NPH insulin use by patients with type 2 diabetes mellitus in Minas Gerais, Brazil: prevalence and associated factors
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Universidade Federal de Minas Gerais
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Artigo de evento
Título alternativo
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Membros da banca
Resumo
Background: NPH insulin is an important therapeutic
alternative for the maintenance of glycemic control in
patients with type 2 diabetes mellitus (DM2) in the
Brazilian Public Health System (SUS). It is currently
considered the third-line treatment in SUS or considered for patients with plasma glucose above 300 mg/
dL at the time of diagnosis.
Objectives: To assess the prevalence of NPH insulin
use and associated factors among patients with DM2.
Methods: Cross-sectional study was conducted in 63
municipalities of Minas Gerais in 2014. The dependent
variable was defined as the use of NPH insulin. The independent variables were gender, age, marital status,
education, race, self-reported health, diagnosis time,
hypoglycemic crisis in the last month, comorbidities,
medical visits in the past year, type of health care (public or private), regular physical activity, polypharmacy
(use five or more drugs) and interruption of routine activities in the last 15 days. Bivariate and multivariate
logistic regression analysis was performed to identify
factors associated with NPH insulin use.
Results: A total of 2192 patients with DM2 were
interviewed and 25% used either insulin or analogue
to insulin. The prevalence of NPH insulin use among
the participants was 22.1%. Approximately 62% of
the NPH insulin users took the medication twice a
day, and 33% took it once a day. The following factors
were associated with the use of NPH insulin among
those patients: diagnostic time above 10 years (OR =
2.78; CI 95% 2.22–3.47), having hypoglycemic crisis
in the last month (OR = 2.39; CI 95% 1.85–3.09), using less than 5 drugs (OR = 1.71; CI 95% 1.34–
2.19), having more than 5 comorbidities (OR = 1.48;
CI 95% 1.15–1.90), consulting with the doctor more
than 3 times on the previous year (OR = 1.46; CI
95% 1.15–1.85) and diabetic foot (OR = 1.53; CI
95% 1.08–2.16) and diabetic neuropathy (OR = 1.40;
CI 95% 1.06–1.85) as complications of the DM2.
Conclusions: NPH was the most used insulin among
the participants. NPH insulin use are associated disease progression characteristics such as having longer
diagnostic time, difficulty in glycemic control and
complications. Trained professionals are needed to
provide adequate care for diabetic patients, especially
when using NPH insulin, and therefore to promote a
rational use of medicines and to minimize the negative
consequences of treatment discontinuation on the
health of this population.
Abstract
Assunto
Diabetes mellitus, Insulina
Palavras-chave
Diabetes mellitus, Insulina, Insulina NPH
Citação
Departamento
Curso
Endereço externo
https://onlinelibrary.wiley.com/doi/full/10.1002/pds.4275