The impact of ethnicity, educational and economic status on the prescription of insulin therapeutic regimens and on glycemic control in patients with type 1 diabetes. A nationwide study in Brazil

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorGOMES, Marilia Brito
dc.contributor.authorRODACKI, Melanie
dc.contributor.authorPAVIN, Elizabeth Joao
dc.contributor.authorCOBAS, Roberta Arnoldi
dc.contributor.authorFELICIO, Joao S.
dc.contributor.authorZAJDENVERG, Lenita
dc.contributor.authorNEGRATO, Carlos Antonio
dc.contributor.groupauthorCORREA-GIANELLA, Maria Lucia Cardillo
dc.contributor.groupauthorADMONI, Sharon Nina
dc.contributor.groupauthorSANTOS, Daniele Pereira dos
dc.date.accessioned2018-09-13T15:22:33Z
dc.date.available2018-09-13T15:22:33Z
dc.date.issued2017
dc.description.abstractAims: Establish the relationship between demographic, educational and economic status on insulin therapeutic regimens (ITRs) and on glycemic control in patients with type 1 diabetes. Methods: This was a cross-sectional, multicenter study with 1760 patients conducted between August 2011 and August 2014 in 10 Brazilian cities. Results: Patients were stratified according to ITRs as follows: only NPH insulin (group 1, n = 80(4.5%)); only long-acting insulin analogs (group 2, n = 6(0.3%)); continuous subcutaneous insulin infusion (CSII) (group 3, n = 62(3.5%)); NPH plus regular insulin (group 4, n = 710(40.3%)); NPH plus ultra-rapid insulin analogs (group 5, n = 259(14.8%)); long-acting insulin analogs plus regular insulin (group 6, n = 25(4.4%)) and long-acting plus ultrarapid insulin analogs (group 7, n = 618 (35.1%)). As group A (provided free of charge by the government) we considered groups 1 and 4, and as group B (obtained through lawsuit or out-of-pocket) groups 2, 3 and 7. Results: Multivariate logistic analysis showed that independent variables related to group B were older age, more years of school attendance, higher economic status and ethnicity (Caucasians). The independent variables related to better glycemic control were older age, higher adherence to diet, higher frequency of self-monitoring of blood glucose, more years of school attendance and belonging to group B. Conclusions: In Brazilian National Health Care System, prescriptions of insulin analogs or CSII are more frequent in Caucasian patients with type 1 diabetes, with higher economic status and more years of school attendance. Among these variables years of school attendance was the only one associated with better glycemic control.
dc.description.indexMEDLINE
dc.description.sponsorshipConselho Nacional de Desenvolvimento Cientifico e Tecnologico do Brasil
dc.description.sponsorshipFundacao do Amparo a Pesquisa do Estado do Rio de Janeiro
dc.identifier.citationDIABETES RESEARCH AND CLINICAL PRACTICE, v.134, p.44-52, 2017
dc.identifier.doi10.1016/j.diabres.2017.09.013
dc.identifier.eissn1872-8227
dc.identifier.issn0168-8227
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/28010
dc.language.isoeng
dc.publisherELSEVIER IRELAND LTD
dc.relation.ispartofDiabetes Research and Clinical Practice
dc.rightsrestrictedAccess
dc.rights.holderCopyright ELSEVIER IRELAND LTD
dc.subjectType 1 diabetes
dc.subjectGlycemic control
dc.subjectInsulin therapeutic regimens
dc.subject.othermulticenter
dc.subject.otherglucose
dc.subject.othercare
dc.subject.otherhypoglycemia
dc.subject.othermetaanalysis
dc.subject.otherassociation
dc.subject.otherprevalence
dc.subject.othermellitus
dc.subject.otheroutcomes
dc.subject.otherchildren
dc.subject.wosEndocrinology & Metabolism
dc.titleThe impact of ethnicity, educational and economic status on the prescription of insulin therapeutic regimens and on glycemic control in patients with type 1 diabetes. A nationwide study in Brazil
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.author.externalGOMES, Marilia Brito:State Univ Hosp Rio Janeiro, Diabet Unit, Dept Internal Med, Rio De Janeiro, Brazil
hcfmusp.author.externalRODACKI, Melanie:Univ Fed Rio de Janeiro, Dept Internal Med, Diabet & Nutr Sect, Rio De Janeiro, Brazil
hcfmusp.author.externalPAVIN, Elizabeth Joao:Univ Estadual Campinas, Fac Med Sci, Dept Internal Med, Div Endocrinol, Sao Paulo, Brazil
hcfmusp.author.externalCOBAS, Roberta Arnoldi:State Univ Hosp Rio Janeiro, Diabet Unit, Dept Internal Med, Rio De Janeiro, Brazil
hcfmusp.author.externalFELICIO, Joao S.:Fed Univ Para, Div Endocrinol, Univ Hosp Joao de Barros Barreto, Belem, Para, Brazil
hcfmusp.author.externalZAJDENVERG, Lenita:Univ Fed Rio de Janeiro, Dept Internal Med, Diabet & Nutr Sect, Rio De Janeiro, Brazil
hcfmusp.author.externalNEGRATO, Carlos Antonio:Baurus Diabet Assoc, Dept Internal Med, Sao Paulo, Brazil
hcfmusp.citation.scopus16
hcfmusp.description.beginpage44
hcfmusp.description.endpage52
hcfmusp.description.volume134
hcfmusp.origemWOS
hcfmusp.origem.pubmed28951342
hcfmusp.origem.scopus2-s2.0-85041265660
hcfmusp.origem.wosWOS:000417318700006
hcfmusp.publisher.cityCLARE
hcfmusp.publisher.countryIRELAND
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