Fatores Que Influenciam na Autogestão do Diabetes Mellitus e da Insulinoterapia: Revisão Integrativa da Literatura
DOI:
https://doi.org/10.36489/saudecoletiva.2025v15i95p15518-15551Palabras clave:
Autocuidado, Automanejo, Diabetes MellitusResumen
OBJETIVO: Comprender os factores que influyen en la autogestão de la diabetes mellitus y la insulinoterapia. MÉTODO: Trata-se de una revisión integrativa de la literatura, utilizando una estrategia PICo. A pesquisa embasou-se na questão: “¿Quais são os fatores que influenciam a autogestão eficaz do diabetes e da insulinoterapia em pessoas com diabetes?”. Os descritores e palavras-chave foram extraídos dos Descritores em Ciências da Saúde. El levantamiento realizado a través del Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). RESULTADOS: Los factores que más influyen en la autogestión de la diabetes en los foros socioeconómicos, clínicos e interpesados. Cuando la insulinoterapia, los factores que también influyen en la carga cognitiva en la gerencia de la condición, el poco conocimiento sobre el uso y la técnica de aplicación de la insulina, y la dificultad para modificar el comportamiento. CONCLUSÃO: Evidencia-se a necessidade em subsidiar recursos que contribuam com a autogestão.
Citas
International Diabetes Federation. IDF. Diabetes Atlas. [Internet]. 2021;10. Disponível em: https://www.diabetesatlas.org
Pan American Health Organization. PAHO. Country Snapshot Of Diabetes Prevention And Control In The Americas. [Internet]. 2021. Disponível em: https://iris.paho.org/handle/10665.2/55326
Ministério da Saúde (BR). Secretaria de Vigilância em Saúde. Departamento de Análise em Saúde e Vigilância de Doenças Não Transmissíveis. Vigitel Brasil 2021. Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico: estimativas sobre frequência e distribuição sociodemográfica de fatores de risco e proteção para doenças crônicas nas capitais dos 26 estados brasileiros e no Distrito Federal em 2021. 1ª ed. Brasília: Ministério da Saúde; 2021. Disponível em: https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/svsa/vigitel/vigitel-brasil-2021-estimativas-sobre-frequencia-e-distribuicao-sociodemografica-de-fatores-de-risco-e-protecao-para-doencas-cronicas/view
Muzy J, Campos MR, Emmerick I, Silva RS, Schramm JMA. Prevalência de diabetes mellitus e suas complicações e caracterização das lacunas na atenção à saúde a partir da triangulação de pesquisas. Cadernos de Saúde Pública. [Internet]. 2021;37(5):e00076120. doi: https://doi.org/10.1590/0102-311X00076120
Herman WH. The Global Burden of Diabetes: An Overview. Dagogo-Jack, S. (eds) Diabetes Mellitus in developing countries and underserved communities. Springer, Cham. [Internet]. 2017;1-5. doi: https://doi.org/10.1007/978-3-319-41559-8_1
Harding JL, Pavkov ME, Magliano DJ, Shaw EJ, Gregg EW. Global trends in diabetes complications: a review of current evidence. Diabetologia. [Internet]. 2019;62(1):3-16. doi: https://doi.org/10.1007/s00125-018-4711-2
Uddin F, Ali B, Junaid N. Prevalence of diabetic complications in newly diagnosed type 2 diabetes patients in Pakistan: findings from national registry. J Ayub Med Coll Abbottabad. [Internet]. 2018;30:652-S658. Disponível em: https://jamc.ayubmed.edu.pk/jamc/index.php/jamc/article/view/5248/2621
