Análise da gestão da insulinoterapia por pacientes com diabetes acompanhados na atenção primária à saúde: estudo piloto

Abstract

This study aims to analyze the management of insulin therapy through its phases and steps (pre-preparation, preparation and administration), of patients with diabetes, monitored in Primary Health Care. This is a pilot study, with a quantitative approach and cross-sectional design, carried out in Primary Health Care in the city of Fortaleza, CE, from March 2022 to June 2024, composed of people with type 1 and 2 Diabetes Mellitus, who use insulin. The inclusion criteria were: being 18 years of age or older; having a diagnosis of Diabetes Mellitus confirmed in a clinical and/or electronic medical record of type 1 or type 2 diabetes, in Primary Health Care in Fortaleza, CE; being using insulin (regardless of the type) with or without association with oral antidiabetics; being on insulin treatment for at least six months; and using insulin in the morning, due to laboratory tests performed in fasting conditions. And the exclusion criteria were: using an insulin pump and being pregnant. The sample was non-probabilistic, resulting in 100 people. Data were collected from September 2023 to April 2024, through the application of a form with sociodemographic and clinical information; collection of laboratory tests: fasting venous blood glucose, capillary blood glucose and glycated hemoglobin; filming of the preparation and application of the insulin dose by the patient; clinical examination to detect lipodystrophy and near visual acuity test. The parameters of the laboratory tests and the phases of insulin therapy followed the recommendations of the Brazilian Diabetes Society. The data were treated statistically, including measures of central tendency, percentages, 95% confidence interval and chi-square test. The statistical program R Studio® 4.2.3 was used. Regarding the phases of insulin therapy, only the pre-preparation of insulin was performed correctly by part of the population investigated (9%). Regarding the preparation and application phases, no participant performed all the steps correctly, making it impossible to perform a statistical test to investigate a possible association. Therefore, it is concluded that no participant performed all the phases of insulin therapy correctly. Therefore, it is necessary to further investigate this topic through other studies, expanding the methodological design.