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TRATAMIENTO EN ADULTOS CON DIABETES MELLITUS TIPO 1: ¿QUÉ VARIABLES IMPACTAN EN EL CONTROL GLUCÉMICO?

Eva López González, María Ruiz Morosino, Alicia García, Silvia Milrad, Ángela Luongo, Solange Houssay, Cristina Varela, Claudio González

Resumen


Objetivos: analizar modalidades terapéuticas en personas con diabetes mellitus tipo 1 (DM1) y su relación con el control glucémico.

Resultados: 514 pacientes, edad 40,6±14,6 años, sexo femenino 55,1%, antigüedad DM1 17,4±12,0 años, media A1C 8,0±1,5 %, media glucemia de ayunas 147,2±69,1 mg/dl, frecuencia de automonitoreo 3,3±1,5 veces/día. El 38,8% presentó A1C<7%, mientras el 60,9% tenía A1C <8%.

Insulinoterapia intensificada 75,1%; con bomba de infusión 8,6%, realizaba conteo de hidratos, 62,1%. La media de A1C fue 7,8±1,5% en el tratamiento intensificado y 8,4±1,7% en el tratamiento convencional (p=0,001). Presentó hipoglucemias en la última semana el 67%, siendo mayor en el grupo intensificado (p=0,0001).

En regresión logística múltiple, el mejor control glucémico correlacionó con la realización de actividad física (p<0,002), conteo de hidratos (p<0,04), respetar horario de comidas (p=0,0001) y mayor frecuencia de automonitoreo (p=0,004).

Conclusiones: El 38,8% presentó A1C< 7%. La insulinoterapia intensificada se asoció a mejores niveles de A1C y con mayor frecuencia de hipoglucemias. El mejor control correlacionó con realización de actividad física, respetar el horario de comidas, el conteo de hidratos y mayor frecuencia de automonitoreo.

 

 


Palabras clave


Diabetes tipo 1; adultos; tratamiento intensificado; control glucémico

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DOI: http://dx.doi.org/10.47196/diab.v48i2.207

Copyright (c) 2020 Sociedad Argentina de Diabetes Asociación Civil

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