AUTOGESTÃO, CONHECIMENTO E MANEJO DE INSULINA POR IDOSOS E CUIDADORES: AVALIAÇÃO NA ATENÇÃO PRIMÁRIA À SAÚDE

Abstract

Introduction: Diabetes mellitus is a metabolic disorder and one of the most prevalent chronic diseases in the general population. It is associated with serious complications and can severely compromise health and quality of life indicators. Elderly people are frequently affected and need to develop specific knowledge and skills for managing the disease, especially in the context of insulin therapy. Objective: To evaluate the knowledge of elderly people and/or caregivers about the self-management of insulin therapy. Method: An observational, cross-sectional, and analytical study was conducted between February and August 2025 in Primary Health Care in the municipality of Coxim, Mato Grosso do Sul. Sixty-one elderly people and 21 informal caregivers participated, selected by convenience sampling, and completed a questionnaire for sociodemographic, clinical, and therapeutic characterization, as well as an instrument on knowledge and use/management of insulin. Knowledge was classified according to level (excellent, good, fair, and poor) and degree of performance (sufficient and insufficient), and the analysis was expressed by descriptive and inferential measures. Pearson's Chi-square test estimated the associations between knowledge level and degree of performance. Results: The elderly people were mostly female 42 (69.8%), with a mean age of 69.45 (6.94) years. Type 2 diabetes was the most frequent condition of the disease, the prevalent time since diagnosis was 10 to 15 years and the treatment time was less than 5 years 21 (34.4%). The following complications were evidenced in the studied sample: retinopathy 45 (73.8%), diabetic foot 19 (31.1%), and amputations 6 (9.8%). In the assessment of knowledge, important limitations and failures were identified in the recognition of the syringe and needle size and graduation (9.9%); disinfection of the vial rubber (33.3%); aspiration of the syringe before introducing the contents into the body (50%); massage at the application site (31.1%); verification of the product's expiration date (27.9%); sequence of aspiration and/or application of insulin (31.1%); storage in a container with and without ice (21.3%). Of the 30 items evaluated, 11 (33.3%) were classified as poor knowledge and only 8 (26.7%) as excellent. A statistically significant difference (p <0.001) was evidenced between performance and level of knowledge identified. Conclusion: The knowledge of elderly people and informal caregivers about self-management of insulin therapy is limited, highlighting important gaps capable of determining the success of treatment and the occurrence of complications. Understanding how these variables relate to the sociodemographic characteristics of the investigated sample is essential for planning effective, safe interventions adapted to the needs of the population and based on evidence.