Automonitorização contínua com sensor de sistema flash em pacientes portadores de diabetes mellitus tipo 1: adesão, controle glicêmico estimado e hipoglicemias
Autor(a) principal: | |
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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/14747 |
Resumo: | Introduction: Patients with type 1 diabetes mellitus (T1DM), due to their high glycemic lability, require more frequent glycemic self-monitoring, most often performed by digital puncture. Our objective was to evaluate adherence by T1DM patients who used to self-monitor 3 to 5 times daily to a Continuous Glucose Monitoring System (CGMS), as well as to observe whether there was an improvement in estimated glycemic control and hypoglycemia rates. Methods: Prospective cohort study with 35 patients with T1DM (mostly female, 62.8%, 31.7 ± 10.3 years, 60.9 ± 13.6 kg, 1.6 ± 0.08 m, BMI 23.4 ± 5.04, T1DM time of 11.71 ± 8.81 years) decompensated using exclusively capillary glycemic self-monitoring (AMGC). These patients used FreeStyle® Libre (FSL), a subcutaneous CGMS sensor, which was changed every 15 days by the medical team for 3 months. The following sensor information was evaluated: number of daily screenings (RD), percentage of data captured (DC), estimated glycated hemoglobin (A1c E), mean glycemia (MG), hypoglycemic indicators [percentage (PH), number of events (EH), duration (DH)]. Sensor data over the 3 months were evaluated by Friedman test and the Connover's post test was applied to variables with significant difference. All data were analyzed using SPSS version 20 software, considering significant p < 0.05. Results: There was a significant increase in RD, which went from 3 to 5 capillary checks to an average of 13.1 ± 10.6 times per day with FSL. The patients used the sensor properly since the average percentage of CD was 88.5% ± 8.1. We found no differences over time in the estimated glycemic control as well as in the hypoglycemic indicators, which had a mean percentage > 8.4%, higher than the ADA recommended value of 4%. Conclusions: The replacement of AMGC by FSL allowed patients to considerably increase their number of measurements and their diabetes knowledge. Despite good sensor adherence, they did not improve the estimated glycemic control and hypoglycemia indicators, the latter remaining higher than the values indicated for good glycemic control. |
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Nascimento, Guilherme AndradeSimões, Carla Raquel Oliveira2021-11-17T14:52:47Z2021-11-17T14:52:47Z2019-09-26NASCIMENTO, Guilherme Andrade. Automonitorização contínua com sensor de sistema flash em pacientes portadores de diabetes mellitus tipo 1: adesão, controle glicêmico estimado e hipoglicemias. 2019. 35 f. Trabalho de Conclusão de Curso (Graduação em Medicina) - Centro de Ciências Biológicas e da Saúde, Departamento de Medicina, Universidade Federal de Sergipe, Aracaju, 2019.https://ri.ufs.br/jspui/handle/riufs/14747Introduction: Patients with type 1 diabetes mellitus (T1DM), due to their high glycemic lability, require more frequent glycemic self-monitoring, most often performed by digital puncture. Our objective was to evaluate adherence by T1DM patients who used to self-monitor 3 to 5 times daily to a Continuous Glucose Monitoring System (CGMS), as well as to observe