RESUMO
OBJECTIVE: To evaluate the retention of information after participation in multidisciplinary group in patients with gestational diabetes mellitus (GDM) through a phone contact. METHOD: 122 pregnant women diagnosed with gestational diabetes were included. After diagnosis of gestational diabetes, the patients were referred to the multidisciplinary group where they received medical, nutrition and nursing guidelines related to the disease. After three days these patients received one telephone call from a nurse, who made the same questions regarding the information received. In the statistical analysis, results were presented as absolute and relative frequencies. RESULTS: Most patients 119/122 patients (97.5%) were managing to do self glucose monitoring. Twenty-one patients (17.2%) reported having difficulty performing the blood glucose, especially finger pricking. When questioning whether the woman was following the proposed diet, 24/122 (19.7%) patients said they did not; the meal frequency was not reached by 23/122 (18.9%) of the women, and forty-seven (38.5%) of the women reported having ingested sugar in the days following the guidance in multidisciplinary group. CONCLUSION: Regarding the proposed treatment, there was good adherence of patients, especially in relation to blood glucose monitoring. As for nutritional control, we observed greater difficulty in following the guidelines demonstrating the need for long-term monitoring, as well as further clarification to the patients about the importance of nutrition in diabetes management.
Assuntos
Diabetes Gestacional/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Cooperação do Paciente/estatística & dados numéricos , Educação de Pacientes como Assunto/métodos , Automonitorização da Glicemia/estatística & dados numéricos , Capilares , Dieta para Diabéticos/estatística & dados numéricos , Feminino , Humanos , Entrevistas como Assunto , Estudos Longitudinais , Gravidez , Retenção Psicológica , Inquéritos e QuestionáriosRESUMO
SUMMARY Objective: To evaluate the retention of information after participation in multidisciplinary group in patients with gestational diabetes mellitus (GDM) through a phone contact. Method: 122 pregnant women diagnosed with gestational diabetes were included. After diagnosis of gestational diabetes, the patients were referred to the multidisciplinary group where they received medical, nutrition and nursing guidelines related to the disease. After three days these patients received one telephone call from a nurse, who made the same questions regarding the information received. In the statistical analysis, results were presented as absolute and relative frequencies. Results: Most patients 119/122 patients (97.5%) were managing to do self glucose monitoring. Twenty-one patients (17.2%) reported having difficulty performing the blood glucose, especially finger pricking. When questioning whether the woman was following the proposed diet, 24/122 (19.7%) patients said they did not; the meal frequency was not reached by 23/122 (18.9%) of the women, and forty-seven (38.5%) of the women reported having ingested sugar in the days following the guidance in multidisciplinary group. Conclusion: Regarding the proposed treatment, there was good adherence of patients, especially in relation to blood glucose monitoring. As for nutritional control, we observed greater difficulty in following the guidelines demonstrating the need for long-term monitoring, as well as further clarification to the patients about the importance of nutrition in diabetes management.
RESUMO Objetivo: avaliar a retenção de informações, após participação em grupo multiprofissional, em pacientes com diabetes mellitus gestacional (DMG), por meio de contato telefônico. Método: foram incluídas 122 gestantes com diagnóstico de DMG. Após o diagnóstico, as pacientes eram encaminhadas ao grupo multiprofissional para receber orientações médicas, nutricionais e de enfermagem relacionadas à doença. Após três dias, as pacientes receberam um contato telefônico de um enfermeiro, que realizou perguntas relacionadas às informações recebidas. Na análise estatística, os resultados foram apresentados em frequências absolutas e relativas. Resultados: a maioria das pacientes, 119/122 (97,5%), estava conseguindo fazer a automonitorização glicêmica. Vinte e uma pacientes (17,2%) referiram ter dificuldades para realizar a glicemia capilar, sendo a principal relacionada às lancetas. Quanto à dieta proposta, 24/122 (19,7%) referiram que não estavam conseguindo cumprir; o fracionamento da dieta não foi alcançado por 23/122 (18,9%) das gestantes e 47 (38,5%) relataram ter ingerido açúcar nos dias seguintes à orientação do grupo multiprofissional. Conclusão: em relação ao tratamento proposto, houve boa adesão das pacientes, especialmente quanto à automonitorização glicêmica. Em relação aos controles nutricionais, observamos maior dificuldade no seguimento das orientações, mostrando haver necessidade de seguimento em longo prazo e de fornecer melhor esclarecimento às pacientes sobre a importância da nutrição no controle do diabetes.
