Living with Diabetes: Quality of Life and Functional Impairment among Adults with Type 2 Diabetes in Northern Brazil

Living with Diabetes: Quality of Life and Functional Impairment among Adults with Type 2 Diabetes in Northern Brazil | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Living with Diabetes: Quality of Life and Functional Impairment among Adults with Type 2 Diabetes in Northern Brazil Joana Marcela Sales Lucena, Denise Maria Martins Vancea, Jorge Luiz de Brito Gomes, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7076089/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background Type 2 diabetes mellitus (T2DM) is a growing public health concern in Brazil, especially in underserved regions where social and geographic barriers may affect disease management and quality of life. Functional capacity and health-related quality of life (HRQoL) are critical dimensions often overlooked in primary care approaches. Objective To assess the functional capacity and HRQoL of individuals with T2DM receiving care in primary health units in Tocantinópolis, Northern Brazil, and to explore associations with sociodemographic and clinical variables. Methods This is a cross-sectional, descriptive, and analytical study involving 99 adults diagnosed with T2DM. Functional capacity was evaluated using the International Physical Activity Questionnaire (IPAQ), and HRQoL was assessed through the WHOQOL-bref. Sociodemographic and clinical data were also collected. Statistical analysis included descriptive statistics and correlation tests. Results Most participants were women (71%), with a mean age of 58.7 years. The physical and psychological domains of WHOQOL-bref presented the lowest scores, while the social domain had the highest. Functional capacity was low for the majority of participants. There were significant associations between low physical activity levels and poorer HRQoL scores in the physical and psychological domains. Conclusion Individuals with T2DM in this sample presented reduced functional capacity and compromised HRQoL, particularly in domains related to physical and psychological well-being. These findings highlight the urgent need for integrated health strategies in primary care that address physical activity and emotional support for people living with diabetes in remote and low-resource settings. Health sciences/Diseases Health sciences/Endocrinology Health sciences/Health care Health sciences/Medical research Type 2 Diabetes Mellitus Health-Related Quality of Life Functional Capacity Glycemic Control Self-Care Rural Health Figures Figure 1 Figure 2 Figure 3 Figure 4 1. Introduction Type 2 diabetes mellitus (T2DM) is a chronic disease with a major impact on global health and well-being, ranking among the ten leading causes of death worldwide. In 2024, the International Diabetes Federation (IDF) estimated that over 589 million adults aged 20–79 were living with diabetes—more than 90% of which were type 2 cases. Approximately 252 million people remain undiagnosed, and 81% of all diabetes cases are concentrated in low- and middle-income countries, such as Brazil. The global burden of the disease led to more than 3.4 million deaths in 2024—equivalent to one death every nine seconds—and annual healthcare costs exceeding US $ 1 trillion[ 1 ]. This is alarming because it highlights the urgent need for preventive strategies and interventions to improve quality of life for people living with T2DM, especially in vulnerable contexts. T2DM is associated with significant physical, psychological, and social consequences, including microvascular complications (retinopathy, nephropathy, neuropathy) and macrovascular complications (coronary artery disease, cerebrovascular disease, peripheral vascular disease), all of which can severely affect a patient's daily functioning and well-being[ 2 ], [ 3 ]. Beyond its clinical manifestations, the diagnosis often requires major lifestyle changes—such as dietary adjustments, glucose monitoring, and regular physical activity—which may lead to emotional distress and reduced health-related quality of life (HRQoL). Quality of life refers to an individual’s perception of well-being across multiple domains, including physical health, social relationships, and emotional state[ 4 ]. HRQoL captures how individuals perceive the impact of health condition on their physical, psychological, and social functioning[ 5 ]. This