Association between Self-Care Behaviors and Inadequate Glycemic Control in ELSA-Brasil Participants with Type 2 Diabetes

Abstract

Background: Type 2 diabetes is a prevalent chronic condition, often associated with metabolic and cardiovascular complications. Objective: This study aimed to evaluate the association between self-care behaviors, such as consumption of ultra-processed foods, vegetables, greens and fruits, physical activity, adherence to pharmacological treatment and smoking, and inadequate glycemic control in ELSA-Brasil participants with type 2 diabetes. Methods: This is a cross-sectional study with 2,567 individuals, in which the associations between the variables of interest were analyzed by multiple logistic regression (p<0.05). Results: Adherence to pharmacological treatment was the only behavior consistently associated with inadequate glycemic control. Participants with low adherence were more than twice as likely to have inadequate levels of glycated hemoglobin (OR: 2.09; 95%CI 1.14–4.10). Consumption of ultra-processed foods and insufficient intake of leafy vegetables showed initial associations that did not remain significant after adjustments, suggesting the influence of additional factors, such as socioeconomic conditions. Conclusion: These results reinforce the need for interventions that combine health education, self-care support and public policies aimed at equality of treatment access, contributing to glycemic control and the reduction of complications associated with type 2 diabetes.