EQUITY AND NUTRITIONAL THERAPY IN THE MANAGEMENT OF TYPE 2 DIABETES MELLITUS: SOCIAL DETERMINANTS AND THE CHALLENGES OF CARE IN THE BRAZILIAN PUBLIC HEALTH SYSTEM (SUS)

Abstract

Type 2 Diabetes Mellitus (T2DM) is a chronic disease with significant public health impact, associated with high economic and social costs, particularly within the context of the Brazilian Unified Health System (SUS). This study aims to analyze the effects of T2DM on Brazil’s public health system, highlighting the importance of prevention, disease management, and interdisciplinary care in mitigating these impacts. The research was conducted through a narrative literature review, with a qualitative and descriptive approach, considering studies published between 2015 and 2025 in databases such as SciELO, PubMed, LILACS, and Google Scholar. Topics addressed included the epidemiology of the disease, risk factors, clinical complications, healthcare costs, and the role of nutrition professionals in therapeutic management. Findings indicate that T2DM is associated with modifiable factors such as poor diet, physical inactivity, and excess abdominal fat, as well as social determinants including low income and limited education. Complications such as retinopathy, neuropathy, and nephropathy increase morbidity, mortality, and hospitalization costs, placing a considerable burden on the SUS. Scientific evidence suggests that investing in prevention, health education, and lifestyle modifications is more sustainable and effective than treating advanced complications. Nutritionists play a central role in T2DM management by designing individualized meal plans, promoting nutritional education, and integrating multidisciplinary actions that improve patients’ quality of life. Additionally, the inclusion of foods rich in fiber, bioactive compounds, and probiotics may help control glycemia and reduce systemic inflammation. It is concluded that effective management of T2DM requires a continuous and integrated approach, combining prevention, early diagnosis, and patient-centered care, with coordinated action between healthcare professionals and public policies.