Educational intervention for the prevention of kidney damage in diabetic patients
Keywords:
diabetes mellitus, diabetic nephropathies, microalbuminuriaAbstract
Introduction: diabetic nephropathy is an important complication of diabetes mellitus, and because of its repercussion, it is a must to investigate it in the initial stages. Objective: to determine the impact of an educational intervention on the metabolic control of diabetic patients and on the progression of kidney damage. Method: an intervention study was conducted in a medical office from January 2017 to January 2018. The sample consisted in 21 diabetic patients. The variables were: age, sex, type and time of diabetes mellitus, degree of metabolic control, associated vascular risk factors and microalbuminuria. The study was divided into stages. An initial diagnosis was made, and on this basis, an educational intervention strategy was designed and carried out, later the variables were evaluated. Results: female patients and diabetes mellitus type 2 predominated. A 42.9% of patients had more than 10 years of evolution of the disease. Before the intervention, 71.2% of patients had poor metabolic control of their disease. The vascular risk factors that were most frequently associated with a poor metabolic control were hypertension (87.5%), dyslipidemia (31.3%) and ischemic heart disease (25%). Before the intervention, 38% of patients presented positive microalbuminuria. After the intervention, there was improvement in metabolic control and very significant and favorable changes in microalbuminuria values. Conclusions: the educational intervention was effective; it was shown by the favorable changes in the metabolic control and the markers of kidney damage in the patients of the study.Downloads
References
1. Díaz Díaz O, González NO. Manual para el diagnóstico y tratamiento del paciente diabético en el nivel primario de salud [Internet]. La Habana: Editorial Ciencias Médicas; 2016 [citado 12 Ene 2018]. Disponible en: http://www.bvs.sld.cu/libros/manual_diag_ttmo_paciente_diabetico/manual_diag_ttmo_pte_diabetico_completo.pdf
2. International Diabetes Federation. IDF Diabetes Atlas. 8th ed. Brussels, Belgium: International Diabetes Federation; 2017. Disponible en: http://diabetesatlas.org/resources/2017-atlas.html
3. Organización Mundial de la Salud. Informe mundial sobre la diabetes. Ginebra: World Health Organization; 2016. Disponible en: https://apps.who.int/iris/bitstream/handle/10665/254649/9789243565255-spa.pdf;jsessionid=13779BC035BF1BDD57DC41BEEEC3FECA?sequence=1
4. Cuba. Ministerio de Salud Pública. Anuario Estadístico de Salud 2016 [Internet]. La Habana: Ciencias Médicas; 2017 [citado 12 En 2018]. Disponible en: http://files.sld.cu/dne/files/2017/05/Anuario_Estad%C3%ADstico_de_Salud_e_2016_edici%C3%B3n_2017.pdf
5. Granela K, Cardoso Y, Gutiérrez A, Carvajal M. Sex education for children and adolescents with type 1 diabetes in Camagüey province, Cuba. MEDICC Rev [Internet]. 2013 Jul [citado 9 Ene 2018];15(3):34-7. Disponible en: https://www.scielosp.org/article/ssm/content/raw/?resource_ssm_path=/media/assets/medicc/v15n3/a08v15n3.pdf
6. Gorostidi M, Santamaría R, Alcázar R, Fernández Fresnedo G, Galcerán JM, Goicoechea M, et al. Documento de la Sociedad Española de Nefrología sobre las guías KDIGO para la evaluación y el tratamiento de la enfermedad renal crónica. Nefrología (Madr)[Internet]. 2014 May [citado 9 Ene 2018];34(3):302-316. Disponible en: http://www.revistanefrologia.com/es-documento-sociedad-espanola-nefrologia-sobre-las-guias-kdigo-evaluacion-el-articulo-X0211699514054048
7. Macisaac RJ, Ekinci EI, Jerums G. Progressive diabetic nephropathy. How useful is microalbuminuria?: contra'. Kidney Int [Internet]. 2014 Jul [citado 1 Abr 2018];86(1):50-57. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/24717301