Assuntos
Humanos , Feminino , Gravidez , Conhecimentos, Atitudes e Prática em Saúde , Educação de Pacientes como Assunto/métodos , Cooperação do Paciente/estatística & dados numéricos , Diabetes Gestacional/prevenção & controle , Retenção Psicológica , Capilares , Automonitorização da Glicemia/estatística & dados numéricos , Entrevistas como Assunto , Inquéritos e Questionários , Estudos Longitudinais , Dieta para Diabéticos/estatística & dados numéricosRESUMO
PURPOSE: The purpose of this study was to explore the sociocultural factors affecting the dietary behaviour of Dutch Surinamese patients with type 2 diabetes. METHODS: In this qualitative study, 32 Surinamese primary care patients with type 2 diabetes mellitus participated in semi-structured interviews (16 African Surinamese and 16 Hindustani Surinamese). Interviews were recorded and transcripts were analysed and coded into themes using principles of grounded theory and MAXQDA software. RESULTS: Surinamese food was eaten regularly by all respondents. Most participants were aware of the need to change their diet but reported difficulty with changing their dietary behaviour to meet dietary guidelines. Many perceived these guidelines to be based on Dutch eating habits, making it difficult to reconcile them with Surinamese cooking and eating practices. Firstly, respondents indicated that they did not choose foods based on their nutritional qualities. Instead, choices were based on Surinamese beliefs regarding 'good' (e.g., bitter vegetables) or 'bad' (e.g., spicy dishes) foods for diabetes. Secondly, respondents often perceived recommendations such as eating at fixed times as interfering with traditional values, for example hospitality. Above all, the maintenance of Surinamese cooking and eating practices was regarded as extremely important since the respondents perceived these to be a core element of their identity as Surinamese. CONCLUSIONS: For Surinamese diabetes patients, cooking and eating practices are related to deeply rooted cultural beliefs and values. The wish to maintain one's Surinamese identity may pose difficulty for patients' adherence to dietary guidelines, as these are perceived as being based on 'Dutch' habits. This suggests that immigrants with a long duration of residence in the host country like the Surinamese, who are seen as well integrated might benefit from culturally sensitive diabetes education that is adapted at surface and deep structure.
Assuntos
Cultura , Diabetes Mellitus Tipo 2/dietoterapia , Dieta para Diabéticos/etnologia , Emigrantes e Imigrantes/psicologia , Adulto , Idoso , Diabetes Mellitus Tipo 2/etnologia , Dieta para Diabéticos/psicologia , Dieta para Diabéticos/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Comportamento Alimentar/etnologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Minoritários , Países Baixos/epidemiologia , Inquéritos Nutricionais , Pesquisa Qualitativa , Identificação Social , Suriname/etnologiaRESUMO
OBJECTIVE: To analyze the consumption of sweeteners and dietetic foods by individuals with type 2 diabetes, assisted by the Brazilian National Health System, in the city of Ribeirão Preto, SP. SUBJECTS AND METHODS: Through a questionnaire were interviewed 120 patients were interviewed, stratified by sex, age and level of health care. RESULTS: The use of sweeteners is very frequent by the population in study, with predominance of the liquid type, and the use of dietetic foods is less common, with predominance of soft drinks. The diagnosis of diabetes was determinant for starting the use of both and the used criterion for selection of the sweetener is its flavor. The percentage of the population that knows the difference between diet and light products, that has the habit to read labels, and that is worried with the amount used of sweetener, is small. CONCLUSION: There is a need to include information about the adequate use of these products in the health care activities for patients with diabetes in the different levels of the Brazilian National Health System.
Assuntos
Diabetes Mellitus Tipo 2 , Dieta para Diabéticos/estatística & dados numéricos , Comportamento Alimentar , Conhecimentos, Atitudes e Prática em Saúde , Edulcorantes/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Estudos Transversais , Escolaridade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
OBJETIVO: Analisar o consumo de adoçantes e produtos dietéticos por indivíduos com diabetes melito tipo 2, atendidos pelo Sistema Único de Saúde (SUS) em Ribeirão Preto, SP. SUJEITOS E MÉTODOS: Por meio de questionário, foram entrevistados 120 pacientes, estratificados por sexo, faixa etária e nível de atendimento. RESULTADOS: Os resultados mostram que o uso de adoçantes é frequente na população em estudo, com predomínio do tipo líquido, e o uso de produtos dietéticos é menor, com predomínio dos refrigerantes. O diagnóstico do DM foi determinante para o uso dos produtos e o critério de seleção mais utilizado foi o sabor. É pequena a porcentagem da amostra que sabe a diferença entre diet e light, que tem o hábito de ler o rótulo dos alimentos e que se preocupa com a quantidade utilizada de adoçante. CONCLUSÃO: É uma necessidade a inclusão de informações sobre o uso adequado desses produtos nas atividades assistenciais aos pacientes com DM nos diversos níveis do SUS.
