Fatores associados aos valores inadequados da Hemoglobina A glicada na saúde de idosos com Diabetes Mellitus tipo 2

Abstract

Diabetes Mellitus (DM) is considered a chronic metabolic disease characterized by high blood glucose levels, which in the long term can lead to serious damage to organs and systems. Glycated Haemoglobin (HbA1c) is a molecule capable of influencing the function of erythrocyte and glycemic variants. Therefore, it is used to diagnose and evaluate glycemic control in patients with DM2, being considered as a guide in the evaluation and investigation of individual health, in addition to having a strong link between the development and/or worsening of DM2. OBJECTIVE: To identify the association between inadequate HbA1c values and clinical-functional data on the health of elderly people with DM2 and to show the possible repercussions that the management of the disease can cause in the health care of the elderly with DM. METHOD: This is a cross-sectional analytical observational study, whose sample was selected for convenience and consisted of elderly people aged 60 years or older, diagnosed with type 2 DM, according to the criterion of the American Diabetes Association (ADA), carried out between the period from August 2017 to December 2018. Statistical analyzes were performed using the Mann-Whitney, Kruskal-Wallis tests followed by Dunn's test and the Spearman Correlation Coefficient (ρ), p<0.05. The power of the test with an n of 107 cases was equal to 66%. RESULTS: The sample consisted of 107 cases, characterized by a predominance of women (67.3%); between 60-69 years (63.4%); social participation (59.6%); overweight (62.6%) and sedentary (73.8%); had 3 or more diseases (83.2%), used plipharmacy (90.6%), with a diagnosis of DM ≥ 5 years (70.5%). Almost half of the population had an HbA1c altered to ≥8.1% (49.5%). Lower limb pain was reported in 54.2% and episodes of one or more falls in the last year in 37.4% of individuals. One or more changes in the feet were identified in 85.1%, in which there was a greater change in vibratory (43.9%) and cutaneous-protective (47.7%) sensitivity; cognitive deficit in 40.2% and depressive symptoms (50.5%). CONCLUSION: The findings of this study showed that altered HbA1c was related to most of the variables studied. These clinical and functional findings show the need for early intervention in this population, with prevention and monitoring strategies to minimize the changes that may occur in the course of the disease. As soon, reducing mortality and morbidity by encouraging adherence to self-care with DM. Therefore, it is suggested the importance of conducting longitudinal studies that more accurately assess the impact of DM 2, which may be linked to the prospect of better quality of life despite the chronicity of the disease.