Background/Purpose

Diabetes mellitus is one of the main public health problems worldwide. One important strategy for increasing the effectiveness for controlling diabetes mellitus and preventing complications is self-care supported by healthcare professionals. The aim of the study was to analyze dietary self-care strategies performed by individuals with diabetes mellitus (DM) after hospitalization and their possible influence on hospital readmissions.

Methods

A cross-sectional study was conducted in the public health services qualified to hospitalize individuals with DM in a medium-sized municipality of Brazil. Adults were evaluated 24 months after discharge, assessing self-care strategies (dimensions: diet, physical activity, blood glucose monitoring, foot care, medication, and smoking); and clinical, anthropometric, and biochemical measurements.

Results

A high death rate (33.7%) was verified after 24 months of hospitalization. Almost half (45.9%) of the 37 remaining patients were readmitted to hospital; however, during the 24 month period, only 42.0% received guidance about DM self-care from healthcare professionals. In the evaluation of dietary self-care, only 35.1% of the individuals reported taking care of their diet on 5 or more days a week. Individuals who adhered to self-care guided by health professionals presented twice the prevalence of not being readmitted to hospital (Prevalence ratio = 2.52; 1.27–5.01).

Conclusions

After hospital discharge, individuals with DM presented poor adherence to self-care, especially regarding diet. However, when these individuals adhered to nutritional guidance, there were fewer hospital readmissions. These results reinforce the importance of interdisciplinary educational actions for DM management. However, due to the small sample size because of the high mortality, further studies for this purpose should be conducted.

中文翻译：

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糖尿病患者的饮食自我保健和再入院

背景/目的

糖尿病是全球主要的公共卫生问题之一。提高控制糖尿病和预防并发症的有效性的一项重要策略是由医疗保健专业人员支持的自我保健。该研究的目的是分析糖尿病 (DM) 患者住院后的饮食自我保健策略及其对再入院的可能影响。

方法

一项横断面研究在巴西一个中等城市的有资格住院的 DM 患者的公共卫生服务中进行。成人在出院 24 个月后接受评估，评估自我护理策略（维度：饮食、身体活动、血糖监测、足部护理、药物治疗和吸烟）；以及临床、人体测量和生化测量。

结果

住院 24 个月后证实了高死亡率 (33.7%)。剩余的 37 名患者中几乎有一半 (45.9%) 重新入院；然而，在 24 个月期间，只有 42.0% 的人从医疗保健专业人员那里获得了关于 DM 自我护理的指导。在饮食自我保健的评估中，只有 35.1% 的人报告称每周有 5 天或更多天注意饮食。坚持在卫生专业人员指导下进行自我护理的个人未再次入院的患病率是其两倍（患病率 = 2.52；1.27–5.01）。

结论

出院后，糖尿病患者自我保健的依从性较差，尤其是在饮食方面。然而，当这些人坚持营养指导时，再入院的次数就会减少。这些结果强调了跨学科教育活动对 DM 管理的重要性。然而，由于死亡率高，样本量小，因此应进行进一步的研究。