Avaliação do controle glicêmico a partir da quantidade de carboidrato ingerido por dia pelos pacientes acompanhados no ambulatório de Diabetes Mellitus tipo 1 do Centro de Especialidades Médicas do Centro Universitário do Estado do Pará

Abstract

INTRODUCTION: Recent evidence suggests a strong relationship between the nutritional factor and the control of type 1 diabetes mellitus (DM1) and Latent Autoimmune Diabetes in Adults (LADA). OBJECTIVE: To evaluate glycemic control based on dietary diagnosis in patients with DM1 and LADA. METHODS: Cross-sectional study with patients with DM1 and LADA followed up at the clinical research and endocrinology service of CEMEC-CESUPA, data were collected from medical records on daily nutrition, anthropometric data and glycemic control. RESULTS: 71 patients were eligible for the 60,6% were female; the majority in the age group between 18-28 years, had a time of diagnosis between 1-11 years. Regarding insulin therapy, 77.5% used a basal bolus regimen and 9.8% were on another insulin regimen, 88.7% were on a fixed dose of insulin, while 11.3% used a variable dose of insulin by counting carbohydrates. Those in fixed dose showed a variation of HbA1C 8.6 ± 1.8% and fasting glucose between 189.3 ± 69.3 (mg / dl). Variable dose patients had HbA1C between 7.7 ± 0.84% and fasting blood glucose between 159.8 ± 55.9 (mg / dl), thus a tendency towards better glycemic control was observed among patients on a variable dose of insulin. Regarding physical activity, 37 patients did not exercise regularly. The average amount of carbohydrates eaten daily by patients was 196.8 ± 86.6g. As for fiber consumption, 36 patients (50.7%) took it 0-1 times a day, 29 (40.9%) 2-3 times a day and only 6 (8.4%) 4-5 times a day. day. The individual Basal Metabolic Rate (BMR), calculated using the Harris-Benedict formula, showed that 43 patients (60%) had an intake less than or equal to the ideal kilocalorie (kcal) of their respective BMR. CONCLUSION: This study concludes that there is a favorable glycemic control from the consumption of CHO with an intake of less than 60% of TBM. Carbohydrate counting patients achieved better glycemic control, starting from HbA1C and fasting glycemia, when compared to patients using a fixed dose. In view of this, it is possible to stimulate the education of the population cared for in the outpatient clinic for the counting of carbohydrates, not forgetting the beneficial influence of the association with the practice of regular physical exercise, in order to reduce future complications and promote a better quality of life for them.