Fatores de risco na dificuldade à adesão ao tratamento dietético das pessoas com diabetes mellitus atendidas no ambulatório de um hospital escola

Abstract

Diabetes Mellitus (DM) is a worldwide public health problem that requires permanent control at all levels of health care. Special attention is needed to dietary changes because if not taken seriously, they will have serious consequences for people with diabetes. Thus, different risk factors may interfere making it difficult to comply with the diet and folow the treatment, such as: sociodemographic, cultural, economic characteristics, among others. DM treatment is known to occur through the triad: balanced diet, exercise and medication. Difficulty in therapy related to dietary factor implies loss of quality of life, as well as economic, social and even death. Objective: to analyze the risk factors associated with difficulty in adhering to the dietary treatment of people with diabetes mellitus seen at the outpatient clinic of a teaching hospital. Metodology: this is a methodological study, observational and descriptive, through quantitative and qualitative methods, with a sample of 250 diabetic people over eighteen years, in which all types of DM were analyzed, using a structured questionnaire. The analysis was performed using the logistic regression model to calculate the relative risk, based on the risk factors that interfere with the adherence to dietary treatment and, consequently, the uncontrolled glycemia, also analyzed through the speech from the treatment weaknesses and potentialities of people with diabetes mellitus seen at the outpatient clinic of a teaching hospital. Results: The hospital presented a follow-up of diabetic people, where in a sample of 250 people, the blood glucose rate was verified of 232 individuals, and defined as variable Y to observe the control and uncontrolled, presenting 84.3% of fasting uncontrolled; the casual HGT examination showed 35.4% of lack of control and 2 hours after the meal, 52.8% of lack of control. The result of uncontrolled glucose levels is worrisome and is associated with risk factors that make treatment adherence difficult: constant variations in HGT at different times throughout the day, hyperglycemia, lipodystrophy, mainly due to the dietary factor related to the large consumption of refined carbohydrates and satisfaction with DM not being willing to change lifestyle habits. Conclusion: Risk factors associated with poor dietary control that impair glycemia, decompensating it, make diabetics subject to unpleasant consequences on their quality of life, such as: skin compromise, amputations, neuropathies, retinopathies, cardiovascular disease, kidney disease, and others. Therefore, it is necessary to search for risk factors associated with dietary treatment to help in clinical and strategic decisions such as prevention of harm with public managers, in order to minimize risks and improve the life quality of people with diabetes mellitus.