Google Scholar | Citations: 16429| h-index: 32 | i10-index: 482
Evaluation of glycemic control, comorbidities, complications and mortality twenty-five-year follow-up at a diabetes outpatient clinic in Brazil
PDF (Portuguese (Brazil))

Keywords

Diabetes association
Glycemic control
Comorbidities
Complications
Mortality

How to Cite

Evaluation of glycemic control, comorbidities, complications and mortality twenty-five-year follow-up at a diabetes outpatient clinic in Brazil. (2024). Electronic Journal Collection Health, 24(6), e16289. https://doi.org/10.25248/reas.e16289.2024

Copyright © | All rights reserved.

The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.

Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.

Total reproduction
It is expressly prohibited and must be authorized by the journal.

Abstract

Objective: The objective of this study is to evaluate glycemic control, comorbidities, diabetes-related complications, and mortality among people with DM followed-up at an outpatient clinic based at a Diabetes Association in Brazil. Methods: Sociodemographic, medical and mortality data were obtained from 1,173 patients with type 1 (T1DM) and type 2 diabetes (T2DM) who were evaluated once between 1996-2011 and whose vital status was checked in 2022. Data were analyzed using statistical tests to find out different characteristics between patients with DM1 and DM2. Results: 204 patients had T1DM (17.3%), 969 T2DM (82.6%) and 404 (34.4%) died during the study period (2.8% T1DM and 31.6% T2DM). Among T1DM, 82.3% had inadequate glycemic control, 61.2% had no associated comorbidity and presented varied causes of death. Regarding T2DM, 64.18% had inadequate glycemic control, had more comorbidities, higher rates of smoking and died more frequently due to cardiovascular diseases. Conclusion: Based on glycemic control, current care model provided needs to be rethought to provide more frequent clinical follow-up and structured education. Training health professionals, general practitioners and specialists is urgently needed as well as further long-term prospective studies in this topic. 

PDF (Portuguese (Brazil))

References

ALI MK, et al. Interpreting global trends in type 2 diabetes complications and mortality. Diabetologia, 2022; 65(1): 3-13.

AMERICAN DIABETES ASSOCIATION. Standards of Medical Care in Diabetes. Diabetes Care, 2021; 1(44).

ARMSTRONG DG, et al. Diabetic Foot Ulcers and Their Recurrence. N Engl J Med 2017; 376: 2367-75.

BARROSO WKS, et al. Diretrizes Brasileiras de Hipertensão Arterial – 2020. Arq. Bras. Cardiol., 2021;116(3): 516-658.

BERTOLUCI MC, et al. Diretriz Oficial da Sociedade Brasileira de Diabetes. 2022nd ed., Conectando Pessoas, 2022.

BRASIL. Ministério da Saúde. Programa Farmácia Popular do Brasil: manual básico. Fundação Oswaldo Cruz. Brasília: Editora do Ministério da Saúde, 2005.

BRASIL. Ministério da Saúde. Secretaria de Vigilância em Saúde. Vigitel Brasil 2011: Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico. Ministério da Saúde, Secretaria de Vigilância em Saúde – Brasília: Ministério da Saúde, 2012.

CHATURVEDI N, et al. EURODIAB Prospective Complications Study. Markers of insulin resistance are strong risk factors for retinopathy incidence in type 1 diabetes. Diabetes Care, 2001; 24(2): 284-9.

DAVISON KA, et al. Brazilian Type 1 Diabetes Study Group (BrazDiab1SG). Relationship between adherence to diet, glycemic control and cardiovascular risk factors in patients with type 1 diabetes: a nationwide survey in Brazil. Nutr J. 2014 Mar 7; 13:19.

EEG-OLOFSSON K, et al. Glycemic control and cardiovascular disease in 7,454 patients with type 1 diabetes: an observational study from the Swedish National Diabetes Register (NDR). Diabetes Care, 2010; 33(7): 1640-6.

FALUDI AA, et al. Atualização da Diretriz Brasileira de Dislipidemias e Prevenção da Aterosclerose - 2017. Arquivos Brasileiros de Cardiologia, 2017; 109(1).

FARIA AN, et al. Tratamento de Diabetes Mellitus e Hipertensão Arterial no paciente obeso. In: -- Arquivo Brasileiro de Endocrinologia Metabólica, 2022; 46(2): p.137-142.

FERRANNINI E, CUSHMAN WC. Diabetes and hypertension: the bad companions. Lancet. 2012 Aug 11; 380(9841): 601-10.

FRIEDEWALD WT, et al. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972, 18; 499-502.