whether there was an improvement in estimated glycemic control and hypoglycemia rates. Methods: Prospective cohort study with 35 patients with T1DM (mostly female, 62.8%, 31.7 ± 10.3 years, 60.9 ± 13.6 kg, 1.6 ± 0.08 m, BMI 23.4 ± 5.04, T1DM time of 11.71 ± 8.81 years) decompensated using exclusively capillary glycemic self-monitoring (AMGC). These patients used FreeStyle® Libre (FSL), a subcutaneous CGMS sensor, which was changed every 15 days by the medical team for 3 months. The following sensor information was evaluated: number of daily screenings (RD), percentage of data captured (DC), estimated glycated hemoglobin (A1c E), mean glycemia (MG), hypoglycemic indicators [percentage (PH), number of events (EH), duration (DH)]. Sensor data over the 3 months were evaluated by Friedman test and the Connover's post test was applied to variables with significant difference. All data were analyzed using SPSS version 20 software, considering significant p < 0.05. Results: There was a significant increase in RD, which went from 3 to 5 capillary checks to an average of 13.1 ± 10.6 times per day with FSL. The patients used the sensor properly since the average percentage of CD was 88.5% ± 8.1. We found no differences over time in the estimated glycemic control as well as in the hypoglycemic indicators, which had a mean percentage > 8.4%, higher than the ADA recommended value of 4%. Conclusions: The replacement of AMGC by FSL allowed patients to considerably increase their number of measurements and their diabetes knowledge. Despite good sensor adherence, they did not improve the estimated glycemic control and hypoglycemia indicators, the latter remaining higher than the values indicated for good glycemic control.Introdução: Pacientes portadores de diabetes mellitus tipo 1 (DM1), devido à grande labilidade glicêmica, necessitam de automonitorização glicêmica mais frequente, realizada na maioria das vezes através de punção digital. Nosso objetivo foi avaliar a adesão por portadores de DM1 habituados a automonitorização de 3 a 5 vezes ao dia a um Sistema de Monitorização Contínua de Glicose (CGMS), bem como observar se houve uma melhora no controle glicêmico estimado e nas taxas de hipoglicemias. Métodos: Estudo prospectivo do tipo coorte com 35 pacientes portadores de DM1 (maioria do sexo feminino, 62,8%, com 31,7±10,3 anos, 60,9±13,6 Kg, 1,6±0,08 m, IMC de 23,4±5,04, tempo de DM1 de 11,71 ± 8,81 anos) descompensados que usavam exclusivamente a automonitorização glicêmica capilar (AMGC). Estes pacientes utilizaram por 3 meses o FreeStyle® Libre (FSL), um sensor subcutâneo de CGMS, trocado a cada 15 dias pela equipe médica. Foram avaliadas as seguintes informações do sensor: número de rastreamentos diários (RD), porcentagem de dados capturados (DC), hemoglobina glicada estimada (A1c E), média da glicemia (MG), indicadores de hipoglicemia [porcentagem (PH), número de eventos (EH), duração (DH)]. Os dados do sensor ao longo dos 3 meses foram avaliados pelo Teste de Friedman e o pós teste de Connover’s foi aplicado nas variáveis com diferença significativa. Todos os dados foram analisados no software SPSS, versão 20, considerando significativo um p<0,05. Resultados: Houve um aumento significativo no RD, que saiu de 3 a 5 verificações pelo método capilar para uma média de 13,1 ± 10,6 vezes por dia com o