Lamptey R, Robben MP, Amoakoh-Coleman M, Boateng D, Grobbee DE, Davies MJ, Klipstein-Grobusch K. Structured diabetes self-management education and glycaemic control in low- and middle-income countries: A systematic review. Diabet Med. [Internet]. 2022;39(8):e14812. doi: https://doi.org/10.1111/dme.14812
Lin CE, Wood JJ. Intervenções de autogestão. In: Enciclopédia de transtornos do espectro autista. Volkmar F.R. Nova York: Springer, 2735–2743; 2013
Powers MA, Bardsley AK, Cypress M, Funnell MM, Harms D, Hess-Fischl A, et al. Diabetes Self-management Education and Support in Adults With Type 2 Diabetes: A Consensus Report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. Diabetes Care. [Internet]. 2020;43(7):1636-1649. doi: https://doi.org/10.2337/dci20-0023
Valli C, Suñol R, Orrego C, Guzmán EN, Strammiello V, Adrian N, et al. The development of a core outcomes set for self-management interventions for patients living with obesity. Clin. Obes. [Internet]. 2021;12(1):e12489, 2021. doi: https://doi.org/10.1111/cob.12489
Kolb L. An Effective Model of Diabetes Care and Education: The ADCES7 Self-Care BehaviorsTM. The Science of Diabetes Self-Management and Care. [Internet]. 2021;47(1):30-53. doi: https://doi.org/10.1177/0145721720978154
Bahia L, Almeida-Pititto B. Tratamento do DM2 no SUS. Diretriz Oficial da Sociedade Brasileira de Diabetes. [Internet]; 2024: doi: https://doi.org/10.29327/5412848.2024-3
Silva Júnior WS, Gabbay MAL, Lamounier RN. Insulinoterapia no diabetes mellitus tipo 1 (DM1). Diretriz Oficial da Sociedade Brasileira de Diabetes. [Internet]. 2023. doi: https://doi.org/10.29327/557753.2022-5
Chiang JL, et al. Type 1 Diabetes in Children and Adolescents: A Position Statement by the American Diabetes Association. Diabetes Care. [Internet]. 2018;41(9):2026-2044. doi: https://doi.org/10.2337/dci18-0023
Mathiesen AS, Zoffmann V, Lindschou J, Jakobsen AC, Gluud C, Due-Christensen M, et al. Self-determination theory interventions versus usual care in people with diabetes: a systematic review with meta-analysis and trial sequential analysis. Syst Rev. [Internet]. 2023;12(158):1-22. doi: https://doi.org/10.1186/s13643-023-02308-z
Langerman C, Forbes A, Robert G. A qualitative study of the experiences of insulin use by older people with type 2 diabetes mellitus. BMC Prim Care. [Internet]. 2024;25(180):1-12. doi: https://doi.org/10.1186/s12875-024-02318-3
Whittemore R, Knafl K. The integrative review: updated methodology. J Adv Enfermeiros. [Internet]. 2005;52(5):546-553. doi: https://doi.org/10.1111/j.1365-2648.2005.03621.x
Lockwood C, Porrit K, Munn Z, Rittenmeyer L, Salmond S, Bjerrum M, et al. Chapter 2: Systematic reviews of qualitative evidence. In: Aromataris E, Munn Z, editors. JBI, [Internet]. 2017. doi: https://doi.org/10.46658 /JBIMES-20-03
Centre for Evidence Based Medicine (CEBM). Oxford Centre for Evidence-Based Medicine: Levels of Evidence (March 2009). Oxford: University of Oxford [Internet]. 2009. Disponível em: https://www.cebm.ox.ac.uk/resources/levels-of-evidence/oxford-centre-for-evidence-based-medicine-levels-of-evidence-march-2009
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal For Quality In Health Care. [Internet]. 2007;19(6):349-357. doi: http://dx.doi.org/10.1093/intqhc/mzm042
O’brien C, Rooyen DV, Ricks E. Self-management of persons living with diabetes mellitus type 2: experiences of diabetes nurse educators. Health Sa Gesondheid. [Internet]. 2020; 25:1-11. doi: http://dx.doi.org/10.4102/hsag.v25i0.1381
