THE INFLUENCE OF CULTURE ON TREATMENT ADHERENCE IN DIABETES MELLITUS

Abstract

introduction: Diabetes Mellitus is a multifactorial syndrome resulting from either insufficient insulin production or ineffective insulin utilization. When uncontrolled, it can lead to serious chronic complications, compromising quality of life and increasing medical and pharmacological treatment costs. In Brazil, approximately 12.5 million people are affected. In this context, Primary Health Care plays a crucial role in disease management by combining pharmacological and non-pharmacological interventions. However, insufficient adherence to lifestyle changes, such as diet and exercise, remains a challenge. Methodology: This was a descriptive, bibliographic study of the Integrative Literature Review (ILR) type, which aimed to answer the following question: which cultural factors hinder adherence to diabetes mellitus treatment? The databases consulted were the Latin American and Caribbean Health Sciences Literature (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE), and Nursing Database (BDENF). The search was conducted using the Health Sciences Descriptors (DeCS): Treatment Adherence AND Diabetes Mellitus AND Treatment OR Therapeutic Measures AND Nursing Care AND Primary Health Care. The research was conducted between August and September 2025, applying filters to include only full-text, open-access articles published in Portuguese, English, or Spanish from 2021 to 2025. Studies that did not meet the study objectives, as well as theses, monographs, dissertations, and literature reviews, were excluded. After filtering, article titles and abstracts were read, and those aligned with the topic were selected for full-text reading. Subsequently, the articles that composed the study results were chosen. Results and discussion: The results were organized in a table in Microsoft Word, containing the main information from each publication. The data were then discussed in light of scientific literature, fostering dialogue among the selected authors and contributing to understanding the cultural factors that interfere with treatment adherence in diabetes mellitus. Diabetes mellitus is a chronic disease that requires continuous care and has high prevalence, particularly among the elderly and women. Its management is complex and strongly influenced by cultural factors, such as popular beliefs, traditional dietary habits, low educational level, and lack of family support. These elements hinder the understanding of medical guidance and adherence to treatment, compromising glycemic control and increasing the risk of complications, such as diabetic foot. Primary Health Care, through the Family Health Strategy, plays an essential role in promoting health education and developing care strategies that respect patients’ cultural particularities. Conclusion: Therefore, cultural factors must be recognized as determinants of adherence to diabetes mellitus treatment. The integration of biomedical and sociocultural knowledge is essential for developing more effective, humanized, and patient-centered care practices.