Adesão à automonitorização na diabetes tipo 2: plataforma “ClouDi” vs. acompanhamento presencial.
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Introdução: Apenas 30% dos hospitais possuem protocolo padronizado para alta de pacientes tratados com insulina e metade dos pacientes relatou dificuldades no acompanhamento e ajuste da terapêutica na transição do hospital para o ambulatório. O uso do mHealth pode melhorar a adesão ao automonitoramento com glicometria capilar, porém, em pacientes em transição do hospital para o ambulatório, a informação é limitada. O objetivo é avaliar a adesão e as características sociodemográficas de pacientes com Diabetes Tipo 2 (DM2) vinculados a um programa de educação, por meio do uso de mHealth (ClouDi) com educação presencial durante a pandemia de COVID -19.
Metodologia: Estudo prospectivo longitudinal, foram incluídos pacientes internados com diagnóstico de DM2, com indicação de tratamento insulínico na alta hospitalar no período de outubro de 2020 a 2021, avaliados por consulta de educação em diabetes.
Resultados: Dos 86 doentes (44% do sexo feminino, 41 utilizadores do ClouDi, idade média 58,8 ± 11,2 anos, com duração média da diabetes de 7,8 ± 7,4 anos), 53,6% encontravam-se no estrato 2, 92,9% pertenciam ao regime contributivo , 42,9% com ensino fundamental básico e 51,2% empregados. Adesão ao uso de monitorização com glicometria capilar em pacientes ClouDi comparados a pacientes em cuidados habituais (64,4% vs 28,2%, p<0,001), independente de variáveis sociodemográficas.
Conclusão: O uso do ClouDi esteve associado à maior adesão ao acompanhamento com glicometria capilar independente das variáveis sociodemográficas. O uso dessa tecnologia pode ser útil no monitoramento de pacientes usuários de insulina na alta hospitalar.
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Aschner P, Gagliardino JJ, Ilkova H, Lavalle F, Ramachandran A, Mbanya JC, et al. Persistent poor glycaemic control in individuals with type 2 diabetes in developing countries: 12 years of real-world evidence of the International Diabetes Management Practices Study (IDMPS). Diabetologia. 2020; 63(4):711–21. DOI: 10.1007/s00125-019-05078-3
DANE. Indicadores básicos de TIC en Hogares [Internet]. Gobierno de Colombia. [citado el 11 de febrero de 2024]. Disponible en: https://www.dane.gov.co/index.php/estadisticas-por-tema/tecnologia-e-innovacion/tecnologias-de-la-informacion-y-las-comunicaciones-tic/indicadores-basicos-de-tic-en-hogares?phpMyAd%20min=3om27vamm65hhkhrtgc8rrn2g4
DANE. Encuesta de Tecnologías de la Información y las Comunicaciones en Hogares (ENTIC Hogares) [Internet]. Gobierno de Colombia [citado el 11 de febrero de 2024]. Disponible en: https://www.dane.gov.co/index.php/estadisticas-por-tema/tecnologia-e-innovacion/tecnologias-de-la-informacion-y-las-comunicaciones-tic/encuesta-de-tecnologias-de-la-informacion-y-las-comunicaciones-en-hogares-entic-hogares
Garber AJ, Handelsman Y, Grunberger G, Einhorn D, Abrahamson MJ, Barzilay JI, et al. Consensus statement by the american association of clinical endocrinologists and american college of endocrinology on the comprehensive type 2 diabetes management algorithm - 2020 executive summary. Endocr Pract Off J Am Coll Endocrinol Am Assoc Clin Endocrinol. 2020; 26(1):107–39. DOI: 10.4158/CS-2019-0472
Chircop J, Sheffield D, Kotera Y. Systematic Review of Self-Monitoring of Blood Glucose in Patients With Type 2 Diabetes. Nurs Res. 2021;70(6):487–97. DOI: 10.1097/NNR.0000000000000542
Gómez Medina AM, Henao Carrillo DC, Silva León JD, Gómez González JA, Muñoz Velandia OM, Conde Brahim L, et al. Results From a Virtual Clinic for the Follow-up of Patients Using the Advanced Hybrid Closed-Loop System. Journal of Diabetes Science and Technology. 2023;0(0). DOI: 10.1177/19322968231204376