Sayeed AK, Qayyum A, Jamshed F, Gill U, Usama SM, Asghar K, Tahir A. Impact of Diabetes-related Self-management on Glycemic Control in Type II Diabetes Mellitus. Cureus [Internet]. 2020;12(4):e7845. doi: https://doi.org/10.7759/cureus.7845
Bezo BH, Huang Y, Lin C. Factors influencing self‐management behaviours among patients with type 2 diabetes mellitus in the Solomon Islands. Journal Of Clinical Nursing. [Internet]; 2020;29:852-862. doi: http://dx.doi.org/10.1111/jocn.15139
Kumar L, Mohammadnezhad M. Perceptions of patients on factors affecting diabetes self-management among type 2 diabetes mellitus (T2DM) patients in Fiji: a qualitative study. Heliyon. [Internet]. 2022;8(6):e09728. doi: http://dx.doi.org/10.1016/j.heliyon.2022.e09728
Li S, Li Y, Zhang L, Bi Y, Zou Y, Liu L, et al. Impact of fear of hypoglycaemia on self-management in patients with type 2 diabetes mellitus: structural equation modelling. Acta Diabetol. [Internet]. 2022;59:641-650. doi: https://doi-org.ez17.periodicos.capes.gov.br/10.1007/s00592-021-01839-y
Kumar L, Mohammadnezhad M. Health Care Workers' Perceptions on Factors Affecting Diabetes Self-Management Among Type 2 Diabetes Mellitus Patients in Fiji: a qualitative study. Frontiers In Public Health. [Internet]; 2022;10:779266. doi: http://dx.doi.org/10.3389/fpubh.2022.779266
Korsah KA, Agyeman‐Yeboah J. Narratives of type 2 diabetes mellitus patients regarding the influence of social issues on diabetes self‐management: implications for patient care. Nursing Open. [Internet]. 2023;10(8):5741-5748. doi: http://dx.doi.org/10.1002/nop2.1825
Jiang X, Jiang H, Li M. The Role of Self-Efficacy Enhancement in Improving Self-Management Behavior for Type 2 Diabetes Mellitus Patients. Diabetes, Metabolic Syndrome And Obesity. [Internet]. 2024;17:3131-3138. doi: http://dx.doi.org/10.2147/dmso.s460864
Pamungkas RA, Chamroonsawasdi K, Vatanasomboon P, Charupoonphol P. Barriers to Effective Diabetes Mellitus Self-Management (DMSM) Practice for Glycemic Uncontrolled Type 2 Diabetes Mellitus (T2DM): a socio cultural context of indonesian communities in west sulawesi. Eur J Investig Saúde Psicólogo Educação. [Internet]. 2019;10(1):250-261. doi: http://dx.doi.org/10.3390/ejihpe10010020
Fu C, Lee L, Huang L, Tsay S, Chen C. Psychological insulin resistance and its impact on self‐management in type II diabetes mellitus patients treated with insulin therapy. Int J Nurs Pract. [Internet]. 2023;30(2):e13190. doi: http://dx.doi.org/10.1111/ijn.13190
Al-Qahtani AM. Frequency and factors associated with inadequate self-care behaviors in patients with type 2 diabetes mellitus in Najran, Saudi Arabia. Saudi Med J. [Internet]. 2020;41(9):955-964. doi: https://doi.org/10.15537/smj.2020.9.25339
Alshahri, BK, Bamashmoos M, Alnaimi MI, Alsayil S, Basaqer S, Al-Hariri MT, et al. Assessment of Self-Management Care and Glycated Hemoglobin Levels Among Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study From the Kingdom of Saudi Arabia. Cureus. [Internet].2020;12(12):e11925. doi: 10.7759/cureus.11925
Despins LA.; Wakefield BJ. Making sense of blood glucose data and self‐management in individuals with type 2 diabetes mellitus: a qualitative study. Journal Of Clinical Nursing, [Internet]. 2020;29:2572-2588. doi: http://dx.doi.org/10.1111/jocn.15280
Wang D, Liu Z, Liu Y, Zhao L, Xu L, He S, et al. Knowledge, attitudes, and practices among patients with diabetes mellitus and hyperuricemia toward disease self-management. Front Public Health. [Internet]. 2024;12:1-16. doi: https://doi.org/10.3389/fpubh.2024.1426259
