Self-reported diabetes in older people: comparison of prevalences and control measures

OBJECTIVE The objective of this study was to analyze the prevalence of diabetes in older people and the adopted control measures. METHODS Data regarding older diabetic individuals who participated in the Health Surveys conducted in the Municipality of Sao Paulo, SP, ISA-Capital, in 2003 and 2008, which were cross-sectional studies, were analyzed. Prevalences and confidence intervals were compared between 2003 and 2008, according to sociodemographic variables. The combination of the databases was performed when the confidence intervals overlapped. The Chi-square (level of significance of 5%) and the Pearson’s Chi-square (Rao-Scott) tests were performed. The variables without overlap between the confidence intervals were not tested. RESULTS The age of the older adults was 60-69 years. The majority were women, Caucasian, with an income of between > 0.5 and 2.5 times the minimum salary and low levels of schooling. The prevalence of diabetes was 17.6% (95%CI 14.9;20.6) in 2003 and 20.1% (95%CI 17.3;23.1) in 2008, which indicates a growth over this period (p at the limit of significance). The most prevalent measure adopted by the older adults to control diabetes was hypoglycemic agents, followed by diet. Physical activity was not frequent, despite the significant differences observed between 2003 and 2008 results. The use of public health services to control diabetes was significantly higher in older individuals with lower income and lower levels of education. CONCLUSIONS Diabetes is a complex and challenging disease for patients and the health systems. Measures that encourage health promotion practices are necessary because they presented a smaller proportion than the use of hypoglycemic agents. Public health policies should be implemented, and aimed mainly at older individuals with low income and schooling levels. These changes are essential to improve the health condition of older diabetic patients

Interações medicamentosas potenciais entre idosos em uso dos anti-hipertensivos da Relação Nacional de Medicamentos Essenciais do Ministério da Saúde do Brasil

O objetivo deste estudo foi estimar a prevalência de interações medicamentosas potenciais entre anti-hipertensivos e outros fármacos. Foi realizado um inquérito domiciliar com pessoas de 60 anos ou mais de idade, residentes no Rio de Janeiro, Brasil. Foram identificadas as interações medicamentosas potenciais entre os anti- hipertensivos com evidência estabelecida, provável ou suspeita e com gravidade moderada ou elevada. Foram entrevistados 577 idosos (média de idade = 72 anos), 45,2% dos quais em uso de anti-hipertensivos, sendo 31,0% deles sujeitos a interações medicamentosas potenciais. A maioria das interações foi moderadamente grave. Comparados aos demais, os sujeitos às interações medicamentosas potenciais têm chance acima de 4 vezes de usar 5 ou mais medicamentos e acima de duas vezes de ter sido hospitalizado no ano anterior. Entre os pares de interações mais frequentes, 75% produzem redução do efeito hipotensivo (65/87), o que pode resultar em baixa efetividade no controle da pressão arterial, prescrição de mais medicamentos e risco de outros efeitos adversos e de interações