OBJECTIVE: To analyze the consumption of sweeteners and dietetic foods by individuals with type 2 diabetes, assisted by the Brazilian National Health System, in the city of Ribeirão Preto, SP. SUBJECTS AND METHODS: Through a questionnaire were interviewed 120 patients were interviewed, stratified by sex, age and level of health care. RESULTS: The use of sweeteners is very frequent by the population in study, with predominance of the liquid type, and the use of dietetic foods is less common, with predominance of soft drinks. The diagnosis of diabetes was determinant for starting the use of both and the used criterion for selection of the sweetener is its flavor. The percentage of the population that knows the difference between diet and light products, that has the habit to read labels, and that is worried with the amount used of sweetener, is small. CONCLUSION: There is a need to include information about the adequate use of these products in the health care activities for patients with diabetes in the different levels of the Brazilian National Health System.
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dieta para Diabéticos/estatística & dados numéricos , Comportamento Alimentar , Conhecimentos, Atitudes e Prática em Saúde , Edulcorantes/administração & dosagem , Brasil , Estudos Transversais , Escolaridade , Inquéritos e QuestionáriosAssuntos
Humanos , Doença Crônica , Dieta para Diabéticos/estatística & dados numéricos , Dieta para Diabéticos/tendências , Educação em Saúde , Promoção da Saúde , Serviços de Assistência Domiciliar , Atenção Primária à Saúde , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/prevenção & controle , ObesidadeAssuntos
Humanos , Promoção da Saúde , Atenção Primária à Saúde , Doença Crônica , Dieta para Diabéticos/estatística & dados numéricos , Dieta para Diabéticos/tendências , Serviços de Assistência Domiciliar , Educação em Saúde , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/prevenção & controle , ObesidadeRESUMO
INTRODUÇÃO: A contagem de carboidratos talvez seja o planejamento alimentar mais preciso e flexível, especialmente naqueles portadores de diabetes tipo 1 (DM1). OBJETIVO: Avaliar o grau de satisfação dessa abordagem em DM1 em programa de insulinoterapia intensiva. MÉTODOS: 50 pacientes com DM1 submetidos à contagem de carboidratos por 6 meses responderam um questionário relacionado ao estilo de vida. RESULTADOS: As respostas foram favoráveis acima de 80 por cento aos quesitos relacionados à escolha do número de refeições, comer fora de casa, horário das refeições, planejamento das atividades sociais e diárias, realização de glicemia e leituras de rótulos dos alimentos; entre 60 e 80 por cento, na escolha do tipo de alimento, na quantidade de comida, no consumo de alimentos ricos em açúcar e participação de atividades de última hora. CONCLUSÕES: Conforme a opinião dos participantes, a contagem de carboidratos é um procedimento muito bem aceito, permitindo uma melhor qualidade de vida.
Assuntos
Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Diabetes Mellitus Tipo 1/dietoterapia , Dieta para Diabéticos/métodos , Carboidratos da Dieta/administração & dosagem , Satisfação do Paciente , Dieta para Diabéticos/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Carbohydrate counting is probably the most precise and flexible meal planning approach available, especially for those with type 1 diabetes (DM1). OBJECTIVE: To evaluate the degree of satisfaction of that approach in patients treated by intensive insulin therapy. METHODS: 50 DM1 patients submitted to carbohydrate counting for 6 months answered a questionnaire related to the lifestyle. RESULTS: The answers were favorable in: >80% to requirements related to the choice of the number of meals, to eat out, schedules of meals and social and daily activities, glycemic monitorization and interest in reading food labels; 60% to 80% answered favorably to topics related to the choice of the food type, the amount of food, the consumption of food rich in sugar and the participation of last minute activities. CONCLUSIONS: According to the participants' opinion, carbohydrate counting is a very well accepted procedure, allowing a better lifestyle.
