Economic status and clinical care in young type 1 diabetes patients: a nationwide multicenter study in Brazil

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art_MANNA_Economic_status_and_clinical_care_in_young_type_2013.PDF (218.25 KB)
Citações na Scopus
31
Tipo de produção
article
Data de publicação
2013
Editora
SPRINGER-VERLAG ITALIA SRL
DOI
Indexadores
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Autores
GOMES, Marilia B.
MATHEUS, Alessandra Saldanha de Mattos
CALLIARI, Luis Eduardo
LUESCHER, Jorge Luiz
COBAS, Roberta A.
COELHO, Wellington Siqueira
TSCHIEDEL, Balduino
RAMOS, Alberto Jose
Autor de Grupo de pesquisa
Editores
Coordenadores
Organizadores
Citação
ACTA DIABETOLOGICA, v.50, n.5, p.743-752, 2013
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
The aim of this study is to evaluate the influence of economic status on clinical care provided to Brazilian youths with type 1 diabetes in daily practice, according to the American Diabetes Association's guidelines. This was a cross-sectional, multicenter study conducted between 2008 and 2010 in 28 public clinics in Brazil. Data were obtained from 1,692 patients (55.3 % female, 56.4 % Caucasian), with a mean age of 13 years (range, 1-18), a mean age at diagnosis of 7.1 +/- A 4 years and diabetes duration of 5 +/- A 3.7 years. Overall, 75 % of the patients were of a low or very low economic status. HbA1c goals were reached by 23.2 %, LDL cholesterol by 57.9 %, systolic blood pressure by 83.9 % and diastolic blood pressure by 73.9 % of the patients. In total, 20.2 % of the patients were overweight and 9.2 % were obese. Patients from very low economic status were less likely to attend tertiary care level when compared with those from low, medium and high economic status, 64.2 % versus 75.5 % versus 78.3 % and 74.0 %; p < 0.001, respectively. The rate of annual screening for retinopathy, nephropathy and for foot alterations was 66.2, 69.7 and 62.7 %, respectively. Insulin dose, age, very low economic status, daily frequency of self-blood glucose monitoring and female gender were independently associated with poor glycemic control. Screening for diabetic complications and attaining glucose, lipid and blood pressure goals present a challenge for young Brazilian type 1 diabetes patients. The low economic status of the majority of our patients may represent a barrier to reaching these goals.
Palavras-chave
Type 1 diabetes, Chronic complications, Diabetes in youths
URI
https://observatorio.fm.usp.br/handle/OPI/4477
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Coleções
Artigos e Materiais de Revistas Científicas - HC/ICr
Artigos e Materiais de Revistas Científicas - LIM/36
Artigos e Materiais de Revistas Científicas - ODS/03