Autocuidado com a alimentação de indivíduos com diabetes mellitus após internação hospitalar

Abstract

Introduction: Self-care enables individuals, especially those with diabetes mellitus (DM), to recognize the importance of healthy lifestyle to control the disease, making them more involved in the caring process. Objectives: To analyse the self-care strategies regarding eating established by individuals with DM after hospitalization in the city of Divinópolis, Minas Gerais, and its influence on hospital readmissions. Methods: Cross-sectional study with individuals 18 years hospitalized for DM in the municipality of Divinópolis-MG in the period from August to October 2013, after eighteen months of hospital discharge. It was collected socioeconomic data, information regarding access to health services, changes in food intake and self-care strategies (QAD). It was performed clinical, anthropometric and biochemical evaluation. Descriptive analysis and Poisson Regression with robust variance were used to investigate the association between self-care, eating and hospital readmissions. Results: After 18 months of hospitalization, 37 individuals were evaluated. The mean age was 64.7 years, the majority (91.7%) had low education (<8 years of education) and per capita income (505.25 ± 243.62). The overweight (62.2%), hypertension (81.1%) and dyslipidaemia (40.5%) were frequent, and 51.3% of respondents had two or more DM complications. Almost half (45.9%) of subjects were hospitalized in the period; 42.0% received guidelines from health professional about treatment; and 27.0% nutritionist guidelines. The biochemical evaluation revealed negative changes in blood glucose fasting (67.6%), glycated haemoglobin (40.5%) and lipid decontrol (30.0%). The food intake was inadequate, and most reported eating less than six meals per day (78.4%), and infrequent consumption of whole foods (97.3%), fruit (62.2%) and vegetables (56.8%). After hospitalization, positive changes in diet occurred for the consumption of fried foods (40.1%) and foods high in sugar (33.4%). On the other hand, the intake of sausages and other processed meats, processed seasonings and industrialized products (38.2%). In self-care evaluation, according to QAD, the item "medicines" got the greatest adhesion and the item "physical activity" the lowest. Only 35.1% reported taking care of diet on five or more days a week. However, individuals who adhered self-care regarding food intake reduced by up to twice the prevalence of readmission (RP = 2.1; 1.153.50). Conclusion: Individuals with DM, after 18 months of hospital discharge, presented high percentage of complications and poor adhesion to self-care with DM, especially for food and physical activity, which are essential to control the disease and prevent complications. But, those who reported taking care of their diet had a lower prevalence of hospital readmissions, indicating the need to increase the nutritional care to improve the health and quality of life of individuals.