AUTOCUIDADO NO DIABETES MELLITUS TIPO 1: DESAFIOS NA APLICAÇÃO DA RAZÃO CARBOIDRATO/INSULINA E DO FATOR DE SENSIBILIDADE EM AMBULATÓRIO INTERDISCIPLINAR

Resumo

Introduction: Type 1 Diabetes Mellitus (T1DM) is a chronic condition that requires intensive insulin therapy and active participation of patients and their caregivers in self -care to achieve adequate glycemic control. The carbohydrate-to-insulin ratio (ICR) and the correction factor (CF) are essential tools for adjusting prandial insulin and correcting glycemic fluctuations; however, their proper use remains challenging in clinical practice. Objective: To describe the experience of an interdisciplinary outpatient clinic in i dentifying barriers related to the use of ICR and CF in children and adolescents with T1DM. Methods: This is an experience report based on observations from routine clinical and educational activities at the Interdisciplinary Diabetes Center of the University of Marília (CENID/UNIMAR), a university-based specialized diabetes clinic. Results: A significant proportion of patients, even after receiving guidance from medical and nutrition teams, were unable to report their total daily insulin dose, demonstrated limitations in carbohydrate counting and insecurity in applying correction factors. Additional barriers included low educational level of caregivers-often parents or grandparents -disease denial, and difficulty understanding the need for glycemic adjustmen ts outside main meals, such as snacks and physical activity. Continuous education, associated with interdisciplinary follow-up, proved essential for reinforcing guidance, along with the use of technological tools such as carbohydrate - counting mobile applications to support daily decision -making. Periodic educational actions enable the family to understand the dynamics of insulin therapy and reduce anxiety during treatment.These limitations reduce patient autonomy, increase insulin dosing errors, and hinder the achievement of individualized glycemic targets, directly impacting time in range, quality of life, and the risk of diabetes-related complications. Conclusion: Although ICR and CF are essential tools in T1DM management, their effectiveness depends on proper understanding, adherence, and continuous use by patients and caregivers. Structured educational strategies, interdisciplinary approaches, and adaptation to patients’ sociocultural context are fundamental to improving self-care and therapeutic outcomes.