Insegurança Alimentar e Controle Glicêmico no Diabetes Mellitus Tipo 2: Uma Revisão Integrativa Sobre os Determinantes Sociais da Saúde.
DOI:
https://doi.org/10.36557/2674-8169.2026v8n8p458-471Keywords:
Type 2 Diabetes Mellitus, food insecurity, social determinant of health, Glycated HemoglobinAbstract
Introduction: Metabolic homeostasis in Type 2 Diabetes Mellitus (T2DM) is strongly influenced by social determinants of health. Food Insecurity (FI) emerges as one of the main factors hindering adequate glycemic control. Objective: To analyze the literature on the multifactorial impact of food insecurity on glycated hemoglobin (HbA1c) control in patients with T2DM, evaluating nutritional, psychosocial, and behavioral pathways. Methods: An integrative literature review was conducted using PubMed, Scopus, Web of Science, and SciELO databases, applying the descriptors "Food insecurity", "Type 2 diabetes", "Glycemic control", and "Social determinants of health". Articles published between 2010 and 2026 were included. Results: The synthesis of the included studies indicates that FI worsens glycemic control through three main pathways: (1) nutritional, characterized by replacing fresh foods with low-cost ultra-processed products; (2) psychosocial, through increased allostatic load and diabetes distress; and (3) behavioral, manifested by medication rationing (treat-or-eat dilemma). Epidemiological data show that patients experiencing FI have a substantially higher risk of uncontrolled HbA1c and exacerbated comorbidities. Conclusion: Food insecurity acts as a determinant in type 2 Diabetes Mellitus destabilization. It is essential to include social screening and strengthen public policies and interventions, such as medically tailored meals, in the clinical management guidelines for the disease.
Keywords: Type 2 Diabetes Mellitus; Food Insecurity; Social Determinants of Health; Glycated Hemoglobin.
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Copyright (c) 2026 Isla Kelly Alves de Andrade, Aryane Nery Pereira , Belchior Junio Resende Marins, Fernando Daniel Pereira Barbosa, Fernando José Ferro Filho, Gabriel Sousa Franco, Júlia Rocha Guimarães Umbelino Di Louza , Maria Rita Moraes Leão, Nathália de Souza Lopes, Renata Souza Martins, Naysa Gabrielly Alves de Andrade
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors are copyright holders under a CCBY 4.0 license.