Assuntos
Diabetes Mellitus Tipo 1/dietoterapia , Dieta para Diabéticos/métodos , Carboidratos da Dieta/administração & dosagem , Satisfação do Paciente , Adolescente , Adulto , Criança , Dieta para Diabéticos/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
UNLABELLED: The introduction of fat and carbohydrates replacers has been a revolutionary advance in treating obesity and diabetes mellitus. Since these materials have shown to have beneficial effects on the metabolic profiles of diabetic patients, they should be useful in designing specific foods for patients with diabetes. OBJECTIVE: To compare metabolic and anthropometric improvements elicited by a diet based on the American Diabetic Association's nutrition recommendations with a modified, low-energy diet incorporating fat replacers and non-sucrose sweeteners. DESIGN: A total of 16 male, well controlled type 2 diabetes patients were divided into two groups of eight; one group received the diet based on the American Diabetic Association's nutrition recommendations, and the other was fed a modified, low-calorie diet containing a fat replacer (beta-glucans derived from oats) and the sweeteners, sucralose and fructose. Both groups were maintained on their respective diets for 4 weeks. All patients performed daily aerobic exercise consisting of walking for 60 minutes. Body weight, body mass index, basal glycemia, hemoglobin HbA1C, and lipid profile were determined in each patient before starting the diets and after 4 weeks of dietary intervention. RESULTS: Both diets produced significant improvements in weight, body mass index, lipid profile, basal glucose, and HbA1C. However, the experimental diet was superior to the American Diabetic Association's diet in improving metabolic and anthropometric profile: greater increase in HDL cholesterol and larger decreases in HbA1C, weight, and body mass index. CONCLUSIONS: A diet incorporating a fat replacer and non-sucrose sweeteners produced a greater improvement in metabolic and anthropometric variables in well controlled type 2 diabetic patients when compared with a diet based on American Diabetic Association's nutrition recommendations.
Assuntos
Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/tratamento farmacológico , Dieta para Diabéticos , Glucanos/administração & dosagem , Sacarose/análogos & derivados , Edulcorantes/administração & dosagem , beta-Glucanas , Biomarcadores/sangue , Glicemia/metabolismo , Índice de Massa Corporal , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Diabetes Mellitus Tipo 2/prevenção & controle , Dieta para Diabéticos/estatística & dados numéricos , Exercício Físico , Feminino , Frutose/administração & dosagem , Hemoglobinas Glicadas/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Sacarose/administração & dosagem , Fatores de Tempo , Resultado do Tratamento , Triglicerídeos/sangueAssuntos
Humanos , Diabetes Mellitus/dietoterapia , Nefropatias Diabéticas/dietoterapia , Proteínas Alimentares/administração & dosagem , Nefropatias Diabéticas/prevenção & controle , Dieta para Diabéticos/normas , Dieta para Diabéticos/estatística & dados numéricos , Creatinina/efeitos adversos , Creatinina/urinaAssuntos
Humanos , Diabetes Mellitus/dietoterapia , Nefropatias Diabéticas/dietoterapia , Proteínas Alimentares/administração & dosagem , Nefropatias Diabéticas/prevenção & controle , Dieta para Diabéticos/normas , Dieta para Diabéticos/estatística & dados numéricos , Creatinina/efeitos adversos , Creatinina/urinaRESUMO
A cross-sectional study was conducted to investigate the prescription patterns of general practitioners for non-insulin dependent diabetes mellitus patients in Guadalajara, Mexico. Two hundred and forty medical prescriptions were evaluated. These were indicated by 16 primary care physicians. Results showed that physicians prescribed pharmacologic agents in 93 per cent of the cases, dietary control in 73 per cent, and physical exercise in 48 per cent. A combination therapy of these three measures was employed in 40 per cent of the patients, but the combination regimen of diet and exercise was given only to 3 per cent of the patients. Data showed significant differences in prescribing patterns according to gender of physicians; male physicians prescribed the three measures by more than 10 per cent; On the contrary, female physicians prescribed the drug as the only therapy 27 per cent of the time. The proportion of prescribing diet and exercise measures increased with more years of professional experience. These observations support the findings that prescription patterns by primary care physicians do not meet the criteria currently recommended by international committees for diabetes therapy. We discuss some implications for the metabolic control of the disease and the quality of medical care.