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Factors associated with glycemic control in people with diabetes at the Family Health Strategy in Pernambuco
Rodrigo Fonseca Lima1, Annick Fontbonne2, Eduardo Maia Freese de Carvalho1
1Fundação Oswaldo Cruz, Centro de Pesquisa Aggeu Magalhães, Departamento de Saúde Coletiva, Recife, PE, Brazil.
Objective:
Identifying factors associated with glycemic control in people with type 2 Diabetes Mellitus (DM) registered in the Family Health Strategy (FHS) in Pernambuco, Brazil.
Method:
Associations between glycemic control (glycosylated hemoglobin A lower or equal to 7%) presented by people with DM and variables related to sociodemographic conditions, lifestyle, characteristics of diabetes, treatment and follow-up of patients by health services were investigated by multiple regression.
Results:
More than 65% of the participants presented inadequate glycemic control, especially those with lower age, longer illness duration, more annual contacts with FHS and complex therapeutic regimen. People with DM without referrals to specialists presented greater glycemic control. Associations with education level and obesity did not remain significant in the multivariate model.
Conclusion:
The evolution of diabetes hinders adequate control, however, attention to younger people with DM and referrals to specialists are factors that can improve glycemic control.
Objetivo:
Identificar fatores associados ao controle glicêmico em pessoas com Diabetes Mellitus (DM) tipo 2 cadastradas na Estratégia Saúde da Família (ESF) em Pernambuco, Brasil.
MéTodo:
Foram investigadas, por regressão múltipla, as associações entre o controle glicêmico (hemoglobina A glicosilada menor ou maior ou igual a 7%) apresentado pelas pessoas com DM e variáveis relacionadas com condições sociodemográficas, hábitos de vida, características do diabetes, de seu tratamento e acompanhamento dos pacientes pelos serviços de saúde.
Resultados:
Mais de 65% dos participantes apresentaram controle glicêmico inadequado, principalmente aqueles com idade menor, duração da doença mais longa, mais contatos anuais com a ESF e regime terapêutico complexo. Pessoas com DM sem encaminhamentos para especialistas apresentaram um maior descontrole glicêmico. Associações com escolaridade e obesidade não permaneceram significativas no modelo multivariado.
ConclusãO:
A evolução do diabetes dificulta o controle adequado, todavia, a atenção às pessoas com DM mais jovens e os encaminhamentos para especialistas são fatores suscetíveis de melhora do controle glicêmico.
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