perception can influence personal decision-making and guide health professionals in tailoring patient-centered care strategies. There are few studies assessing the impact of type 2 diabetes mellitus (T2DM) on health-related quality of life (HRQoL) and its relationship with functional capacity[ 6 ], [ 7 ]. Most existing research has examined isolated associations—such as between HRQoL and reduced flexibility, cardiorespiratory fitness, or muscle strength—without analyzing the combined effects of these factors[ 3 ], [ 7 ], [ 8 ], [ 9 ]. Considering that HRQoL is multidimensional, assessing the interplay between disease characteristics and physical function may provide a more accurate understanding of how T2DM affects quality of life. In Brazil, as in many low- and middle-income countries, diabetes-related impairments in functional capacity and HRQoL remain under-addressed in primary care, particularly in remote regions with limited access to health services. Therefore, this study aimed to investigate whether functional capacity variables and glycemic control are predictors of HRQoL among individuals with T2DM living in a small town in northern Brazil. 2. Methods 2.1 Type of Study This is a cross-sectional predictive study approved by the Ethics Committee of the Federal University of Tocantins – UFT (CAAE: 59157316.2.0000.5519). 2.2 Population and Sample The study included adults with type 2 diabetes mellitus (T2DM) registered in primary care units in Tocantins, Brazil. Sample size was calculated using G-Power® with a minimum of 118 participants; however, convenience sampling was applied among eligible patients from all six basic health units. Inclusion criteria: age over 40, confirmed T2DM diagnosis, and SUS registration. Exclusion criteria included cognitive impairments or physical limitations that prevented participation. 2.3 Instruments and Variables Participants were interviewed using a structured questionnaire (25–30 minutes) covering sociodemographic data, health perception, physical activity (IPAQ, long version), and quality of life using the Diabetes Quality of Life questionnaire (DQOL), which has been validated for the Brazilian population [ 10 ]. The calculation of HRQoL scores followed the method by Jacobson et al. (1994)[ 11 ]. Additional tests included anthropometry, blood pressure, and HbA1c. Functional capacity was assessed through validated protocols measuring strength (handgrip, sit-to-stand), flexibility, mobility (Timed Up and Go), and cardiorespiratory fitness (6-minute walk). Glycemic control was determined using HbA1c collected after fasting. 2.4 Statistical Analysis Descriptive statistics (mean, SD, frequencies) and linear regression models were used to evaluate the association between HRQoL domains and independent variables (e.g., HbA1c, functional capacity). Assumptions were tested via Kolmogorov-Smirnov, VIF, Breusch-Pagan, and Durbin-Watson tests. Effect sizes were calculated using Cohen's f2. Variables with p-values ≤ 0.20 were retained in the final model, as recommended for exploratory regression models [ 12 ], and those with a p-value greater than this were removed by the Backward method. Analyses were conducted in R 3.6.2 and Excel. The dataset supporting the findings of this study is publicly available on Zenodo at the following DOI: https://doi.org/10.5281/zenodo.15657420 . 3. Results 3.1 Descriptive results Considering a population of 624 people with DM2 and hypertensive patients treated at Basic Health Units in the city, 373 visits were carried out, of which 261 were considered losses (people who were absent, who ignored the fact of having diabetes, or who had already died at the time of the visit by the data collection team), and 12 refusals. In total, 100 people with DM2 participated in the collection with the questionnaire, which corresponds to 16% of the total population of the city and 32 (5%) had complete data (questionnaire, blood collection, and functional tests) (Fig. 1 ). Considering the results presented in Table 1 , most participants were female (67.7%), 56% of respondents are married, and the majority have non-white skin color and incomplete high school (88.89% are literate). In addition, the mean age of respondents is approximately 64 years, more than 50% of respondents are middle class, and the mean BMI of respondents is approximately 27 kg/m 2 . Not all had complete data, so the amount of variables changed