Palavras-chave
Controle glicêmico
Hemoglobina glicada
Perfil clínico-epidemiológico
Fatores associados
Resumo
Introdução: O diabetes mellitus afeta 422 milhões de adultos no mundo. O controle glicêmico adequado previne complicações, mas muitos pacientes não alcançam as metas terapêuticas. Objetivo: Sintetizar as evidências sobre o perfil clínico-epidemiológico e os fatores associados ao controle glicêmico em pacientes com diabetes mellitus. Material e Métodos: Revisão integrativa da literatura conduzida conforme o referencial metodológico de Whittemore e Knafl, com fluxo de seleção adaptado das recomendações PRISMA., com buscas nas bases Semantic Scholar, PubMed, OpenAlex e arXiv, realizadas em outubro e novembro de 2024, abrangendo publicações de 2005 a 2024. Incluíram-se estudos observacionais com adultos (≥18 anos) com diabetes tipo 1 ou 2, que avaliassem hemoglobina glicada ou glicemia de jejum e fatores associados. Excluíram-se diabetes gestacional, pré-diabetes e populações pediátricas. O risco de viés foi avaliado. Resultados e Discussão: Foram incluídos 24 estudos (amostras de 60 a 34.737 participantes). A hemoglobina glicada média basal variou de 8,5% a 9,8%. Apenas 17% dos jovens e 21% dos adultos com diabetes tipo 1 atingiram as metas da American Diabetes Association. Fatores associados a pior controle glicêmico: sexo feminino, idade superior a 50 anos, maior duração do diabetes, complicações microvasculares, baixa escolaridade e baixa adesão medicamentosa. Fatores associados à melhor controle: atividade física, dieta saudável, adesão medicamentosa, ativação do paciente e uso de monitorização contínua da glicose. Conclusão: O controle glicêmico permanece subótimo globalmente. Múltiplos fatores modificáveis e não modificáveis influenciam os desfechos. As abordagens clínicas devem integrar modificação do estilo de vida, suporte à adesão, tecnologia e determinantes sociais da saúde.
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Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Copyright (c) 2026 João Victor Pavão de Castro, Isana Maria de Souza Feitosa Lima, João Marcelo Sousa e Sousa Costa, Fernando Pinheiro Costa Junior, José Ibrahim Magalhães Assub, Ezequias Rodrigues Pestana (Autor)