Fang L, Lezhi L, Rong X, Xia L, Yuting X, Chang K. Social avoidance and distress in adults with type 1 diabetes and their correlation with self-management level and blood sugar control. J Cent South Univ. [Internet]. 2020;45(7):834-839. doi: https://dx.doi.org/10.11817/j.issn.1672-7347.2020.190415
Jiang T, Liu C, Jiang P, Cheng W, Xiaohong S, Yuan J, et al. The Effect of Diabetes Management Shared Care Clinic on Glycated Hemoglobin A1c Compliance and Self-Management Abilities in Patients with Type 2 Diabetes Mellitus. Int J Clin Pract. [Internet]. 2023;2023(1):1-10. doi: https://doi.org/10.1155/2023/2493634
Chen H, Su B. Factors Related to the Continuity of Care and Self-Management of Patients with Type 2 Diabetes Mellitus: a cross-sectional study in taiwan. Healthcare. [Internet];2022;10(10):1-12. doi: http://dx.doi.org/10.3390/healthcare10102088
Bao H. Effects of Messaging Framing on the Self-Management Activities and Self-Efficacies of Patients with Type 2 Diabetes Mellitus. Iran J Public Health. [Internet]; 2023;52(6):1248-1258. doi: https://doi.org/10.18502/ijph.v52i6.12991
Jafar N, Huriyati E, Haryani, Setyawati, A. Enhancing knowledge of Diabetes self-management and quality of life in people with Diabetes Mellitus by using Guru Diabetes Apps-based health coaching. J Public Health Res. [Internet]. 2023;12(3). doi: http://dx.doi.org/10.1177/22799036231186338
Regeer H, Empelen PV, Bilo HJG, Koning EJP, Huisman SD. Change is possible: how increased patient activation is associated with favorable changes in well-being, self-management and health outcomes among people with type 2 diabetes mellitus. Patient Educ Couns. [Internet]. 2022;105(4):821-827. doi: https://doi.org/10.1016/j.pec.2021.07.014
Patra S, Patro BK, Padhy SK, Mantri J. Prevalence of diabetes distress and its relationship with self-management in patients with type 2 diabetes mellitus. Industrial Psychiatry Journal. [Internet]. 2021;30(2):234-239. doi: http://dx.doi.org/10.4103/ipj.ipj_60_19
Suplici SER, Meirelles BHS, Lacerda JT, Silva DMGV. Self-care among people with Diabetes Mellitus and quality of care in Primary Health Care. Rev Bras Enferm. [Internet]. 2021;74(2):1-8. doi: https://doi.org/10.1590/0034-7167-2020-0351
Kassa RN, Hailemariam HA, Habte MH, Gebresilassie AM. Self-care knowledge, attitude and associated factors among outpatients with diabetes mellitus in Arsi Zone, Southeast Ethiopia. PLOS Glob Public Health. [Internet]. 2021;1(1):e0000097. doi: https://doi.org/10.1371/journal.pgph.0000097
Durai V, Samya V, Akila GV, Shriraam V, Jasmine A, Muthuthandavan AR, et al. Self-care practices and factors influencing self-care among type 2 diabetes mellitus patients in a rural health center in South India. J Educ Health Promot. [Internet]. 2021;10(1):1-7. doi: http://dx.doi.org/10.4103/jehp.jehp_269_20
Luciani M, Montali L, Nicolò G, Fabrizi D, Mauro S, Ausili D. Self-care is Renouncement, Routine, and Control: the experience of adults with type 2 diabetes mellitus. Clin Nurs Res. [Internet]. 2020;30(6):892-900. doi: http://dx.doi.org/10.1177/1054773820969540
Mirzazadeh-Qashqaei F, Zarea K, Rashidi H, Haghighizadeh MH. The relationship between self-care, spiritual well-being and coping strategies in patients with type 2 diabetes mellitus. Journal Of Research In Nursing. [Internet]. 2023;28(4):259-269. doi: http://dx.doi.org/10.1177/17449871231172401