in each variable. Table 1 Sociodemographic characteristics of Brazilians with DM2, in 2018. Sample Variables n % Sex Female 67 67.68% Male 32 32.32% Total 99 100 Skin color White 21 22.11% Not white 74 77.89% Total 95 100 Schooling Illiterate 11 11.22% Elementary* 57 58.16% High school* 16 16.33% Higher* 14 14.29% Total 98 100 Class A/B 13 14.94% Socioeconomic status Class C 47 54.03% Class D/E 27 31.03% Total 87 100 Mean SD Age (years) 64.15 11.88 Income (reais/month) 1085.58 385.65 BMI (kg/m 2 ) 27.47 4.33 * complete and incomplete. BMI: body mass index. SD: standard deviation. Table 2 shows the physical characteristics of the sample. The mean time of diagnosis of diabetes mellitus was approximately 6 years, the mean systolic pressure was approximately 130 mmHg, and the mean diastolic pressure of respondents was 79.5 mmHg. As for the anthropometric characteristics, the mean abdominal circumference was approximately 95 centimeters, indicating a high value and a greater risk of cardiovascular events[ 13 ]; the mean body mass of the interviewees was approximately 68kg and the average fat percentage of the individuals was 32.06%. Regarding the variables related to functional capacity, the average strength of the upper limbs was 21.45 kgf, considered an expected value for the mean age[ 14 ]; on the other hand, lower limb strength had a mean of nine repetitions per 30 seconds, which can be considered a lower value than expected [ 14 ]. The mean flexibility was 23.25 cm, considered a very good mean flexibility for the age group of this sample [ 15 ]. The mobility of the group, measured by the TUG, presented a mean time of 26 seconds, a value classified as a moderate risk of falls [ 16 ], while cardiorespiratory fitness had an average of approximately 400 meters in 6 minutes, which can be considered a value below the expected for the mean age[ 14 ]. Regarding glycemic control, the mean capillary blood glucose was 237 mg/dL and the mean glycated hemoglobin was 8.84mg/dL (Table 2 ), these values are above those recommended for people with DM2, which are 115mg/dL and 7% for fasting glucose and glycated hemoglobin, respectively[ 17 ]. Table 2 Physical characteristics of Brazilians with type 2 diabetes, in 2018. Sample Variables Minimum Mean Median Maximum Standard deviation Reference values DM2 diagnosis time (months) 1.00 79.62 72.00 360.00 48.51 - Systolic pressure (mmHg) 98.60 131.39 129.80 197.60 17.50 120 Diastolic pressure (mmHg) 56.00 78.53 79.45 107.30 9.95 80 Heart rate (bpm) 52.70 77.95 79.00 150.00 12.17 - Height (m) 1.40 1.58 1.58 1.78 0.09 - Body mass (kg) 33.90 68.91 66.65 101.90 11.47 - Abdominal circumference (cm) 66.50 95.25 97.00 119.70 9.65 88 (women) 102 (men) [ 13 ] Fat percentage (%) 16.70 32.06 31.55 52.20 8.81 - Upper limb strength (Kg) 11.20 21.45 21.20 42.90 6.59 33.14[ 14 ] Lower limb strength (repetitions/30 seconds) 2.00 9.76 10.00 14.70 2.06 10.0[ 14 ] Flexibility (cm) 6.00 23.25 24.00 44.60 10.10 10.0[ 14 ] Mobility (seconds) 14.00 26.21 25.00 45.00 7.50 10.01 and 20 s (low risk of falls) Cardiorespiratory fitness (meters) 0.00 433.75 414.50 690.00 106.28 622 (± 80) (men) 551 (± 71) (women)[ 49 ] Capillary blood glucose (mg/dL) 71.00 237.13 230.50 546.00 104.14 - Glycated hemoglobin (mg/dL) 4.60 8.69 8.20 17.00 2.40 6.5–7% mmHg: millimeters of mercury; bpm: beats per minute (heart rate); m: meter. Kg: kilogram; Cm: centimeter; mg/dL: milligrams per deciliter. As shown in Fig. 2 , approximately 40% used at least 2 medications to control diabetes, only nine participants used insulin, 70% reported using other medications that were not for DM2, and almost 80% of the sample reported having some type of DM2 complication. However, when asked specifically about which complication (eye, kidney, heart, or foot problems) the majority reported not having the complication or any other health problem, with the exception of hypertension, which was the most commonly reported complication among the participants (63.54%) (Table 3 ). These data are important because they emphasize the importance of information for the patient during the consultations, as considering that the DM2 diagnosis time had an average of six years, it is possible that the patients already have some complications, but have no knowledge about them or have not been informed about them by the doctor. Table 3 Characteristics of chronic complications of Brazilians with type 2 diabetes, in 