Caminhos percorridos ate a amputação por pessoas com diabetes mellitus em um serviço público de referência

Abstract

Initial Considerations: Diabetes Mellitus is a chronic disease that affects approximately 7% of the world's population, characterized by a metabolic syndrome that compromises blood glucose levels. Complications resulting from changes in blood glucose levels include neuropathy, nephropathy and infectious diseases. It is estimated that one third of people with diabetes will develop ulcers; half of these will face infections, and approximately 17% may require lower limb amputations, which can range from the forefoot to the thigh. Objectives: This study aimed to understand the paths taken by people with Diabetes Mellitus to amputation. Method: The research adopted a descriptive and qualitative approach, conducted in a vascular surgery clinic, with approval from the research ethics committee under opinion 7,257,995. Diabetic patients who had undergone amputations participated in the study, using a semistructured form to investigate therapeutic pathways. People over 18 years of age diagnosed with diabetes were included, excluding those with cognitive and auditory deficits. The interviews were recorded, transcribed in full and analyzed according to the content analysis method proposed by Bardin, grouping responses by semantic similarity into categories. Results: The study involved 18 amputee participants admitted to a referral hospital. Of the interviewees, 61% were women, aged between 50 and 70 years (57%) and 50% were widows. The analysis of the narratives allowed categorization into three main themes: Understanding and discovering diabetes, Paths taken by the person with diabetes until amputation and the cause of the injuries, and Diabetes from the patient's point of view. And it can be seen through the analysis that the often late diagnosis, without adequate follow-up, can lead patients with DM to amputation.Final Considerations: The study highlighted the importance of understanding the therapeutic pathway of patients with Diabetes Mellitus until amputation, revealing significant gaps in early diagnosis and effective management of the disease. Improvements in the integration of health services, together with the promotion of educational campaigns, are vital to prevent serious complications. Involving patients in the formulation of health policies that meet their needs can provide better outcomes and increase quality of life. More inclusive and patient-centered approaches are essential to overcome these challenges and significantly improve Diabetes Mellitus care. Keywords: Persons with Amputation. Surgical Amputation. Diabetes Mellitus. Diabetes Complications. Diabetic Foot