Wascher TC, Stechemesser L, Harreiter J. [Blood glucose self monitoring]. Wien Klin Wochenschr. 2023 Jan;135(Suppl 1):143–146. Disponible en: https://link.springer.com/article/10.1007/s00508-023-02172-w
Andrès E, Meyer L, Zulfiqar A-A, Hajjam M, Talha S, Bahougne T, et al. Telemonitoring in diabetes: evolution of concepts and technologies, with a focus on results of the more recent studies. J Med Life. 2019;12(3):203–14. Disponible en: 10.25122/jml-2019-0006
Shan R, Sarkar S, Martin SS. Digital health technology and mobile devices for the management of diabetes mellitus: state of the art. Diabetologia. 2019 Jun;62(6):877–87. DOI: 10.1007/s00125-019-4864-7
Diagnosis and Classification of Diabetes: Standards of Care in Diabetes-2024. Diabetes Care. 2024 Jan;47(Suppl 1):S20–42. Disponible en: http://dx.doi.org/10.2337/dc24-S002
Franc S, Hanaire H, Benhamou P-Y, Schaepelynck P, Catargi B, Farret A, et al. DIABEO System Combining a Mobile App Software With and Without Telemonitoring Versus Standard Care: A Randomized Controlled Trial in Diabetes Patients Poorly Controlled with a Basal-Bolus Insulin Regimen. Diabetes Technol Ther. 2020 Dec;22(12):904–11. Disponible en: http://dx.doi.org/10.1089/dia.2020.0021
Hu Y, Wen X, Wang F, Yang D, Liu S, Li P, et al. Effect of telemedicine intervention on hypoglycaemia in diabetes patients: A systematic review and meta-analysis of randomised controlled trials. J Telemed Telecare. 2019 Aug;25(7):402–13. Disponible en: http://dx.doi.org/10.1177/1357633X18776823
Machado S, Marques R, Nascimento E, Matos A, Henriques C. Relationship between HbA1c and capillary blood glucose self-monitoring in type 2 diabetics. Rom J Intern Med. 2019 Jun;57(2):125–32. Disponible en: http://dx.doi.org/10.2478/rjim-2018-0043
Munshi KD, Amelung K, Carter CS, James R, Shah BR, Henderson RR. Impact of a diabetes remote monitoring program on medication adherence. J Manag care Spec Pharm. 2021 Jun;27(6):724–31. Disponible en: http://dx.doi.org/10.18553/jmcp.2021.27.6.724
Yang Y, Lee EY, Kim H-S, Lee S-H, Yoon K-H, Cho J-H. Effect of a Mobile Phone-Based Glucose-Monitoring and Feedback System for Type 2 Diabetes Management in Multiple Primary Care Clinic Settings: Cluster Randomized Controlled Trial. JMIR mHealth uHealth. 2020 Feb;8(2):e16266. Disponible en: http://dx.doi.org/10.2196/16266
von Storch K, Graaf E, Wunderlich M, Rietz C, Polidori MC, Woopen C. Telemedicine-Assisted Self-Management Program for Type 2 Diabetes Patients. Diabetes Technol Ther. 2019 Sep;21(9):514–21. Disponible en: http://dx.doi.org/10.1089/dia.2019.0056
Roca S, Lozano ML, García J, Alesanco Á. Validation of a Virtual Assistant for Improving Medication Adherence in Patients with Comorbid Type 2 Diabetes Mellitus and Depressive Disorder. Int J Environ Res Public Health. 2021 Nov;18(22). Disponible en: http://dx.doi.org/10.3390/ijerph182212056
León-Vargas F, Martin C, Garcia-Jaramillo M, Aldea A, Leal Y, Herrero P, et al. Is a cloud-based platform useful for diabetes management in Colombia? The Tidepool experience. Comput Methods Programs Biomed. 2021 Sep;208:106205. Disponible en: http://dx.doi.org/10.1016/j.cmpb.2021.106205
María Gómez A, Cristina Henao D, León Vargas F, Mauricio Muñoz O, David Lucero O, García Jaramillo M, et al. Efficacy of the mHealth application in patients with type 2 diabetes transitioning from inpatient to outpatient care: A randomized controlled clinical trial. Diabetes Res Clin Pract. 2022 Jul;189:109948. Disponible en: https://www.diabetesresearchclinicalpractice.com/article/S0168-8227(22)00762-8/fulltext
Bém R. Telemedicine in diabetology. Vnitr Lek. 2022;68(3):144–53.
