Abstract
Objective: To apply an intensive and multidisciplinary education protocol in order to decrease, improve, delay or cancel the beginning of neuropathy and the manifestation of lesions in diabetic patients. Methodology: This is a cross-sectional descriptive study carried out at the Diabetes Mellitus Outpatient Clinic and Ward of Santa Marcelina Hospital in Porto Velho. This research was based on cases of patients with Diabetes and Diabetics with Leprosy. The criteria used to include the patients were: being treated with insulin therapy, not to be amputated, being on high medication of the leprosy at the moment of the evaluation and to present nutritional risk classification by the screening. The population was divided into two groups of fifteen patients: eight diabetic patients, four male and four female. Seven diabetics associated with leprosy were 4 males and 3 females. The monofilament test (Semmes-Weinstein 10 g) was used as the classification basis. Results and Discussion: Group A, called the intensive care group, began diabetes education work with medical, nutritional and rehabilitation guidelines by a multidisciplinary team for an average period of 15 days in the ward and after discharged with biweekly monitoring. Group B, called conventional care, received the same guidelines in outpatient care and the monitoring followed the quarterly protocol. Both groups were evaluated and reassessed for a period of 180 days in the outpatient clinic. Group A consisted of 8 (100%) patients, 4 (50%) diabetics and 4 (50%) diabetics and leprosy patients. Conclusion: Intensive education in diabetes showed an improvement in the sensitivity, healing and nutritional status of the patients, leading to an improvement in quality of life and disability level, reducing or delaying the beginning of neurological complications. The protocol intensive method demonstrated a 100% improvement in patients in group A.
Highlights
The health care service in hospitalized patients of Santa Marcelina Hospital treats patients with wounds of different etiologies (Leprosy, cutaneous leishmaniasis, diabetes mellitus, arterial hypertension, peripheral venous insufficiency, pressure ulcer) [1]
This research was based on cases of patients with Diabetes and Diabetics with Leprosy
The population was divided into two groups of fifteen patients: eight diabetic patients, four male and four female
Summary
The health care service in hospitalized patients of Santa Marcelina Hospital treats patients with wounds of different etiologies (Leprosy, cutaneous leishmaniasis, diabetes mellitus, arterial hypertension, peripheral venous insufficiency, pressure ulcer) [1]. For a perfect treatment this service has standardized according to scientific researches and tests, behaviors and products, always finishing it in order to prevent infection, to reduce the healing time and to increase the patient’s quality of life [8]. This protocol is subject to regular evaluations and necessary reformulations, according to the technological, scientific and political advances in health. In addition to local factors, there are systemic factors that can affect the restore process of skin and tissues such as age, immobility, nutritional status, associated diseases and the use of continuous drugs, mainly immunosuppressive drugs. Evaluation of the evolution of the wound is necessary in order to continue or modify the previously established procedures [10]
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