Impacto do uso de um sensor de monitorização contínua de glicose no controle glicêmico de pacientes portadores de diabetes mellitus tipo 1

• Autor(a) principal: Oliveira, Matheus Cisneiros Silva de
• Data de Publicação: 2019
• Tipo de documento: Trabalho de conclusão de curso
• Idioma: por
• Título da fonte: Repositório Institucional da UFS
• Texto Completo: https://ri.ufs.br/jspui/handle/riufs/14814
• topic: diabetes mellitus tipo 1; Hemoglobina Glicada; controle glicêmico; sensor de monitorização contínua de glicose; type 1 diabetes mellitus; glycated hemoglobin; glycemic control; FreeStyle Libre

Objective: New technologies contribute to the clinical and therapeutic management of diabetes mellitus (DM), especially those with type 1 DM (DM1). These require glycemic self-monitoring, conventionally performed through 3-5 digital punctures/day. The Flash Glucose Monitoring System uses a subcutaneous sensor that is changed every 15 days and allows 8 hours of recording without re-reading. This study aimed to evaluate the impact of self-monitoring by flash system on glycated hemoglobin (HbA1C) levels and insulin therapy in patients with DM1.Methods: Prospective cohort with 35 patients with T1DM (62.8% female, 31.7±10.3 years, 60.9±13.6 kg, 1.6±0.08 m, BMI of 23.4±5,04, mean DM time of diagnosis DM 7,7 ± 8,3 years and 81% SUS dependent) who used the FreeStyle® Libre sensor changed every 15 days for 3 months. All 6 exchanges were performed by the medical team along with clinical evaluation and insulin therapy adjustments through sensor information. HPLC HbA1C (mg/dl) was dosed on the day of first sensor placement and removal of the last. Total daily insulin dose (DDTI, U), sum of basal and prandial dose; basal daily dose (DDB, U), prandial daily dose (DDP, U) and basal insulin percentage (PIB,%) were evaluated before and after 3 months. Data were expressed as mean ± standard deviation and statistical analysis was performed using the IBM SPSS software, by paired T test and considered significant p <0.05. Results: HbA1C decreased from 8.6 ± 1.3% to 7.9 ± 0.9% (p = 0.001). The DDTI did not change (before, 44.9 ± 21.3U and after 44.5 ± 21.2U; p = 0.601). DDB and PIB decreased (26.5 ± 13.1U to 23.9 ± 12.2U; p = 0.004 and 58.2 ± 7.4 to 51.1 ± 8.0, p = 0.001; respectively). The daily prandial dose (DDP) increased from 18.5 ± 8.4U to 20.6 ± 9.2, p = 0.008.Conclusions: The replacement of conventional self-monitoring (multiple digital punctures) with the use of the flash system reduced HbA1C without increasing the total insulin dose of patients with DM1. The improvement in basal-bolus proportion at the end of the study contributed to this result