FSL. Os pacientes utilizaram o sensor adequadamente visto o percentual médio de DC ter sido de 88,5% ±8,1. Não encontramos diferenças ao longo do tempo no controle glicêmico estimado bem como nos indicadores de hipoglicemia, que teve um percentual médio > 8,4%, superior ao valor recomendado pela ADA de 4%. Conclusões: A substituição da AMGC pelo FSL permitiu aos pacientes um aumento considerável no número de aferições e no conhecimento do seu diabetes. Apesar da boa adesão ao sensor, não obtiveram melhora no controle glicêmico estimado e nos indicadores de hipoglicemia, esta última se mantendo mais elevada do que os valores indicados para um bom controle glicêmico.AracajuporSistema flash de monitoramento de glicoseFreeStyle libreDiabetes MellitusTipo 1Flash glucose monitoring systemType 1Automonitorização contínua com sensor de sistema flash em pacientes portadores de diabetes mellitus tipo 1: adesão, controle glicêmico estimado e hipoglicemiasinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/bachelorThesisUniversidade Federal de SergipeDME - Departamento de Medicina – Aracaju - Presencialreponame:Repositório Institucional da UFSinstname:Universidade Federal de Sergipe (UFS)instacron:UFSinfo:eu-repo/semantics/openAccessLICENSElicense.txtlicense.txttext/plain; charset=utf-81475https://ri.ufs.br/jspui/bitstream/riufs/14747/1/license.txt098cbbf65c2c15e1fb2e49c5d306a44cMD51ORIGINALGuilherme_Andrade_Nascimento.pdfGuilherme_Andrade_Nascimento.pdfapplication/pdf1188538https://ri.ufs.br/jspui/bitstream/riufs/14747/2/Guilherme_Andrade_Nascimento.pdf7761f4534cf52e63a954626fcbc21f23MD52TEXTGuilherme_Andrade_Nascimento.pdf.txtGuilherme_Andrade_Nascimento.pdf.txtExtracted texttext/plain63513https://ri.ufs.br/jspui/bitstream/riufs/14747/3/Guilherme_Andrade_Nascimento.pdf.txt378d67c71b3e22157eebc6ffebc01093MD53THUMBNAILGuilherme_Andrade_Nascimento.pdf.jpgGuilherme_Andrade_Nascimento.pdf.jpgGenerated Thumbnailimage/jpeg1257https://ri.ufs.br/jspui/bitstream/riufs/14747/4/Guilherme_Andrade_Nascimento.pdf.jpgc70a117789f8fa8a36d1560262cf6ab0MD54riufs/147472021-11-17 11:52:47.555oai:ufs.br:riufs/14747TElDRU7Dh0EgREUgRElTVFJJQlVJw4fDg08gTsODTy1FWENMVVNJVkEKCkNvbSBhIGFwcmVzZW50YcOnw6NvIGRlc3RhIGxpY2Vuw6dhLCB2b2PDqiAobyBhdXRvcihlcykgb3UgbyB0aXR1bGFyIGRvcyBkaXJlaXRvcyBkZSBhdXRvcikgY29uY2VkZSDDoCBVbml2ZXJzaWRhZGUgRmVkZXJhbCBkZSBTZXJnaXBlIG8gZGlyZWl0byBuw6NvLWV4Y2x1c2l2byBkZSByZXByb2R1emlyIHNldSB0cmFiYWxobyBubyBmb3JtYXRvIGVsZXRyw7RuaWNvLCBpbmNsdWluZG8gb3MgZm9ybWF0b3Mgw6F1ZGlvIG91IHbDrWRlby4KClZvY8OqIGNvbmNvcmRhIHF1ZSBhIFVuaXZlcnNpZGFkZSBGZWRlcmFsIGRlIFNlcmdpcGUgcG9kZSwgc2VtIGFsdGVyYXIgbyBjb250ZcO6ZG8sIHRyYW5zcG9yIHNldSB0cmFiYWxobyBwYXJhIHF1YWxxdWVyIG1laW8gb3UgZm9ybWF0byBwYXJhIGZpbnMgZGUgcHJlc2VydmHDp8Ojby4KClZvY8OqIHRhbWLDqW0gY29uY29yZGEgcXVlIGEgVW5pdmVyc2lkYWRlIEZlZGVyYWwgZGUgU2VyZ2lwZSBwb2RlIG1hbnRlciBtYWlzIGRlIHVtYSBjw7NwaWEgZGUgc2V1IHRyYWJhbGhvIHBhcmEgZmlucyBkZSBzZWd1cmFuw6dhLCBiYWNrLXVwIGUgcHJlc2VydmHDp8Ojby4KClZvY8OqIGRlY2xhcmEgcXVlIHNldSB0cmFiYWxobyDDqSBvcmlnaW5hbCBlIHF1ZSB2b2PDqiB0ZW0gbyBwb2RlciBkZSBjb25jZWRlciBvcyBkaXJlaXRvcyBjb250aWRvcyBuZXN0YSBsaWNlbsOnYS4gVm9jw6ogdGFtYsOpbSBkZWNsYXJhIHF1ZSBvIGRlcMOzc2l0bywgcXVlIHNlamEgZGUgc2V1IGNvbmhlY2ltZW50bywgbsOjbyBpbmZyaW5nZSBkaXJlaXRvcyBhdXRvcmFpcyBkZSBuaW5ndcOpbS4KCkNhc28gbyB0cmFiYWxobyBjb250ZW5oYSBtYXRlcmlhbCBxdWUgdm9jw6ogbsOjbyBwb3NzdWkgYSB0aXR1bGFyaWRhZGUgZG9zIGRpcmVpdG9zIGF1dG9yYWlzLCB2b2PDqiBkZWNsYXJhIHF1ZSBvYnRldmUgYSBwZXJtaXNzw6NvIGlycmVzdHJpdGEgZG8gZGV0ZW50b3IgZG9zIGRpcmVpdG9zIGF1dG9yYWlzIHBhcmEgY29uY2VkZXIgw6AgVW5pdmVyc2lkYWRlIEZlZGVyYWwgZGUgU2VyZ2lwZSBvcyBkaXJlaXRvcyBhcHJlc2VudGFkb3MgbmVzdGEgbGljZW7Dp2EsIGUgcXVlIGVzc2UgbWF0ZXJpYWwgZGUgcHJvcHJpZWRhZGUgZGUgdGVyY2Vpcm9zIGVzdMOhIGNsYXJhbWVudGUgaWRlbnRpZmljYWRvIGUgcmVjb25oZWNpZG8gbm8gdGV4dG8gb3Ugbm8gY29udGXDumRvLgoKQSBVbml2ZXJzaWRhZGUgRmVkZXJhbCBkZSBTZXJnaXBlIHNlIGNvbXByb21ldGUgYSBpZGVudGlmaWNhciBjbGFyYW1lbnRlIG8gc2V1IG5vbWUocykgb3UgbyhzKSBub21lKHMpIGRvKHMpIApkZXRlbnRvcihlcykgZG9zIGRpcmVpdG9zIGF1dG9yYWlzIGRvIHRyYWJhbGhvLCBlIG7Do28gZmFyw6EgcXVhbHF1ZXIgYWx0ZXJhw6fDo28sIGFsw6ltIGRhcXVlbGFzIGNvbmNlZGlkYXMgcG9yIGVzdGEgbGljZW7Dp2EuIAo=Repositório InstitucionalPUBhttps://ri.ufs.br/oai/requestrepositorio@academico.ufs.bropendoar:2021-11-17T14:52:47Repositório Institucional da UFS - Universidade Federal de Sergipe (UFS)false |
dc.title.pt_BR.fl_str_mv |
Automonitorização contínua com sensor de sistema flash em pacientes portadores de diabetes mellitus tipo 1: adesão, controle glicêmico estimado e hipoglicemias |
title |
Automonitorização contínua com sensor de sistema flash em pacientes portadores de diabetes mellitus tipo 1: adesão, controle glicêmico estimado e hipoglicemias |
spellingShingle |
Automonitorização contínua com sensor de sistema flash em pacientes portadores de diabetes mellitus tipo 1: adesão, controle glicêmico estimado e hipoglicemias Nascimento, Guilherme Andrade Sistema flash de monitoramento de glicose FreeStyle libre Diabetes Mellitus Tipo 1 Flash glucose monitoring system Type 1 |
title_short |
Automonitorização contínua com sensor de sistema flash em pacientes portadores de diabetes mellitus tipo 1: adesão, controle glicêmico estimado e hipoglicemias |
title_full |
Automonitorização contínua com sensor de sistema flash em pacientes portadores de diabetes mellitus tipo 1: adesão, controle glicêmico estimado e hipoglicemias |
title_fullStr |
Automonitorização contínua com sensor de sistema flash em pacientes portadores de diabetes mellitus tipo 1: adesão, controle glicêmico estimado e hipoglicemias |
title_full_unstemmed |
Automonitorização contínua com sensor de sistema flash em pacientes portadores de diabetes mellitus tipo 1: adesão, controle glicêmico estimado e hipoglicemias |
title_sort |
Automonitorização contínua com sensor de sistema flash em pacientes portadores de diabetes mellitus tipo 1: adesão, controle glicêmico estimado e hipoglicemias |
author |
Nascimento, Guilherme Andrade |
author_facet |
Nascimento, Guilherme Andrade |
author_role |
author |
dc.contributor.author.fl_str_mv |
Nascimento, Guilherme Andrade |
dc.contributor.advisor1.fl_str_mv |
Simões, Carla Raquel Oliveira |
contributor_str_mv |
Simões, Carla Raquel Oliveira |
dc.subject.por.fl_str_mv |
Sistema flash de monitoramento de glicose FreeStyle libre Diabetes Mellitus Tipo 1 |
topic |
Sistema flash de monitoramento de glicose FreeStyle libre Diabetes Mellitus Tipo 1 Flash glucose monitoring system Type 1 |
dc.subject.eng.fl_str_mv |
Flash glucose monitoring system Type 1 |
description |
