Avanços no tratamento do diabetes mellitus tipo 2: a intersecção entre nutrição e novas medicações

This narrative review critically analyzed the effects of nutrition and emerging pharmacological therapies in the management of type 2 diabetes mellitus (T2DM), integrating these approaches as complementary and patient-centered strategies. Beyond well-established dietary patterns such as the Mediterranean diet and low-glycemic index diets, this review incorporated the NOVA food classification system as a central interpretative framework, emphasizing the degree of food processing. Recent evidence associates high consumption of ultra-processed foods with increased risk of obesity, insulin resistance, and T2DM, supporting the prioritization of unprocessed or minimally processed foods as a sustainable and real-world-applicable strategy. In parallel, pharmacological advances, including GLP-1 receptor agonists, dual GIP/GLP-1 receptor agonists, SGLT2 inhibitors, and once-weekly basal insulins, have expanded therapeutic options by promoting greater HbA1c reduction, significant weight loss, and cardiovascular and renal benefits. Despite their greater individual effect size, these therapies face challenges related to cost, accessibility, and long-term adherence. Contemporary T2DM management therefore requires an integrated model combining modern pharmacotherapy, nutrition grounded in food processing quality, structured health education, and multiprofessional support, while considering clinical effectiveness, cost-effectiveness, sustainability, and equity within public health systems.