) has dispensed insulin analogues by means of clinical validated protocols since 2004. However, data on outcomes of follow-up are still unknown. Objective: To evaluate the results of glycated hemoglobin (HbA1c) among diabetic patients treated with insulin analogues. Methods: It is a retrospective cohort study involving data of type 1(DM1) and type 2 diabetes (DM2) patients 18 years old and above who were registered to participate at the insulin analogues dispense program of the SHS-FD. Evaluation of criteria of insulin treatment continuity was based on HbA1c values achieved in the follow-up period: in the target, <7 %, patients between 18 and 65 years old; <8 % for those above 65 years old; out of target, when values were superior these cut off points for both age groups; and minimum 0.5 % reduction of two HbA1c values during follow-up. Results: Two hundred and fifteen formularies were analyzed: Type 2 patients (63.7 %) and female sex were the most prevalent (63.7 %), (p < 0.05). Mean age and SD were 41.5 ± 23.5 years among DM1 and 60.5 ± 28.5 in those with DM2. HbA1c in the target was found in 26 %, 48 % were out of target and 26 % achieved 0.5 % minimum reduction in HbA1c value (p < 0.05). The main clinical characteristics associated with HbA1c found to be in the target were older age (>65 years), more than three medical appointments in the follow-up and lower mean HbA1c in the patient selection for inclusion criteria in the dispense program (p < 0.05). Conclusion: The low number of patients using insulin analogues in the target group, considered to be in good control, implies the need to reevaluate both level of patients self-care knowledge and glucose monitoring prior their inclusion in the insulin analogue dispense program. Reinforcement and training of health professional teams in enrollment procedures should be on mandatory basis to avoid protocol failure or deviations.
format Artigo
author Leite, Eliziane Brandão
Pedrosa, Hermelinda Cordeiro
Casulari, Luiz Augusto
author_sort Leite, Eliziane Brandão
title Results of glycated hemoglobin during treatment with insulin analogues dispensed in the public health system of Federal District in Brazil
title_short Results of glycated hemoglobin during treatment with insulin analogues dispensed in the public health system of Federal District in Brazil
title_full Results of glycated hemoglobin during treatment with insulin analogues dispensed in the public health system of Federal District in Brazil
title_fullStr Results of glycated hemoglobin during treatment with insulin analogues dispensed in the public health system of Federal District in Brazil
title_full_unstemmed Results of glycated hemoglobin during treatment with insulin analogues dispensed in the public health system of Federal District in Brazil
title_sort results of glycated hemoglobin during treatment with insulin analogues dispensed in the public health system of federal district in brazil
publisher BioMed Central
publishDate 2021
url https://repositorio.unb.br/handle/10482/40950
https://doi.org/10.1186/s13098-015-0061-0
_version_ 1710449541864488960
score 13.657419

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