2018. Sample Variables Items n % Self-reported complications Yes 76 79.17% No 20 20.83% Retinopathy Yes 40 41.67% No 56 58.33% Diabetic foot Yes 5 5.21% No 91 94.79% Nephropathy Yes 17 17.71% No 79 82.29% Hypertension Yes 61 63.54% No 35 36.46% Heart disease Yes 12 12.50% No 84 87.50% Neuropathy Yes 11 11.46% No 85 88.54% Other health problems Yes 4 4.17% No 92 95.83% In Fig. 3 , approximately 41% of the participants are overweight and most of the participants were classified as physically inactive. Regarding the assessment of quality of life, and perception of their sleep health status, almost all participants perceived all these aspects as “regular”. The HRQoL of the sample is presented in Fig. 4 . The data show that the mean score of the general quality of life was 70.8 points, which indicates a high HRQoL, from a score of 0 to 100 points. Regarding domains, the social/vocational concerns domain received the highest score, followed by diabetes-related concerns and diabetes impact. The domain with the lowest score, indicating the lowest HRQoL, was the Satisfaction with treatment domain. With respect to the association between HRQoL, DM2 characteristics, variables related to functional capacity, and glycemic control, Table 4 presents the linear regression models for each domain and the overall HRQoL score. Thirty-two observations that had complete data to compose the multiple linear regression model were considered for analysis. Considering the final sample size, the Effect Size was calculated using the Cohen test, and the result indicated an effect size of 1.09, considered high for the sample[ 18 ]. Table 4 Linear regression models (baseline and adjusted) between Health-Related Quality of Life (HRQoL) and independent variables of Brazilians with type 2 diabetes, in 2018. Dependent variables Independent variables β Standard error t-value p 1. Satisfaction with treatment Base model (R 2 = 11.8%) Intercept -109.783 64.379 -1.705 0.102 * DTDM2 (years) -0.907 1.118 -0.811 0.426 No complications from DM2 3.785 7.241 0.523 0.606 Strength of upper limbs (Kg) 0.273 0.690 0.397 0.695 Strength of lower limbs (rep.) 3.122 1.499 2.082 0.049 * Flexibility (cm) 0.271 0.287 0.945 0.355 Mobility (seconds) 2.200 1.070 2.056 0.051 * Cardiorespiratory fitness (m) 0.161 0.084 1.914 0.068 * HbA1c (%) 0.195 1.383 0.141 0.889 Final model (R 2 = 12.5%) (ES = 1.09) Intercept 21.596 14.551 1.484 0.149 * No complications from DM2 7.878 5.955 1.323 0.197 * Strength of upper limbs (Kg) 2.489 1.342 1.855 0.074 * Strength of lower limbs (rep.) 0.360 0.276 1.303 0.200 * 2. Impact of Diabetes Base model (R 2 = 0.8%) Intercept 34.366 62.434 0.550 0.587 DTDM2 (years) 0.511 1.084 0.471 0.642 No complications from DM2 0.186 7.023 0.027 0.979 Strength of upper limbs (Kg) -0.422 0.669 -0.632 0.534 Strength of lower limbs (rep.) 2.476 1.454 1.703 0.102 * Flexibility (cm) 0.233 0.278 0.839 0.410 Mobility (seconds) 0.550 1.038 0.531 0.601 Cardiorespiratory fitness (m) 0.052 0.082 0.638 0.530 HbA1c (%) -2.332 1.341 -1.739 0.095 * Final model Intercept 72.475 16.245 4.461 < 0.001 * (R 2 = 14.4%) Strength of lower limbs (rep.) 2.104 1.216 1.731 0.094 * (ES = 1.07) HbA1c (%) -2.109 1.122 -1.880 0.070 * 3. Social/vocational concerns Intercept (R 2 = 14.3%) DTDM2 (years) 0.829 0.557 1.489 0.150 * No complications from DM2 7.066 3.604 1.960 0.062 * Strength of upper limbs (Kg) 0.183 0.343 0.533 0.599 Strength of lower limbs (rep.) 0.652 0.746 0.874 0.391 Flexibility (cm) 0.296 0.143 2.075 0.049 * Mobility (seconds) -0.605 0.533 -1.135 0.268 Cardiorespiratory fitness (m) -0.077 0.042 -1.828 0.080 * HbA1c (%) -1.435 0.688 -2.086 0.048 * Final model (R 2 = 0.125%) (ES = 0.14) Intercept 96.261 6.893 13.966 < 0.001 * Flexibility (cm) 0.260 0.139 1.872 0.071 * HbA1c (%) -0.955 0.626 -1.525 0.138 * 4. Diabetes-related concerns (R 2 = − 0.044%) Intercept -18.018 98.268 -0.183 0.856 DTDM2 (years) 2.106 1.707 1.234 0.230 No complications from DM2 14.331 11.053 1.297 0.208 Strength of upper limbs (Kg) 0.550 1.053 0.522 0.607 Strength of lower limbs (rep.) 2.736 2.289 1.196 0.244 Flexibility (cm) 0.219 0.438 0.501 0.621 Mobility (seconds) 1.521 1.633 0.931 0.361 Cardiorespiratory fitness (m) 0.041 0.128 0.317 0.754 HbA1c (%) -2.950 2.110 -1.398 0.176 * Final model* - - - - - 5. Overall HRQoL score Base model (R 2 = 11.8%) Intercept -2.448 49.861 -0.049 0.961 DTDM2 (years) 0.236 0.866 0.272 0.788 No complications