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  2. Keyword: Glycemic Control
Protocol for Improving Hypertension and Diabetes Control Through Lifestyle Intervention in a Cluster Randomized Clinical Trial
IJCS
Original Article

Protocol for Improving Hypertension and Diabetes Control Through Lifestyle Intervention in a Cluster Randomized Clinical Trial

Daisy Motta-Santos et al. Thiago Barbabela de Castro Soares Maria Cecília Ramos de Carvalho Regina Márcia Faria de Moura … Sueli Ferreira da Fonseca Larissa Morelli Ferraz Guimarães Reginaldo Gonçalves Clara Rodrigues Alves de Oliveira Aline Cristine Souza Lopes Milena Soriano Marcolino

Abstract

Background:

Hypertension and Diabetes Mellitus (DM) are prevalent chronic conditions and major risk factors for cardiovascular diseases. Adequate control of these conditions is challenging, and lifestyle changes are crucial to achieving better management.

Objectives:

To evaluate the effectiveness of a multifaceted and multidisciplinary intervention to improve the control of hypertension and DM in the primary care setting.

Methods:

This cluster randomized clinical trial focuses on lifestyle modifications for managing hypertension and DM, addressing gaps in current non-pharmacological interventions. Primary care professionals are trained to promote health education on physical activity and nutrition. Support is provided through a telementoring program, including messaging app communication, biweekly online meetings (teletutoring), and asynchronous teleconsultations. Primary care professionals conduct twice-weekly group activities with structured intensity adjustments and biweekly health education sessions using interactive methods like conversations, games, and group dynamics. For patients unable to join group activities, brief counseling and guidance on unsupervised physical activity are offered.

Results:

The primary outcomes are blood pressure and glycated hemoglobin values. The innovative intervention program aims to empower primary care professionals and reduce barriers to care through lifestyle changes, improved health education, and support systems for both supervised and unsupervised interventions. Conclusions: Supporting primary care professionals through education and remote assistance can enhance the effectiveness of lifestyle interventions, contributing significantly to the control of hypertension and DM in primary care settings. Trial registration: Previously registered with .

  • Exercise
  • Glycemic Control
  • Healthy Diet
  • Hypertension
  • Primary Health Care
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Creative Commons Attribution (CC BY) Creative Commons license
01/06/2026 DOI: 10.36660/ijcs.20250045 Views 1
Association between Self-Care Behaviors and Inadequate Glycemic Control in ELSA-Brasil Participants with Type 2 Diabetes
ABC
Original Article

Association between Self-Care Behaviors and Inadequate Glycemic Control in ELSA-Brasil Participants with Type 2 Diabetes

Gisele de Souza Tupinambá et al. Odaleia Barbosa de Aguiar Bruno Pereira de Moura Maria Inês Schmidt … Maria Del Carmen Bisi Molina Rosane Harter Griep Maria de Jesus Mendes da Fonseca

Abstract

Background

Type 2 diabetes is a prevalent chronic condition, often associated with metabolic and cardiovascular complications.

Objective

This study aimed to evaluate the association between self-care behaviors, such as consumption of ultra-processed foods, vegetables, greens and fruits, physical activity, adherence to pharmacological treatment and smoking, and inadequate glycemic control in ELSA-Brasil participants with type 2 diabetes.

Methods

This is a cross-sectional study with 2,567 individuals, in which the associations between the variables of interest were analyzed by multiple logistic regression (p<0.05).

Results

Adherence to pharmacological treatment was the only behavior consistently associated with inadequate glycemic control. Participants with low adherence were more than twice as likely to have inadequate levels of glycated hemoglobin (OR: 2.09; 95%CI 1.14–4.10). Consumption of ultra-processed foods and insufficient intake of leafy vegetables showed initial associations that did not remain significant after adjustments, suggesting the influence of additional factors, such as socioeconomic conditions.

Conclusion

These results reinforce the need for interventions that combine health education, self-care support and public policies aimed at equality of treatment access, contributing to glycemic control and the reduction of complications associated with type 2 diabetes.

  • Glycemic Control
  • medication adherence
  • Processed Food
  • Self-Care
  • Type 2 Diabetes Mellitus
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Creative Commons Attribution (CC BY) Creative Commons license
07/07/2025 DOI: 10.36660/abc.20240867i Views 1

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Motta-Santos D, Soares TBC, Carvalho MCR, Moura RMF, Fonseca SF, Guimarães LMF, Gonçalves R, et al. Protocol for Improving Hypertension and Diabetes Control Through Lifestyle Intervention in a Cluster Randomized Clinical Trial. International Journal of Cardiovascular Sciences 2026;39:e20250045.