Afaya RA, Bam V, Lomotey AY, Afaya A. Clinical factors influencing knowledge and self‐care practice among adults with type 2 diabetes mellitus. Nursing Open. [Internet]. 2022;10(4):2492-2500. doi: http://dx.doi.org/10.1002/nop2.1506
Gupta SK, Lakshmi PVM, Chakrapani V, Rastogi A, Kaur M. Understanding the diabetes self-care behaviour in rural areas: perspective of patients with type 2 diabetes mellitus and healthcare professionals. Plos One. [Internet]. 2024;19(2):e0297132. doi: http://dx.doi.org/10.1371/journal.pone.0297132
Consoli A, Formoso G. Patient perceptions of insulin therapy in diabetes self-management with insulin injection devices. Acta Diabetol. [Internet]. 2023;60(5):705-710. doi: http://dx.doi.org/10.1007/s00592-023-02054-7
Lin J, Li X, Jiang S, Ma X, Yang Y, Zhou Z. Utilizing Technology-Enabled Intervention to Improve Blood Glucose Self-Management Outcome in Type 2 Diabetic Patients Initiated on Insulin Therapy: a retrospective real-world study. Int J Endocrinol. [Internet]. 2020;2020(1):1-8. doi: http://dx.doi.org/10.1155/2020/7249782
Liang W, Lo SHS, Chow KM, Zhong J, Xiaoying N. Perception of self-management and glycaemic control in people with type 2 diabetes receiving insulin injection therapy: A qualitative study. Prim Care Diabetes. [Internet]. 2023;1796):587-594. doi: https://doi.org/10.1016/j.pcd.2023.08.006
Deger TB, Çakmak HSG, Erdogan BB, Deger MO. Effect of Insulin Pen Training Using the Teach-Back Method on Diabetes Self-Management, Quality of Life, and HbA1c Levels in Older Patients with Type 2 Diabetes: a quasi-experimental study. Healthcare. [Internet]. 2024;12(18):1-12. doi: https://doi.org/10.3390/healthcare12181854
Lemos CA, Golçalves AMRF, Vieira EM, Pereira LRL. Demandas de aprendizado da autogestão do diabetes: estudo qualitativo com pessoas que utilizam a insulina. Rev Lat Am Enfermagem. [Internet]. 2024;32:e4167. doi: https://doi.org/10.1590/1518-8345.6963.4168
Santos WP, Sousa MM, Gouveia BLA, Soares MJG, Almeida AM, Oliveira SHS. Factors related to tissue complications resulting from insulin therapy: a cross-sectional study. Rev Esc Enferm USP. [Internet]. 2022;56:1-8. doi: http://dx.doi.org/10.1590/1980-220x-reeusp-2021-0249
Cunha GH, Fontenele MSM, Siqueira LR, Lima MAC, Gomes MEC, Ramalho AKL. Prática insulinoterápica realizada por pessoas com diabetes na Atenção Primária em Saúde. Rev Esc Enferm USP. [Internet]. 2020;54:e03620. doi: http://dx.doi.org/10.1590/s1980-220x2019002903620
Persson M, Leksell J, Ernersson A, Rosenqvist U, Hornsten A. ‘Striving for freedom or remaining with what is well-known’: a focus-group study of self-management among people with type 1 diabetes who have suboptimal glycaemic control despite continuous subcutaneous insulin infusion. Bmj Open., [Internet]. 2022;12:e057836. doi: http://dx.doi.org/10.1136/bmjopen-2021-057836
Reis, P., Arruda, G.O.; Nass, E.M.A.; Ratuchnei, E.S.; Haddas, M.C.F.L.; Marcon, S.S. Autocuidado e percepção do tratamento para o diabetes por pessoas em uso de insulina. Revista de Enfermagem da UFSM. [Internet]. 2020;10(60):1-20. doi: http://dx.doi.org/10.5902/2179769239880
Aje AA, Fakeye TO. Factors associated with disease knowledge and attitude among ambulatory patients with type 2 diabetes – a multicenter study. BMC Endocr Disord. [Internet]. 2024;24(158):1-9. doi: https://doi.org/10.1186/s12902-024-01696-0
