Relationship between adherence to diet, glycemic control and cardiovascular risk factors in patients with type 1 diabetes: a nationwide survey in Brazil

被引:38
作者
Davison, Kariane A. K. [1 ]
Negrato, Carlos A. [1 ]
Cobas, Roberta [2 ]
Matheus, Alessandra [2 ]
Tannus, Lucianne [2 ]
Palma, Catia S. [2 ]
Japiassu, Leticia [2 ]
Carneiro, Joao R. I. [2 ]
Rodacki, Melanie [3 ]
Zajdenverg, Lenita [3 ]
Araujo, Neuza B. C. [4 ]
Cordeiro, Marilena M. [4 ]
Luescher, Jorge Luiz [5 ]
Berardo, Renata S. [5 ]
Nery, Marcia [6 ]
Cani, Catarina [6 ]
Marques, Maria do Carmo A. [6 ]
Calliari, Luiz Eduardo [7 ]
Noronha, Renata M. [7 ]
Manna, Thais D. [8 ]
Savoldelli, Roberta [8 ]
Penha, Fernanda G. [8 ]
Foss, Milton C. [9 ]
Foss-Freitas, Maria Cristina [9 ]
Guedes, Maria de Fatima [1 ]
Dib, Sergio A. [10 ]
Dualib, Patricia [10 ]
Silva, Saulo C. [11 ]
Sepulveda, Janice [11 ]
Sampaio, Emerson [12 ]
Rea, Rosangela R. [13 ]
Faria, Ana Cristina R. A. [13 ]
Tschiedel, Balduino
Lavigne, Suzana
Cardozo, Gustavo A.
Pires, Antonio C. [14 ]
Robles, Fernando C. [14 ]
Azevedo, Mirela [15 ]
Canani, Luis Henrique [15 ]
Zucatti, Alessandra T. [15 ]
Coral, Marisa H. C. [16 ]
Pereira, Daniela A. [16 ]
Araujo, Luiz Antonio [17 ]
Pedrosa, Hermelinda C. [18 ]
Tolentino, Monica [18 ]
Prado, Flaviene A. [18 ]
Rassi, Nelson [19 ]
Araujo, Leticia B. [19 ]
Fonseca, Reine M. C. [20 ]
Guedes, Alexis D. [20 ]
机构
[1] Baurus Diabet Assoc, Dept Internal Med, Sao Paulo, Brazil
[2] State Univ Hosp Rio de Janeiro, Dept Internal Med, Diabet Unit, Rio De Janeiro, Brazil
[3] Fed Univ Hosp Rio de Janeiro, Rio De Janeiro, Brazil
[4] Gen Hosp Bonsucesso, Rio De Janeiro, Brazil
[5] Univ Hosp Clementino Fraga Filho, Children Inst Martagao Teixeira, Rio De Janeiro, Brazil
[6] Univ Hosp Sao Paulo, Diabet Unit, Sao Paulo, Brazil
[7] Santa Casa Hosp, Pediat Unit Endocrinol, Sao Paulo, Brazil
[8] Univ Hosp Sao Paulo, Children Inst Endocrinol, Sao Paulo, Brazil
[9] Univ Sao Paulo, Ribeirao Preto Med Sch, Sao Paulo, Brazil
[10] Fed Univ Sao Paulo State, Diabet Unit, Sao Paulo, Brazil
[11] Hosp Santa Casa Belo Horizonte, Endocrinol Unit, Belo Horizonte, MG, Brazil
[12] State Univ Hosp Londrina, Diabet Unit, Londrina, Parana, Brazil
[13] Univ Fed Parana, Clin Hosp, BR-80060000 Curitiba, Parana, Brazil
[14] State Univ Sao Jose do Rio Preto, Sch Med, Dept Internal Med, Sao Paulo, Brazil
[15] Clin Hosp Porto Alegre, Porto Alegre, RS, Brazil
[16] Univ Hosp Santa Catarina, Florianopolis, SC, Brazil
[17] Endocrinol & Diabet Inst Joinville, Joinville, SC, Brazil
[18] Reg Hosp Taguatinga, Brasilia, DF, Brazil
[19] Gen Hosp Goiania, Goiania, Go, Brazil
[20] Diabet & Endocrinol Ctr Bahia, Salvador, BA, Brazil
[21] Univ Fed Maranhao, Sao Luis, Maranhao, Brazil
[22] Diabet & Hypertens Ctr Ceara, Fortaleza, Ceara, Brazil
[23] Univ Fed Ceara, Fortaleza, Ceara, Brazil
[24] Fed Univ Hosp Campina Grande, Campina Grande, Paraiba, Brazil
[25] Adriano Jorge Hosp, Getulio Vargas Univ Hosp Amazonas, Manaus, Amazonas, Brazil
关键词
Type; 1; diabetes; Glycemic control; Dietitian; Diet; Diabetes care; Adherence to diet; SITUATIONAL OBSTACLES; ADOLESCENTS; CHILDREN; YOUTH; INTERVENTION; BEHAVIORS; MELLITUS; THERAPY; HABITS; GENDER;
D O I
10.1186/1475-2891-13-19
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background: To determine the relationship between adherence to the diet reported by patients with type 1 diabetes under routine clinical care in Brazil, and demographic, socioeconomic status, glycemic control and cardiovascular risk factors. Methods: This was a cross-sectional, multicenter study conducted between December 2008 and December 2010 in 28 public clinics in 20 Brazilian cities. The data was obtained from 3,180 patients, aged 22 +/- 11.8 years (56.3% females, 57.4% Caucasians and 43.6% non-Caucasians). The mean time since diabetes diagnosis was 11.7 +/- 8.1 years. Results: Overall, 1,722 (54.2%) of the patients reported to be adherent to the diet without difference in gender, duration of diabetes and socioeconomic status. Patients who reported adherence to the diet had lower BMI, HbA1c, triglycerides, LDL-cholesterol, non HDL-cholesterol and diastolic blood pressure and had more HbA1c at goal, performed more frequently self-monitoring of blood glucose (p < 0.001), and reported less difficulties to follow specific schedules of diet plans (p < 0.001). Less patients who reported to be adherent were obese or overweight (p = 0.005). The quantity of food and time schedule of the meals were the most frequent complaints. Logistic regression analysis showed that ethnicity, (Caucasians, (OR 1.26 [1.09-1.47]), number of medical clinical visits in the last year (OR 1.10 [1.06-1.15]), carbohydrate counting, (OR 2.22 [1.49-3.30]) and diets recommended by diabetes societies', (OR 1.57 [1.02-2.41]) were related to greater patients' adherence (p < 0.05) and age, [adolescents (OR 0.60 [0.50-0.72]), high BMI (OR 0.58 [0.94-0.98]) and smoking (OR 0.58 [0.41-0.84]) with poor patients' adherence (p < 0.01). Conclusions: Our results suggest that it is necessary to rethink medical nutrition therapy in order to help patients to overcome barriers that impair an optimized adherence to the diet.
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页数:11
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