Electronic Document Format (ABNT)

Motta-Santos, Daisy; Soares, Thiago Barbabela de Castro; Carvalho, Maria Cecília Ramos de; Moura, Regina Márcia Faria de; Fonseca, Sueli Ferreira da; Guimarães, Larissa Morelli Ferraz; Gonçalves, Reginaldo; Oliveira, Clara Rodrigues Alves de; Lopes, Aline Cristine Souza; Marcolino, Milena Soriano. Protocol for Improving Hypertension and Diabetes Control Through Lifestyle Intervention in a Cluster Randomized Clinical Trial. International Journal of Cardiovascular Sciences, v. 39, e20250045, May. 2026.

Electronic Document Format (APA)

Motta-Santos, D., Soares, T. B. C., Carvalho, M. C. R. , Moura, R. M. F. , Fonseca, S. F. , Guimarães, L. M. F., Gonçalves, R., Oliveira, C. R. A. , Lopes, A. C. S., & Marcolino, M. S. (2026). Protocol for Improving Hypertension and Diabetes Control Through Lifestyle Intervention in a Cluster Randomized Clinical Trial. International Journal of Cardiovascular Sciences, 39, e20250045.

Electronic Document Format (ISO)

Motta-Santos, Daisy and Soares, Thiago Barbabela de Castro and Carvalho, Maria Cecília Ramos de and Moura, Regina Márcia Faria de and Fonseca, Sueli Ferreira da and Guimarães, Larissa Morelli Ferraz and Gonçalves, Reginaldo and Oliveira, Clara Rodrigues Alves de and Lopes, Aline Cristine Souza and Marcolino, Milena Soriano. Protocol for Improving Hypertension and Diabetes Control Through Lifestyle Intervention in a Cluster Randomized Clinical Trial. International Journal of Cardiovascular Sciences [online]. 2026, vol. 39, [cited 2026-10-14], e20250045. Available from: <https://journals.cardiol.br/en/article/protocol-for-improving-hypertension-and-diabetes-control-through-lifestyle-intervention-in-a-cluster-randomized-clinical-trial/>. ISSN 2359-4802

EndNote RIS

Electronic Document Format (Vancouver)

Tupinambá GS, Aguiar OB, Moura BP, Schmidt MI, Molina MDCB, Griep RH, Fonseca MJM, et al. Association between Self-Care Behaviors and Inadequate Glycemic Control in ELSA-Brasil Participants with Type 2 Diabetes. Arquivos Brasileiros de Cardiologia 2025;122(6):e20240867.

Electronic Document Format (ABNT)

Tupinambá, Gisele de Souza; Aguiar, Odaleia Barbosa de; Moura, Bruno Pereira de; Schmidt, Maria Inês; Molina, Maria Del Carmen Bisi; Griep, Rosane Harter; Fonseca, Maria de Jesus Mendes da. Association between Self-Care Behaviors and Inadequate Glycemic Control in ELSA-Brasil Participants with Type 2 Diabetes. Arquivos Brasileiros de Cardiologia, v. 122, n. 6, e20240867, Jul. 2025.

Electronic Document Format (APA)

Tupinambá, G. S., Aguiar, O. B. , Moura, B. P. , Schmidt, M. I., Molina, M. D. C. B., Griep, R. H., & Fonseca, M. J. M. (2025). Association between Self-Care Behaviors and Inadequate Glycemic Control in ELSA-Brasil Participants with Type 2 Diabetes. Arquivos Brasileiros de Cardiologia, 122(6), e20240867.

Electronic Document Format (ISO)

Tupinambá, Gisele de Souza and Aguiar, Odaleia Barbosa de and Moura, Bruno Pereira de and Schmidt, Maria Inês and Molina, Maria Del Carmen Bisi and Griep, Rosane Harter and Fonseca, Maria de Jesus Mendes da. Association between Self-Care Behaviors and Inadequate Glycemic Control in ELSA-Brasil Participants with Type 2 Diabetes. Arquivos Brasileiros de Cardiologia [online]. 2025, vol. 122, n. 6, [cited 2026-10-14], e20240867. Available from: <https://journals.cardiol.br/en/article/association-between-self-care-behaviors-and-inadequate-glycemic-control-in-elsa-brasil-participants-with-type-2-diabetes/>. ISSN 0066-782X

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