Muhammad FY, Iliyasu G, Uloko, AE, Gezawa ID, Christiana EA. Diabetes-related Knowledge, Attitude, and Practice among Outpatients of a Tertiary Hospital in North-western Nigeria. Annals of African Medicine. [Internet]. 2021;20(3):222-227. doi: 10.4103/aam.aam_48_20
Santos VEP, Freire VAL, Chiavone FBT, Bezerril MS, Azevedo IC, Moreno IM. Compreensão sobre autocuidado da diabetes mellitus por pacientes atendidos na Atenção Primária à Saúde. Revista Ciência, Cuidado e Saúde. [Internet]. 2023; 22:e65953. doi: 10.4025/ciencuidsaude.v22i0.65953
Dailah HG. The Influence of Nurse-Led Interventions on Diseases Management in Patients with Diabetes Mellitus: A Narrative Review. Healthcare. [Internet]. 2024;12(3):352. doi: https://doi.org/10.3390/healthcare12030352
Shahabi N, Javdan G, Hosseini Z, Aghamolaei T, Ghanbarnejad A, Behzad A. A health promotion model-based intervention to enhance treatment adherence in patients with type 2 diabetes. BMC Public Health. [Internet]. 2024; 24(1943). doi: https://doi.org/10.1186/s12889-024-19452-3
Brevidelli MM, Oliveira AB de, Rodrigues GVG, Gamba MA, De Domenico EBL. Fatores sociodemográficos, clínicos e psicossociais correlacionados ao autocuidado em diabetes. Revista Cuidarte. [Internet]. 2021;12(2). doi: https://doi.org/10.15649/cuidarte.2057
Pereira FO. Aspectos psicológicos de pessoas que padecem de diabetes mellitus. Rev Psi Divers Saúde. [Internet]. 2021;10(1):9-25. doi: https://doi.org/10.17267/2317-3394rpds.v10i1.2978
Felix H, Rowland B, Long CR, Narcisse M-R, Piel M, Goulden PA et al. Diabetes Self-Care Behaviors Among Marshallese Adults Living in the United States. Journal of Immigrant and Minority Health. [Internet]. 2017; 20:1500-1507. doi: https://doi.org/10.1007/s10903-017-0683-4
Neves J C, Cardoso LSP, Silva AA, Soares RD, Pereira JF dos S, Coutinho ACC, Oliveira LS, Silva MBP da, Rodrigues RL, Varão AC de A. Práticas de autocuidado dos portadores de diabetes mellitus tipo II: contribuições da teoria de Dorothea Orem. REAS. [Internet]. 2021;13(5):e7106. doi: https://doi.org/10.25248/reas.e7106.2021
Lima AF, Moreira ACA, Silva MJ, Monteiro PAA, Teixeira PG. A percepção do idoso com diabetes acerca de sua doença e o cuidado de enfermagem/ The perception of the elderly with diabetes on their disease and the nursing care. Ciênc. cuid. Saúde. [Internet]. 2016;15(3):522 -59. doi: https://doi.org/10.4025/ciencuidsaude.v15i3.30884
Barbosa Júnior J, Couto VCC, Vitor KA, Oliveira MG, Pinheiro PLL, Rossi VEC. Insulinoterapia em domicílio: práticas adotadas por uma população de diabéticos no município de formiga -MG. Revista Conexão e Ciência. [Internet]. 201611(2):59-63. doi: https://doi.org/10.24862/cco.v11i2.452
Frid AH, Kreugel G, Grassi G, Halimi S, Hicks D, Hirsch LJ, et al. New insulin delivery recommendations. Rev Mayo Clinic. [Internet]. 2016; 91(9):1231-1255. Doi: https://doi.org/10.1016/j.mayocp.2016.06.010
Costa AKG, Pereira JVGA, Forte Júnior SS, Costa RRO, Amorim EG. Difficulties presented by patients with diabetes in self-administration of insulin: scoping review. Revista Médica de Minas Gerais. [Internet]. 2023;33:e-332023. doi: https://dx.doi.org/10.5935/2238-3182.2023e33203.
Rodrigues GMB, Pecoli PFG, Malerbi FEK. Psicologia e diabetes no Brasil: um mapeamento de profissionais e suas ações. Psicologia: Ciência e Profissão. [Internet]. 2023;43:e255912. doi:https://doi.org/10.1590/1982-3703003255912.








