Efeito do condicionamento aquático e da acupuntura auricular na qualidade de vida, composição corporal e pressão arterial em pessoas com Diabetes mellitus tipo 2

Abstract

Diabetes Mellitus (DM) is a chronic condition characterized by hyperglycemia that occurs when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. In the clinical environment, several treatments for DM and its secondary complications are described, among them two treatment alternatives are auricular acupuncture and aquatic conditioning. The aim of the present study was to evaluate the effect of auricular acupuncture and aquatic conditioning on the quality of life (QL), body composition and systemic blood pressure of people with DM2. A controlled, blinded and randomized clinical trial was carried out. The population consisted of 72 individuals with DM2, of both genders, clinically stable. These individuals were randomized using the Random.ORG software into three groups: aquatic conditioning group (AGC), auricular acupuncture group (GAA) and control group (CG), with 24 patients each. To assess QoL, the Diabetes Quality of Life Measurement Questionnaire (DQOL-Brazil) was used, which contains the following domains: Impact, Satisfaction, Social/Vocational Concerns and Diabetes-Related Concerns. The sum of all domains, called total QOL, was performed. For body composition, the GLASS PRO model G-TECH bioimpedance device was used. Information related to body mass, body mass index, body fat index, water index and muscle mass were recruited. To measure blood pressure, the Omrom HME 7200 device was used. The aquatic training for the GCA took place for five weeks, with the first week for adaptation of the individual to the aquatic environment and the other four weeks the aquatic aerobic training protocol was performed. The GAA intervention consisted of treatment with auricular acupuncture using disposable needles. The treatment consisted of ten sessions, twice a week. All groups (GCA, GAA and GC) participated in an educational lecture at the end of the study. The evaluations were carried out at the moments: before (pre), final (post) and 15 days after the end of the interventions (follow-up). For statistical analysis, the Statistical Package for Social Science (SPSS) program was used. Data were analyzed by Intent to Treat (ITT). The following tests were performed: Shapiro Wilk (normality) Kruskall-Wallis (age and non-parametric variables), One-Way ANOVA (diagnosis time and parametic variables), Chi-square (categorical variables), ANOVA followed by Sidak's Post Hoc (intergroup differences), Friedman (intragroup differences), Power Analysis or Power Test (calculation of power) and Cohen's f (calculation of effect size). Significance level 5% was adopted. In the intragroup analysis, in relation to the QoL questionnaire, in the satisfaction domain, the three groups showed significant improvement in the pre- and follow-up analyses. The GAA also showed significant improvement for post and follow-up analyses. In the impact domain, in addition to the significant differences in the intragroup analysis, the GCA group proved to be superior to the GAA before and to the GAA and to the CG in the post and follow- up period. In the Social/Vocational Concerns domain, only the GAA showed improvement in the intragroup analysis at the time before x follow up. For the Diabetes Related Concerns domain, none of the therapies produced changes. In total QoL, the three groups had significant outcomes after follow-up. In the analysis between groups, GCA was more effective when compared to auricular acupuncture and control. The interventions performed in this study reduced the Body Fat Index and increased the Water Index at the end of the treatment and continued to interfere with the follow-up. The interventions did not influence body mass, BMI and lean mass. In relation to systolic blood pressure and diastolic blood pressure, only water conditioning, in the intragroup analysis, interfered with a decrease in the values of this variable between pre- and follow-up. The study indicated that aquatic conditioning was superior than auricular acupuncture in improving some aspects of quality of life, however, in terms of body composition, they were similar. Additionally, water conditioning can help control blood pressure in people with DM2.