Impacto do uso de um sensor de monitorização instantânea de glicose na qualidade de vida de portadores de diabetes tipo1

Abstract

The diagnosis of type 1 diabetes mellitus (DM1) requires the patient, in addition to lifestyle changes, to apply insulin by multiple doses or pump and self-monitoring, which is conventionally performed by multiple digital punctures. These conditions, especially the latter, may impair health-related quality of life (HRQOL) in patients with DM1. This study aims to evaluate the impact of using a continuous glucose monitoring sensor (SMCG) on the quality of life of DM1 patients accustomed to conventional self-monitoring. This is a prospective cohort of 35 patients with DM1 who used FreeStyle® Libre, a SMCG for three months. They answered a HRQoL questionnaire, the DQOL- Brazil before and after using the sensor. This questionnaire consists of 44 items, divided into four domains: satisfaction, impact, social/vocational concerns (PSV) and diabetes-related concerns (PRDM). We calculated: mean domain scores and overall mean score (EMG). Statistical analysis was performed in IBPM SPSS software version 2.0 by paired t-test and considered significant p<0.05. Among the patients who participated in the study, 62.8% were female, age 31.7±10.3 years, BMI 23.4± 5.0kg/m² and DM1 diagnosis 13.6±7.9 years ago. Of the questionnaire items analyzed after using the sensor, they improved satisfaction with the time spent to check glucose levels, with current treatment, frequency of pain associated with treatment and restriction by their diet, and worsened satisfaction with their sex life; frequency of a bad night's sleep; and concern about whether they will faint. However, there was no change in satisfaction scores in scores for satisfaction (2.37±0.63 and 2.30±0.67; p=0.57), impact (2.58±0.6 and 2.48±0.70; p=0.391), PSV (2.36±0.92 and 2.59±1.10; p=0.185) and PRDM (2.82±1.11 and 2.91±0.90; p=0.635), nor in EMG (2.49±0.5 and 2.50±0.63; p=0.944) before and after sensor use. Replacing the blood glucose monitoring method by multiple digital punctures with the blood glucose monitoring flash sensor did not lead to an improvement in the overall quality of life of patients with DM1. However, there was an improvement in the points that are directly related to the use of this device, such as satisfaction with the time for checking blood glucose and with their treatment, and episodes of pain related to the treatment of diabetes and feeling restricted by their diet became less frequent