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Articles by C. A. Negrato
Total Records ( 2 ) for C. A. Negrato
  C. A. Negrato , R. A. Cobas and M. B. Gomes
  Aims  To examine the temporal trends in the frequency of diabetic ketoacidosis at onset compared to other modalities of diagnosis of Type 1 diabetes in Brazil.

Methods  This was a retrospective, cross-sectional and multicenter study conducted between December 2008 and December 2010 in 28 public clinics at secondary and tertiary levels of care, located in 20 cities in four geographic regions of Brazil. Each clinic provided data extracted from at least 50 outpatients with Type 1 diabetes diagnosed between 1960 and 2010, using standardized chart review forms. Data were obtained from 3591 patients (56.0% females, 57.1% Caucasians). Median values (range) for age, age at diagnosis and duration of diabetes were, respectively, 19 years (1-66 years), 10 years (< 1-44 years) and 7 years (< 1-50 years). Logistic regression was performed with diabetic ketoacidosis (Yes/No) as the dependent variable and other clinical features as independent variables.

Results  Type 1 diabetes diagnosis was made by diabetic ketoacidosis in 1,520 (42.3%), by fasting plasma glucose in 1413 (39.4%), by random blood glucose in 516 (14.4%), by oral glucose tolerance test in 66 (1.8%) and by other methods in 76 (2.1%) cases, respectively. Diagnosis made before the year 2000 had a greater odds to occur by diabetic ketoacidosis (Odds ratio 1.26, 95% confidence intervals (CI) 1.09-1.48). Since then, a decrease has occurred. Economic status, geographic region and age were significantly related to diabetic ketoacidosis at diagnosis.

Conclusions  Although high prevalence of diabetic ketoacidosis at diagnosis of Type 1 diabetes in Brazil is observed, recently, more patients have been diagnosed by other methods.

  M. B. Gomes , L. R. M. Tannus , R. A. Cobas , A. S. M. Matheus , P. Dualib , A. T. Zucatti , C. Cani , A. A. D. Guedes , F. M. Santos , J. Sepulveda , M. Tolentino , M. C. Facanha , A. C. R. A. Faria , S. Lavigne , A. P. Montenegro , M. Rodacki , M. de Fatima Guedes , R. Szundy , M. M. Cordeiro , P. T. S. Santos and C. A. Negrato
 

Aim

The aim of this study was to determine the relationship between the daily frequency of self-monitoring of blood glucose and glycaemic control, demographic and socio-economic status in patients with Type 1 diabetes under routine clinical care in Brazil.

Methods

This was a cross-sectional, multi-centre study conducted between December 2008 and December 2010 in 28 public clinics in 20 Brazilian cities. The data were obtained from 3176 patients, aged 22 ± 11.8 years, of whom 56.3% were female and 57.4% were Caucasian. The mean time since diabetes diagnosis was 11.7 ± 8.1 years.

Results

The prevalence of self-monitoring of blood glucose was 88.5%. There was a significant increase in self-monitoring frequency associated with female gender, lower ages, more intensive diabetes management and higher socio-economic status. A correlation between HbA1c levels and the daily frequency of self-monitoring was observed (rs = -0.13; = 0.001). The mean HbA1c levels were related to the daily frequency of self-monitoring (< 0.001) without additional benefit to patients who performed self-monitoring more than four times daily (9.2, 11.2, 10.2,15.2 and 15% for one, two, three, four, five or more self-monitoring tests daily, respectively; < 0.0001).

Conclusions

The majority of our patients (88.5%) performed three or more self-monitoring tests daily, with more frequent testing reported by females, younger patients, those on intensive insulin regimens and of higher socio-economic status. No additional benefit was found in patients who performed self-monitoring more than four times daily. The diabetes care team must improve patients' education regarding self-monitoring of blood glucose and its benefits.

 
 
 
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