Glycemic Goals and Hypoglycemia: Standards of Care in Diabetes-2024. Diabetes Care. 2024 Jan;47(Suppl 1):S111–25. Disponible en: http://dx.doi.org/10.2337/dc24-S006
Jansa M, Quirós C, Giménez M, Vidal M, Galindo M, Conget I. Análisis psicométrico de las versiones en lengua castellana y catalana de un cuestionario de percepción de la hipoglucemia. Med Clin (Barc). 2015;10:440–4. Disponible en: http://dx.doi.org/10.1016/j.medcli.2013.11.036
Graetz I, Huang J, Muelly ER, Fireman B, Hsu J, Reed ME. Association of Mobile Patient Portal Access With Diabetes Medication Adherence and Glycemic Levels Among Adults With Diabetes. JAMA Netw open. 2020 Feb;3(2):e1921429. Disponible en: http://dx.doi.org/10.1001/jamanetworkopen.2019.21429
Agarwal P, Mukerji G, Desveaux L, Ivers NM, Bhattacharyya O, Hensel JM, et al. Mobile App for Improved Self-Management of Type 2 Diabetes: Multicenter Pragmatic Randomized Controlled Trial. JMIR mHealth uHealth. 2019 Jan;7(1):e10321. Disponible en: http://dx.doi.org/10.2196/10321
Parsons SN, Luzio SD, Harvey JN, Bain SC, Cheung WY, Watkins A, et al. Effect of structured self-monitoring of blood glucose, with and without additional TeleCare support, on overall glycaemic control in non-insulin treated Type 2 diabetes: the SMBG Study, a 12-month randomized controlled trial. Diabet Med. 2019 May;36(5):578–90. Disponible en: http://dx.doi.org/10.1111/dme.13899
Xu R, Xing M, Javaherian K, Peters R, Ross W, Bernal-Mizrachi C. Improving HbA(1c) with Glucose Self-Monitoring in Diabetic Patients with EpxDiabetes, a Phone Call and Text Message-Based Telemedicine Platform: A Randomized Controlled Trial. Telemed J e-health Off J Am Telemed Assoc. 2020 Jun;26(6):784–93. Disponible en: https://www.liebertpub.com/doi/10.1089/tmj.2019.0035
Han C-Y, Zhang J, Ye X-M, Lu J-P, Jin H-Y, Xu W-W, et al. Telemedicine-assisted structured self-monitoring of blood glucose in management of T2DM results of a randomized clinical trial. BMC Med Inform Decis Mak. 2023 Sep;23(1):182. Disponible en: http://dx.doi.org/10.1186/s12911-023-02283-4
Jermendy G, Kecskes A, Nagy A. Nocturnal Hypoglycaemia in Patients with Diabetes Mellitus: Database Analysis of a Cohort Using Telemedicine Support for Self-Monitoring of Blood Glucose over a 10-Year-Long Period. Medicina (Kaunas). 2021 Feb;57(2). Disponible en: http://dx.doi.org/10.3390/medicina57020167
Kerr D, Duncan I, Repetto E, Maroun R, Wu A, Perkins C, et al. Cost analysis of self-monitoring blood glucose in nonintensively managed type 2 diabetes. Am J Manag Care. 2023 Dec;29(12):670–5. Disponible en: https://www.ajmc.com/view/cost-analysis-of-self-monitoring-blood-glucose-in-nonintensively-managed-type-2-diabetes
Siegel KR, Ali MK, Zhou X, Ng BP, Jawanda S, Proia K, et al. Cost-effectiveness of Interventions to Manage Diabetes: Has the Evidence Changed Since 2008? Diabetes Care. 2020 Jul;43(7):1557–92. Disponible en: https://diabetesjournals.org/care/article/43/7/1557/35595/Cost-effectiveness-of-Interventions-to-Manage
