Glycemic control of a diabetic patient on peritoneal dialysis in primary health care
Keywords:
diabetes mellitus, type 2, peritoneal dialysis, glycemic control, primary health care, physicians, family.Abstract
Introduction: Diabetes mellitus and chronic kidney disease are public health problems that cause significant morbidity and mortality.
Objective: To report the case of a patient with diabetic nephropathy on peritoneal dialysis, with poor glycemic controls and multiple complications and emergency admissions, who is treated and stabilized, through a continuous and innovative follow-up in the context of the pandemic.
Case report: A 59-year-old patient, male sex, with type 2 diabetes mellitus for 26 years presented with complications and was not following treatment. He presented with stage V chronic kidney disease and peritoneal dialysis, but had variable glycemia. The COVID-19 pandemic caused him to miss his appointments and be referred to primary care, where virtual monitoring was established, his insulin treatment was changed, and his glycemic controls were improved. Hospitalizations for acute complications decreased by 70%. Glycemic stability was achieved with HbA1c less than 8%.
Conclusions: The importance of continuous and longitudinal patient follow-up through virtual media, especially during the COVID-19 pandemic, to improve glycemic controls and reduce acute complications is highlighted, as well as to involve the family physician in the follow-up and control process.
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