from DM2 3.637 5.608 0.648 0.523 Strength of upper limbs (Kg) -0.019 0.534 -0.035 0.972 Strength of lower limbs (rep.) 2.432 1.161 2.094 0.048 * Flexibility (cm) 0.254 0.222 1.143 0.265 Mobility (seconds) 0.997 0.829 1.203 0.241 Cardiorespiratory fitness (m) 0.067 0.065 1.029 0.314 HbA1c (%) -1.425 1.071 -1.331 0.196 * Final model (R 2 = 12.5%) Intercept 53.617 14.777 3.628 0.001 * (ES = 1.09) DTDM2 (years) 0.524 0.724 0.723 0.476 Strength of lower limbs (rep.) 1.932 1.013 1.906 0.067 * Flexibility (cm) 0.318 0.210 1.513 0.142 * HbA1c (%) -1.307 0.990 -1.321 0.198 * * A model was not found in which the independent variables had an influence on the dependent variable and the assumptions of linear regression were met. N: Newtons; DTDM2: DM2 diagnosis time; rep: repetitions for 30 seconds; m: meters; kg: kilogram; cm: centimeter; m: meter; HbA1c (%) – glycated hemoglobin percentage. ES: effect size according to the calculation of Cohen's f 2 value. Total observations in each model (n): 32 participants. Observing the results of Table 4 , several variables placed in the model were significant, considering a 20% level of significance. Below, five multiple linear regression models will be presented, covering the associations between the HRQoL and its respective domains, the characteristics of DM2, the variables related to functional capacity, and glycemic control. Satisfaction with treatment domain Model 1 analyzed the associations between independent variables and satisfaction with treatment domain. Not having DM2 complications (β = 7.9; p = 0.197), upper limb strength (β = 2.5; p = 0.074), and lower limb strength (β = 0.360; p = 0.2) were associated with this domain. The adjusted model showed that these variables predict 12.5% of the HRQoL satisfaction with treatment domain. Participants who reported no complications had seven points more on the HRQoL than those who had some type of complication resulting from DM2. In addition, those with more strength in the upper and lower limbs also had a better perception of satisfaction with the treatment (Table 4 ). Impact of diabetes mellitus domain Considering the impact of DM2, the results shown in model 2 indicated a positive association with lower limb strength (β = 2.104; p = 0.094) and an inverse association with glycated hemoglobin (β = -2.109; p = 0.070). The final model explained 14.4% (R 2 ) of the variation in the dependent variable. With each addition of one unit in the sit to stand test, the HRQoL score increased by 2.104 points; whereas with each addition of one unit in glycated hemoglobin, there was a decrease of 2 points in terms of the impact of the disease on the HRQoL. Social/vocational concerns domain Model 3 demonstrates the associations of independent variables with the social/vocational concerns domain. Only flexibility had a positive association with this HRQoL domain (β = 0.260; p = 0.071), while the association with glycated hemoglobin was inverse (β = -0.955; p = 0.138), and R 2 was 0.125%. Diabetes-related concerns domain Model 4 refers to the association between the independent variables and the diabetes-related concerns domain. Initially, the base model was analyzed, but a model was not found in which the independent variables had an influence on the dependent variable and the assumptions of linear regression were met, even though all possible combinations between the variables were tested for the realization of the model, however none of the combinations were significant. Thus, the normal linear model is not suitable for thwaw data. Overall HRQoL score Lower limb strength (β = 1.932; p = 0.067), flexibility (β = 0.318; p = 0.142), and glycated hemoglobin (β = -1.307; p = 0.198) were associated with the overall HRQoL score in model 5; this final model predicts 12.5% of the variation in HRQoL. With each increase of one unit in the sit to stand test, the overall quality of life increased by almost two points, and with each increase of one unit in glycated hemoglobin, the general quality of life decreased by 1.307 points. 