DIABETES MELLITUS TIPO 2 SOB A PERSPECTIVA BIOPSICOSSOCIAL: INTEGRAÇÃO ENTRE MECANISMOS METABÓLICOS, COMPORTAMENTAIS E PSICOSSOCIAIS

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TYPE 2 DIABETES MELLITUS FROM A BIOPSYCHOSOCIAL PERSPECTIVE: INTEGRATION BETWEEN METABOLIC, BEHAVIORAL, AND PSYCHOSOCIAL MECHANISMS Sara Priscila da Silva Castilho¹; Ana Elisa Landgraf Sormani¹; Gabriella Dionisio Zampieri¹; João Paulo Galleti Pilon². University of Marília, Marília - São Paulo Medical Professor at the University of Marília, Marília - São Paulo ABSTRACT In the context of type 2 diabetes mellitus (DM2), a biopsychosocial approach is fundamental, since factors such as lifestyle, emotional state, and social support significantly influence both the prognosis and pathophysiology of the disease. However, care strategies still predominantly focus on the biological dimension, neglecting psychosocial aspects that can negatively impact clinical outcome s. This fragmented view limits the effectiveness of interventions and compromises treatment. Therefore, it is necessary to analyze this scenario and propose interventions that promote a more comprehensive care model, focusing on improving the quality of life of individuals. The objective is to analyze biopsychosocial factors and their impact on type 2 diabetes mellitus, systematizing recent scientific evidence and highlighting implications for prevention policies and comprehensive care. An integrative revie w was conducted in the PubMed, LILACS, and Oasis databases, using the descriptors "Diabetes Mellitus, Type 2", "Biopsychosocial", and "Health Behavior". Articles published between 2016 and 2026 were included. The selection followed previously defined eligibility criteria, resulting in 11 studies, whose data were analyzed narratively. A progressive increase in scientific production focused on the quality of life of patients with type 2 diabetes mellitus (DM2) and its relationship with the prognosis of the disease is observed. An observational study conducted with 228 patients demonstrated that approximately 67% of the participants presented depressive symptoms. The analysis of related studies suggests that these findings reflect a consistent association, since living with DM2 is frequently related to emotional suffering and diabetes distress. Evidence indicates that patients who develop depression have poorer glycemic control, with an average increase of 0.92 in glycated hemoglobin (HbA1c) (95% CI: 0.00-1.84), in addition to greater glycemic variability over time. Additionally, the practice of physical activities, especially in outdoor environments, demonstrates positive impacts on emotional well -being. A 24 -week intervention demonstrated a greater reduction in stress in the group that performed outdoor activities (3.7 vs. 2.8; p = 0.007). In addition, significant improvements were observed in HbA1c and indicators of psychological stress. On the other hand, socioeconomic factors, such as income and social class, constitute significant barriers to the adequate management of the disease. Studies conducted in Brazil indicate a higher prevalence of type 2 diabetes mellitus (DM2) in low-income elderly individuals with limited access to health services, highlighting social inequality as an important determinant of quality of life and access to treatment. The management of type 2 diabetes mellitus requires an approach that transcends metabolic control, integrating psychological and social dimensions. Evidence shows that factors such as mental health, physical activity, and socioeconomic conditions directly influence the prognosis of the disease. Therefore, public policies and clinical practices should prioritize comprehensive and interdisciplinary care, promoting quality of life and adherence to treatment.