Introduction: Patients with type 1 diabetes mellitus (T1DM), due to their high glycemic lability, require more frequent glycemic self-monitoring, most often performed by digital puncture. Our objective was to evaluate adherence by T1DM patients who used to self-monitor 3 to 5 times daily to a Continuous Glucose Monitoring System (CGMS), as well as to observe whether there was an improvement in estimated glycemic control and hypoglycemia rates. Methods: Prospective cohort study with 35 patients with T1DM (mostly female, 62.8%, 31.7 ± 10.3 years, 60.9 ± 13.6 kg, 1.6 ± 0.08 m, BMI 23.4 ± 5.04, T1DM time of 11.71 ± 8.81 years) decompensated using exclusively capillary glycemic self-monitoring (AMGC). These patients used FreeStyle® Libre (FSL), a subcutaneous CGMS sensor, which was changed every 15 days by the medical team for 3 months. The following sensor information was evaluated: number of daily screenings (RD), percentage of data captured (DC), estimated glycated hemoglobin (A1c E), mean glycemia (MG), hypoglycemic indicators [percentage (PH), number of events (EH), duration (DH)]. Sensor data over the 3 months were evaluated by Friedman test and the Connover's post test was applied to variables with significant difference. All data were analyzed using SPSS version 20 software, considering significant p < 0.05. Results: There was a significant increase in RD, which went from 3 to 5 capillary checks to an average of 13.1 ± 10.6 times per day with FSL. The patients used the sensor properly since the average percentage of CD was 88.5% ± 8.1. We found no differences over time in the estimated glycemic control as well as in the hypoglycemic indicators, which had a mean percentage > 8.4%, higher than the ADA recommended value of 4%. Conclusions: The replacement of AMGC by FSL allowed patients to considerably increase their number of measurements and their diabetes knowledge. Despite good sensor adherence, they did not improve the estimated glycemic control and hypoglycemia indicators, the latter remaining higher than the values indicated for good glycemic control. |
publishDate |
2019 |
dc.date.issued.fl_str_mv |
2019-09-26 |
dc.date.accessioned.fl_str_mv |
2021-11-17T14:52:47Z |
dc.date.available.fl_str_mv |
2021-11-17T14:52:47Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/bachelorThesis |
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bachelorThesis |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
NASCIMENTO, Guilherme Andrade. Automonitorização contínua com sensor de sistema flash em pacientes portadores de diabetes mellitus tipo 1: adesão, controle glicêmico estimado e hipoglicemias. 2019. 35 f. Trabalho de Conclusão de Curso (Graduação em Medicina) - Centro de Ciências Biológicas e da Saúde, Departamento de Medicina, Universidade Federal de Sergipe, Aracaju, 2019. |
dc.identifier.uri.fl_str_mv |
https://ri.ufs.br/jspui/handle/riufs/14747 |
identifier_str_mv |
NASCIMENTO, Guilherme Andrade. Automonitorização contínua com sensor de sistema flash em pacientes portadores de diabetes mellitus tipo 1: adesão, controle glicêmico estimado e hipoglicemias. 2019. 35 f. Trabalho de Conclusão de Curso (Graduação em Medicina) - Centro de Ciências Biológicas e da Saúde, Departamento de Medicina, Universidade Federal de Sergipe, Aracaju, 2019. |
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Universidade Federal de Sergipe |
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DME - Departamento de Medicina – Aracaju - Presencial |
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