Quality of life perception of type 1 diabetic patients treated with insulin analogs and receiving medication review with follow-up in a public health care service from Ponta Grossa-PR, Brazil

Abstract

Glycemic control in patients with diabetes mellitus type 1 (DM1) reduces the risk of complications but requires a rigorous health care routine. Thus, diabetes education is central to increasing treatment compliance and self-care practices. This study aimed to evaluate the quality of life (QoL) and glycemic control of DM1 patients being treated with insulin analogs and receiving medication review with followup. This was a transversal study that included 110 patients registered at the 3 rd Health Regional of Ponta Grossa-PR, aged ≥ 18 years, and receiving pharmaceutical care for at least 1 year. The Diabetes Quality of Life Measure (DQOL)-Brazil was used to evaluate QoL. The data were statistically analyzed using SPSS version 17.0 with 95% confidence levels. Of the 110 patients, 58.2% were women. The average age was 33.7 years (±10.5), and the average glycated hemoglobin (HbA1c) value was 8% (±1.4). The mean total DQOL-Brazil score was 2.11 (95% confidence interval, 2.02 -2.21). All DQOL-Brazil scores were lower in patients with HbA1c ≤ 8%, indicating a better QoL. Good glycemic control, thus, appears to have a positive influence on the QoL, and pharmaceutical interventions are able to contribute to the achievement of therapeutic targets.Uniterms: Diabetes mellitus type 1/treatment. Diabetes mellitus type 1/treatment/quality of life. Pharmaceutical care. Insulin analogs. Pharmacotherapy follow-up. INTRODUCTIONDiabetes mellitus (DM) is a group of metabolic d i s o r d e r s p r i m a r i l y c h a r a c t e r i z e d b y c h r o n i c hyperglycemia. High glycemic levels are associated with micro-and macrovascular complications leading to damage to, and failure of organs such as the eyes (retinopathy), kidneys (nephropathy), nerves (neuropathy), heart, and blood vessels (ADA, 2016; Braga de Souza et al., 2015;Gross et al., 2002).According to the Diabetes Control and Complications Trial (DCCT), the risk of developing chronic complications is higher in patients with chronically high glycated hemoglobin (HbA1c) levels, and the risk gradually increases with HbA1c levels greater than 7% (Pimazoni Netto et al., 2009). The American Diabetes Association (ADA) defines an HbA1c value < 7% as the acceptable limit for diabetes control. With good glycemic control, patients can be symptom-free, and prevent acute and chronic complications (ADA, 2016;UKPDS, 1999;DCCT, 1988).DM is a chronic condition that requires daily self-care throughout life and has a negative impact on the subjective perception of the quality of life (QoL). However, daily treatment is fundamental to DM control and decreases the risk of complications (Debaty et al., 2008;Wood-Dauphinee, 1999). DM1 therapy includes intensive care demands such as daily blood glucose monitoring, multiple insulin injections, and specific dietary and physical activity recommendations (ADA, 2016). Not understanding all these recommendations and a lack of compliance to treatment leads to a poor glycemic control that can cause severe hyper-or hypoglycemia episodes and chronic complicat...

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