4. Discussion This study aimed to examine whether characteristics of type 2 diabetes mellitus (T2DM), functional capacity, and glycemic control are predictors of health-related quality of life (HRQoL) among Brazilian adults living with T2DM. Our findings indicate that a shorter duration of diagnosis (less than ten years), absence of diabetes-related complications, greater upper and lower limb strength, and higher levels of flexibility were positively associated with better HRQoL and its domains, including satisfaction with treatment (R2 = 12.5%), impact of diabetes (R2 = 14.4%), social/vocational concerns (R2 = 0.125%), and diabetes-related concerns. Conversely, higher levels of glycated hemoglobin were inversely associated with HRQoL (β = -1.307; p = 0.198), suggesting that poor glycemic control may negatively influence individuals' perception of the disease and their social well-being. Previous studies have consistently identified several predictors of HRQoL in patients with T2DM, including female sex [ 19 ], [ 20 ], [ 21 ], advanced age [ 9 ], [ 20 ], and lower socioeconomic status [ 9 ]. Additional negative predictors include insulin use [ 19 ], complex pharmacological treatment [ 22 ], longer disease duration [ 23 ], presence of comorbidities or complications [ 24 ], [ 25 ], and hospitalization history [ 9 ]. Psychosocial stressors such as limited social support, negative coping mechanisms, and low cognitive appraisal also appear to be associated with diminished HRQoL. Physical health factors—frequently exacerbated by T2DM—such as elevated body mass index [ 26 ], reduced flexibility [ 27 ], poor cardiorespiratory fitness [ 27 ], [ 28 ], diminished muscle strength[ 29 ], metabolic syndrome [ 26 ], chronic pain [ 30 ], and fall risk [ 31 ], have also demonstrated negative associations with HRQoL. These findings have been replicated across various regions, including Europe, Asia, and Latin America. The heterogeneity of instruments used in HRQoL assessment complicates cross-study comparisons. Each tool is grounded in different theoretical frameworks and captures distinct domains, limiting generalizability. The present study addressed this limitation by employing the DQOL, a validated instrument specifically designed for individuals with diabetes and culturally adapted for the Brazilian population [ 10 ], [ 11 ]. Our data indicates that functional capacity variables exert considerable influence on HRQoL in individuals with T2DM. These relationships are further shaped by sociodemographic and cultural contexts, especially in a country as diverse as Brazil. 4.1 HRQoL and Diabetes Complications Absence of chronic complications was associated with an increase of up to seven points in the satisfaction with treatment domain (R2 = 12.5%). Previous research has shown that complications such as retinopathy, nephropathy, and neuropathy triple the likelihood of poor HRQoL [ 32 ]. This finding supports the notion that awareness of one's complication status may enhance engagement in preventive behaviors and disease management, generating a positive feedback loop. Drawing on Orem's Self-Care Theory [ 33 ], self-care comprises basic capabilities, health knowledge, and action. In T2DM management, self-care is essential for preventing complications and improving HRQoL. In this sample, self-care practices such as medication adherence, dietary regulation, and foot self-examination were relatively common [ 34 ], [ 35 ], [ 36 ]. However, practices like blood glucose monitoring and physical activity remain insufficient, indicating gaps in comprehensive self-management. 4.2 HRQoL and Muscle Strength Greater upper limb strength was associated with better satisfaction with treatment (R2 = 12.5%), although mean grip strength in the sample was below normative values for the age group [ 14 ]. T2DM is known to impair protein metabolism, accelerating muscle loss. This condition, combined with disease duration and age, may lead to sarcopenia, reduced functionality, and lower HRQoL [ 29 ], [ 37 ], [ 38 ]. While some studies suggest that improved muscle strength reduces insulin resistance [ 39 ], others, such as Giglio et al. (2018)[ 40 ], found no significant relationship between grip strength and hyperglycemia. In this study, despite reduced strength, participants reported satisfaction with care, possibly reflecting the perceived adequacy of care provided by the Brazilian Unified Health System (SUS). Lower limb strength also emerged as a key factor influencing the impact of diabetes on HRQoL (R2 = 14.4%) and the overall HRQoL score (R2 = 12.5%). Given the relationship between muscle weakness, decreased mobility, and fall risk [ 41 ], [ 42 ], promoting muscle strength may mitigate negative health outcomes and enhance well-being. 