Impact of an educational intervention in the management of individuals with uncontrolled type 2 diabetes mellitus using insulin therapy.

OBJECTIVE: To investigate the effects of problematizing intervention in the treatment of individuals with type 2 diabetes mellitus. METHODOLOGY: A randomized clinical trial was conducted in 41 patients ages 18 to 64 with type 2 diabetes who were treated with insulin and had glycosylated hemoglobin greater than 7.0%. The mean age of participants was 55.9 (SD = 5.49). A high percentage of patients had comorbidities such as hypertension (92.7%), dyslipidemia (68.3%), overweight (95%), retinopathy (41%), and neuropathy (39%). The patients in the intervention group participated in 6 educational groups using problematization methodology, whereas the patients in the control group attended only routine consultations. Sociodemographic, clinical, behavioral, and lifestyle variables were assessed. RESULTS: After 6 months of follow-up, no statistically significant difference in glycemic control and anthropometric parameters was observed between participants in either study group. The intervention group showed an increase in knowledge about the disease, and an improvement in total cholesterol and uric acid levels. CONCLUSION: The use of a problematizing intervention provided an improvement in behavioral as well as specific clinical parameters, compared to routine diabetes care. However, longer follow-up time for these patients could bring benefits regarding glycemic control.

Chronic kidney disease: susceptibility in a representative population-based sample.

Chronic kidney disease has high morbidity and mortality. In order to track the disease, we conducted a population-based study in a medium-sized city in Southeastern Brazil. Based on instrument SCreening for Occult REnal Disease (SCORED), we evaluated 1,016 individuals with mean age of 44 (SD = 13.2) years. High blood pressure and diabetes mellitus, major causes of chronic kidney disease, were reported by 34.7% and 10.5% of the individuals, respectively. In addition, 31.3% of the sample presented increased risk for the disease, thus leading to a prevalence estimate of 5.4%. A simple screening method allowed the early detection of a population at risk for chronic kidney disease.

Chronic kidney disease: susceptibility in a representative population-based sample / Doença renal crônica: suscetibilidade em uma amostra representativa de base populacional

ABSTRACT Chronic kidney disease has high morbidity and mortality. In order to track the disease, we conducted a population-based study in a medium-sized city in Southeastern Brazil. Based on instrument SCreening for Occult REnal Disease (SCORED), we evaluated 1,016 individuals with mean age of 44 (SD = 13.2) years. High blood pressure and diabetes mellitus, major causes of chronic kidney disease, were reported by 34.7% and 10.5% of the individuals, respectively. In addition, 31.3% of the sample presented increased risk for the disease, thus leading to a prevalence estimate of 5.4%. A simple screening method allowed the early detection of a population at risk for chronic kidney disease.

RESUMO A doença renal crônica apresenta elevada morbimortalidade. Com o objetivo de rastrear a doença, realizou-se estudo de base populacional em cidade de porte médio do sudeste brasileiro. Com base no instrumento SCreening for Occult REnal Disease (SCORED) foram avaliados 1.016 indivíduos com média de idade 44 (DP = 13,2) anos. Hipertensão arterial e diabetes mellitus, principais causas de doença renal crônica, foram relatados por 34,7% e 10,5%, respectivamente. Além disso, 31,3% da amostra apresentou risco aumentado para a doença, levando a uma estimativa de prevalência de 5,4%. Um método simples para rastreio permitiu a detecção precoce de população de risco para doença renal crônica.

Determinação do estado nutricional: qual o valor de peso e altura autorreferidos? / Determination of nutritional state: what is the value of weight and height self-reported?

Introdução: Altas prevalências de sobrepeso e obesidade são descritas em diferentes populações. No entanto, grande parcela da população tem percepções imprecisas sobre seu peso corporal e, consequentemente, sobre a classificação nutricional. Objetivo: Comparar a percepção autorreferida do peso corporal frente à classificação nutricional baseada na aferição realizada por profissional de saúde em amostra representativa da população de cidade de grande porte do sudeste brasileiro. Material e métodos: Foi realizado estudo transversal por inquérito populacional em cidade de médio porte do sudeste brasileiro, sendo a coleta de dados realizada de junho/2014 a abril/2016. Utilizou-se amostragem domiciliar em três estágios e aproximadamente 4.800 domicílios foram visitados, a partir dos quais, 1.032 participantes foram aleatoriamente selecionados e incluídos na pesquisa. Resultados: A média de idade dos participantes foi de 44±13,2 anos, sendo 53,2% indivíduos do sexo feminino. Com base no autorrelato de peso e altura e cálculo do índice de massa corporal (IMC), observou-se que 58,7% da população se encontravam com excesso de peso. Dos 521 indivíduos que foi possível realizar a avaliação do peso e altura por profissionais de saúde vimos que ao se comparar a classificação nutricional baseada no autorrelato com aquela obtida a partir de dados mensurados pelos profissionais, observou-se que o número de casos de obesidade foi 7,1% maior. Conclusão: Diante dos dados do presente estudo, a autopercepção do excesso de peso pode não ser adequada como ferramenta para avaliação de populações em risco para obesidade/sobrepeso, além disso, os resultados reforçam a necessidade de educação sobre o uso do IMC assim como da importância das orientações por profissionais de saúde.

Introduction: High prevalences of overweight and obesity are described in different populations. However, a large portion of the population has inaccurate perceptions about their body weight and, consequently, about nutritional classification. Objective: To compare the self - reported perception of body weight versus nutritional classification based on the measurement performed by a health professional, in a representative sample of the population of a large city in southeastern Brazil. Material andMethods: A cross - sectional study was conducted by a population survey in a medium - sized city in southeastern Brazil. Data collection was performed from June 2014 to April 2016. Household sampling was used in three stages and approximately 4,800 households were visited, from which 1,032 participants were randomly selected and included in the study. Results: The mean age of participants was 44 ± 13.2 years, of which 53.2% were female. Based on self-report of weight and height and calculation of body mass index (BMI), it was observed that 58.7% of the population were overweight. Of the 521 individuals who were able to perform weight and height assessment by health professionals, we observed that when comparing the nutritional classification based on self-report and that obtained from data measured by professionals, it was observed that the number of cases of obesity was 7.1% higher. Conclusion: Considering the data of the present study, the self-perception of excess weight may not be adequate as a tool for the evaluation of populations at risk for obesity/overweight, in addition, the results reinforce the need for education about BMI use as well as importance of the guidelines by health professionals.