Ações de manejo do diabetes mellitus tipo 2 e comportamentos em saúde de usuários da atenção primária no interior do Amazonas

Abstract

The present study is about an aggregate of two articles, whose objectives were to evaluate the participation in the management actions of type 2 diabetes mellitus (DM2) and its relation with behavioral factors and to describe the level of physical activity (PAL) and its associated factors, in DM2 users assisted by Primary Health Care (PHC) in the interior municipalities of Amazonas, Brazil. These are descriptive cross-sectional studies, with data collected between 2020 and 2023, from users attended at basic health units in municipalities in the interior of Amazonas. Specific questionnaires were used to assess all variables and the International Physical Activity Questionnaire (IPAQ) was used for PAL. The association between the variables was evaluated through bivariate analysis, with chi-square and Fisher's exact tests, and multivariate analysis with logistic regression models, for all analyzes a significance of 5% was considered. The sample consisted of 965 participants. In article 1, participation in actions was low (27.35%) and showed no significant association with PAL (OR: 1.60; 95% CI: 0.99-2.59; p= 0.052) and food consumption ( OR: 0.61; 95% CI: 0.30-1.22; p= 0.16), but was negatively associated with medication adherence (OR: 0.51; 95% CI: 0.36-0, 71; p<0.001), and positively to receiving guidance for the practice of PA (OR: 1.49; 95% CI: 1.10-2.0; p= 0.009) and regular eating (OR: 1.55 ;95%CI: 1.12-2.15;p=0.008). In article 2, most were classified as non-active (67.7%) and did not meet the recommendations (80.5%). Having schooling >8 years (OR: 1.80; 95% CI: 1.31-2.48; p< 0.001), BMI ≥ 30 kg/m² (OR: 1.50; 95% CI: 1.04- 2.17; p= 0.029), taking medication for DM2 (OR: 1.71; 95% CI: 1.15-2.54; p= 0.007), receiving guidance on PA (OR: 1 PAL active, while worse health perception was negatively associated (OR: 0.64; 95% CI: 0.43-0.95; p= 0.027). The results indicate that participation in interventions for DM 2 in PHC in the interior of Amazonas is not related to ideal PA and eating behaviors. The inverse association between participation and medication adherence requires further studies. This underscores the need for effective PHC strategies to promote PA in this population.