8. Departamento de Economía. Hospital Arnaldo Milián Castro. Santa Clara: Villa Clara; 2017.
9. American Diabetes Association. Standard of Medical Care in Diabetes 2012. Diabetes Care [Internet]. 2012 Jan [citado 29 Ene 2018]; 35(supl 1):S64-S71. Disponible en: http://care.diabetesjournals.org/content/35/Supplement_1/S64.extract
10. Jiménez-Corona A, Aguilar-Salinas CA, Rojas-Martínez R, Hernández-Ávila M. Diabetes mellitus tipo 2 y frecuencia de acciones para su prevención y control. Salud Pública Méx [Internet]. 2013 [citado 29 Ene 2018];55(Suppl 2):S137-S143. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0036-36342013000800010&lng=es
11. Díaz Díaz O, Faget Cerero O. Afecciones del páncreas. En: Álvarez Sintes R. Medicina General Integral. Principales afecciones en los contextos familiar y social. La Habana: Editorial Ciencias Médicas; 2014. p.1531-36.
12. Osuna M, Rivera MC, Bocanegra CJ, Lancheros A, Tovar H, Hernández JI, et al. Caracterización de la diabetes mellitus tipo 2 y el control metabólico en el paciente hospitalizado. Acta Med Colomb [Internet]. 2014 Oct-Dec [citado 6 Feb 2018];39(4):344-351. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-24482014000400007&lng=en
13. Valdés Ramos E, Bencosme Rodríguez N. Síndrome metabólico y enfermedad cardiovascular en personas con diabetes mellitus tipo 2. Rev Cubana Endocrinol [Internet]. 2013 May-Ago [citado 22 Ene 2018];24(2):125-135. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561-29532013000200003&lng=es
14. Valdés Ramos E, Campos Arjona MC, Escalona FJ. Frecuencia y factores asociados al tratamiento con insulina en diabéticos tipo 2 de la provincia Granma. Rev Cubana Med [Internet]. 2014 Abr-Jun [citado 22 Ene 2018];53(2):116-126. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75232014000200002&lng=es
15. Valdés Ramos E, Campos Arjona MC. Características clínicas y frecuencia de complicaciones crónicas en personas con diabetes mellitus tipo 2 de diagnóstico reciente. Rev Cubana Med Gen Integr [Internet]. 2013 Abr-Jun [citado 6 Ene de 2018];29(2):121-131. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21252013000200003&lng=es&nrm=iso&tlng=es
16. Sánchez Becerra D, Cuéllar Mata P, Delgadillo Mejía M, Durán Castro E, Deveze Álvarez M. Prevalencia de daño renal en pacientes diabéticos y/o hipertensos mediante prueba tamiz (RAC) en una clínica de Guanajuato. Rev Latinoamer Patol Clín [Internet]. 2012 Ene-Mar [citado 1 Abr 2018];59(1):28-34. Disponible en: http://www.medigraphic.com/pdfs/patol/pt-2012/pt121f.pdf
17. Barbieri M, Rizzo MA, Fava I, Sardu C, Angelico N, Paolisso P, et al. Awaking Blood Pressure Surge and Progression to Microalbuminuria in Type 2 Normotensive Diabetic Patients. Disease Markers [Internet]. 2015 Dic [citado 1 Abr 2018];2015:1-6. Disponible en: https://www.hindawi.com/journals/jdr/2016/5876792/
18. Casanova Moreno Md, Bayarre Vea HD, Navarro Despaigne DA, Sanabria Ramos G, Trasancos Delgado M. Estrategia educativa dirigida a adultos mayores diabéticos tipo 2 y proveedores de salud. Rev Cubana Med Gen Integr [Internet]. 2018 Ene-Mar [citado 19 Jun 2018];34(1):26-36. Disponible en: http://www.revmgi.sld.cu/index.php/mgi/article/view/222
19. Chavan VU, Ramavataram D, Miyani K, Lad H, Nilakhe S. Prevalence of microalbuminuria as a marker of incipient nephropathy in type 2 diabetes patients at smimer hospital, surat. National Journal of Community Medicine [Internet]. 2014 Oct [citado 1 Abr 2018];5(4):468-473. Disponible en: http://njcmindia.org/uploads/5-4_468-473.pdf
20. López Gómez JM, Sacristán Enciso B, Micó M, Arias Meneses F, Sande Medel FD, Alejo S. Cistatina C sérica y microalbuminuria en la detección del daño vascular y renal en estadios precoces, en pacientes de riesgo sin enfermedad renal crónica. Nefrologia [Internet]. 2011 Oct [citado 1 Abr 2018]; 31(5):560-565. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0211-69952011000500007
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