Diabetes mellitus autorreferido na comunidade ribeirinha Itapéua, Coari, Amazonas: perfil epidemiológico, acesso aos serviços de saúde e práticas terapêuticas

Abstract

Introduction: Non-communicable chronic diseases represent one of the main challenges to global public health, accounting for approximately 74% of deaths worldwide. In Brazil, about 16.6 million adults live with Diabetes Mellitus, whose distribution occurs unevenly, with greater impact on socially vulnerable populations. In this context, riverside communities in the Amazon present factors that hinder the prevention, diagnosis, and management of the disease, such as geographic isolation, limited access to health services, low health literacy, and socioeconomic restrictions. Objective: To describe the epidemiological and clinical profile, access to health services, and therapeutic practices related to Diabetes Mellitus in the riverside community of Itapéua, in the municipality of Coari, Amazonas. Methods: This is a descriptive, cross-sectional study with a quantitative approach, conducted between October and November 2024, using probabilistic multistage cluster sampling, involving 76 heads of households from the riverside community of Itapéua, Coari, Amazonas. Data were collected through a structured questionnaire administered in households, including sociodemographic, anthropometric, clinical, behavioral, health service access, and therapeutic variables, and analyzed using descriptive statistics. Results: The prevalence of self-reported DM was 14.5%. The epidemiological profile revealed a predominance of females (72.7% of cases) and an atypical concentration of the disease among young adults aged 18 to 39 years (45.5%). The mean body mass index among diabetic individuals was 30.3 kg/m², characterizing obesity, with a high frequency of cardiometabolic risk according to waist circumference and waist-to-hip ratio. Systemic Arterial Hypertension coexisted in 54.5% of individuals with DM. Among participants without previous diagnosis, 25.3% presented capillary blood glucose levels compatible with prediabetes and 4.0% with established DM, suggesting underdiagnosis related to the disease. Regarding access to health services, the presence of a fixed Primary Health Care Unit in the community eliminated geographic barriers: 100% of participants with DM had used the service in the previous month, and none reported difficulties in receiving care, with travel predominantly on foot and within five minutes. The service was rated as good or very good by 63.7%, although more than 60% classified medication availability as regular or poor. In the therapeutic profile, 81.8% of diabetic individuals reported the use of oral antidiabetic drugs, predominantly metformin (88.9%); 9.1% did not use any type of therapy. Medicinal plants were reported by 27.3% of participants, especially mango tree (Mangifera indica L.) leaf tea, indicated by family members, followed by soursop, guava, jatobá, male papaya tree, pata-de- vaca, and olive tree. Inadequate medication storage conditions, with exposure to light, humidity, and heat, were frequent among users. Conclusion: Diabetes Mellitus constitutes a relevant public health problem in the studied community, with specific epidemiological characteristics and challenges related to the quality of primary health care, highlighting the need for early screening strategies, health education, and strengthening of pharmaceutical assistance in riverside contexts.