GOMES MB, et al. Prevalência de sobrepeso e obesidade em pacientes com diabetes mellitus do tipo 2 no Brasil: estudo multicêntrico nacional [Nationwide multicenter study on the prevalence of overweight and obesity in type 2 diabetes mellitus in the Brazilian population]. Arq Bras Endocrinol Metabol. 2006 Feb; 50(1): 136-44.

GOMES MB, NEGRATO CA. Adherence to insulin therapeutic regimens in patients with type 1 diabetes. A nationwide survey in Brazil, Diabetes Research and Clinical Practice, 2016; 120: p47-55, ISSN 0168-8227.

GORDON DJ, et al. High-density lipoprotein cholesterol and cardiovascular disease. Four pro-spective American studies. Circulation. 1989; 79: 8-15.

IGLAY K, et al. Prevalence and co-prevalence of comorbidities among patients with type 2 diabetes mellitus. Curr Med Res Opin. 2016 Jul; 32(7): 1243-52.

INTERNATIONAL DIABETES FEDERATION. IDF. Diabetes and cardiovascular disease. Brussels, Belgium: International Diabetes Federation, 2016; p. 1–144 .

INTERNATIONAL DIABETES FEDERATION. IDF Diabetes Atlas, 10th edn. Brussels, Belgium: 2021.

INTERNATIONAL WORKING GROUP ON THE DIABETIC FOOT. IWGDF. Consenso Internacional, tradução integral de Pedrosa HC e Andrade AC. Secretaria de Estado de Saúde do Distrito Federal, 2001.

JIA G, SOWERS JR. Hypertension in Diabetes: An Update of Basic Mechanisms and Clinical Disease. Hypertension., 2021; 78(5): 1197-1205.

LUNETTA M, et al. A simplified diagnostic test for ambulatory screening of peripheral diabetic neuropathy. Diabetes Res Clin Pract. 1998; 39(3): 165-72.

MENDES AB, et al. Prevalence and correlates of inadequate glycaemic control: results from a nationwide survey in 6,671 adults with diabetes in Brazil. Acta Diabetol, 2010; 47(2): 137-45.

MILLER KM, et al. T1D Exchange Clinic Network Current state of type 1 diabetes treatment in the U.S.: updated data from the T1D Exchange clinic registry..Diabetes Care, 2015; 38(6): 971-8.

MORAES CMD et al. Prevalência de sobrepeso e obesidade em pacientes com diabetes tipo 1. Arquivos Brasileiros de Endocrinologia & Metabologia [online], 2003; 47(6).

NETTEN, JAAP J., et al. Definitions and Criteria for Diabetic Foot Disease. Diabetes/Metabolism Research and Reviews, 2020; 36(S1).

NORDESTGAARD BG, et al. Nonfasting triglycerides and risk of myocardial infarction, ischemic heart disease, and death in men and women. JAMA. 2007; 298: 299-308.

PITITTO B, et al. Metas no tratamento do diabetes. Diretriz Oficial da Sociedade Brasileira de Diabetes (2022).

PORTA M, BANDELLO F. Diabetic retinopathy. A clinical update. Diabetologia. 2002; 45: 1617-34.

POUPLIER S, et al. The development of multimorbidity during 16 years after diagnosis of type 2 diabetes. J Comorb. , 2018; 24; 8(1):2235042X18801658.

RITZ E. Nephropathy in type 2 diabetes. J Intern Med, 1999; 245(2): 111-26.

ROSSING P, et al. “KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease.” Kidney International, 2022; 102(5); pp. S1–127.

RZEWUSKA M, et al. Epidemiology of multimorbidity within the Brazilian adult general population: evidence from the 2013 National Health Survey (PNS 2013). PLoS One. 2017; 12(2): e0171813.

ŚLIWIŃSKA-MOSSOŃ M, MILNEROWICZ H. The impact of smoking on the development of diabetes and its complications. Diab Vasc Dis Res, 2017; 14(4): 265-276.

SOWERS JR. Recommendations for special populations: diabetes mellitus and the metabolic syndrome. Am J Hypertens, 2003; 16(11 Pt 2): 41S-45S.

TOLONEN N, et al. Finndiane Study Group. Relationship between lipid profiles and kidney function in patients with type 1 diabetes.Diabetologia, 2008; 51(1): 12-20.

VAN DEN BOOM L, et al. Multimorbidity Among Adult Outpatients With Type 1 Diabetes in Germany. Journal of Diabetes Science and Technology., 2022; 16(1): 152-160.

WORLD HEALTH ORGANIZATION. WHO. Obesity: preventing and managing the global epidemic. Report of a World Health Organization Consultation. In WHO Obesity. Technical Report Series, n.284. Genova: World Health Organization; 2000:256.

WORLD HEALTH ORGANIZATION. WHO. WHO global report on trends in prevalence of tobacco use 2000–2025, 4th ed. World Health Organization. 2021.