Tecnologias em saúde para monitoramento glicêmico em adultos com diabetes mellitus tipo 2 : uma revisão integrativa da literatura

Abstract

Diabetes Mellitus, a chronic metabolic disease that has involved around 425 million people worldwide and whose metabolic failure leads to worsening of the condition, systemic complications or even death (IDF in 2017). Such situations can be minimized or prevented through effective monitoring. This study aimed to carry out an integrative review in order to identify the health technologies for conventional monitoring of capillary blood glucose and continuous monitoring of interstitial glucose most used by adults with type 2 diabetes mellitus - DM 2; Characterize the sociodemographic profile; Identify the clinical manifestations or systemic complications presented by adults with DM 2 using conventional capillary blood glucose monitoring and continuous interstitial glucose monitoring, as well as comparing metabolic control through glycated hemoglobin. This study is justified in view of the growing numbers of people with DM 2 and due to the scarcity of studies on health technologies aimed at people with DM 2. Searches were carried out according to the acronym PICOT. Population of interest: Adults with DM 2; Intervention: Conventional monitoring of capillary blood glucose; Control/Comparison: Continuous interstitial glucose monitoring; O/Outcome: Reduction of glycemic levels and Study type: Randomized Clinical Trials. The databases used were Scielo, Medline and Lilacs via BVS, with articles published in English, Portuguese and Spanish and published in the last five years. 207 studies were reviewed and only 05 were included in this review. The writing of this dissertation was adapted from the Main Items for Reporting Systematic Reviews and Meta-analysis - PRISMA. The population consisted mostly of male, white, normotensive patients and smokers who presented clinical manifestations such as neuropathy, retinopathy and nephropathies, they presented hypoglycemia and hyperglycemia during the studies, but not related to the devices. According to data from these studies, it is proven that the measurement of glucose monitoring technologies, such as Continuous Monitoring of Glucose-CGM, Self-Monitoring of Glucose-SMBG and Instant Monitoring of Glucose-FGM and monitoring of capillary blood glucose are effective, but the effectiveness of these they are related to correct use, associated with instructions and monitoring by the health team. It is evident that interstitial glucose monitoring is more effective than capillary glucose, as these interstitial glucose monitoring devices are able to investigate glycemic variability and associate data with therapy through an insulin pump and sending medication values to smartphone and cloud and thus help the health team in decision making. Therefore, these variations will be identified as early as possible and will contribute to guide medical therapy, as well as contribute to better living conditions for people with DM 2. This study can guide managers, sensitizing them, that adherence to CGM devices, SMBG and FGM for monitoring adults with type 2 DM in health services can contribute to reducing public expenses, hospitalizations and complications, as these technologies can identify glycemic variations.