4.3 HRQoL and Flexibility Flexibility was positively associated with better HRQoL, especially in the social/vocational domain (β = 0.260; p = 0.071). Hyperglycemia-induced collagen glycation can increase joint stiffness and contribute to musculoskeletal complications such as tendinopathies and capsulitis [ 43 ]. These conditions limit daily function and can affect mental health [ 44 ]. Despite this, participants in our study demonstrated good flexibility levels, which may help explain their relatively positive HRQoL assessments. 4.4 HRQoL and Glycemic Control Elevated HbA1c levels were inversely related to both overall HRQoL and the social/vocational concerns domain (β = -1.307 and − 0.955, respectively). These findings are aligned with prior literature indicating associations between poor glycemic control and cardiovascular risk, increased BMI, insulin resistance, and reduced treatment responsiveness [ 45 ], [ 46 ], [ 47 ]. A psychoeducational intervention conducted in Saudi Arabia demonstrated improvements in both HbA1c and HRQoL scores following education on diabetes management [ 45 ]. These results underscore the importance of patient understanding in fostering effective self-care and emotional well-being. The ADA (2000) also identifies the burdens of self-management, symptom vigilance, and fear of complications as key determinants of HRQoL. A bidirectional relationship appears to exist as glycemic control deteriorates, HRQoL worsens; conversely, enhanced well-being may promote adherence and metabolic stability [ 48 ]. 4.5 Limitations and Strengths A primary limitation of this study was the substantial loss of participants due to registration issues in local health units, which restricted the sample size for multivariate analysis. Nonetheless, the study's strengths include the use of a diabetes-specific, culturally validated HRQoL instrument, detailed characterization of a remote Brazilian population, and the integration of multiple physical and clinical variables. As the first Brazilian investigation to examine the relationship between functional capacity and HRQoL among individuals with T2DM, this study provides foundational insights to inform future research and public health strategies. 5. Conclusion Variables related to disease characteristics (diagnosis time of less than ten years and no DM2 complications) and variables related to functional capacity (upper and lower limb strength and flexibility) were positively associated with better HRQoL and its domains (satisfaction with treatment, DM2 impact, social/vocational concerns, and DM2-related concerns). On the other hand, glycated hemoglobin demonstrated an inverse association with HRQoL, indicating that poor glycemic control can worsen the perception of the Impact of the disease and the social concerns of people with diabetes. Declarations Ethics approval and consent to participate This study was approved by the Comitê de Ética em Pesquisa com Seres Humanos da Universidade Federal do Tocantins (CEP/UFT) – Ethics Committee for Research Involving Human Subjects at the Federal University of Tocantins, under protocol CAAE: 59157316.2.0000.5519. The research complied with the ethical principles outlined in Resolution No. 466/2012 of the Brazilian National Health Council and the Declaration of Helsinki. All participants were fully informed about the aims, procedures, potential risks, and benefits of the study. Participation was voluntary, and all individuals provided written consent by signing a Free and Informed Consent Form (FICF) prior to inclusion. Consent for publication All participants provided written informed consent ( Termo de Consentimento Livre e Esclarecido – TCLE ) authorizing the use and publication of anonymized data collected for the purposes of this study. Availability of data and materials The datasets generated and/or analyzed during the current study are publicly available in the Zenodo repository at: https://doi.org/10.5281/zenodo.15657420. Competing interests The authors declare no competing interests. Funding This research was carried out with the author’s own funding. Authors' contributions JMSL and WRM participated in the conception, planning, execution of the research, data analysis, and writing of the manuscript. DMMV, SCRR, ALAR, JLBG, and LGGP participated in the analysis of the results, writing of the manuscript, and critical review of the discussion. Acknowledgements We would like to thank the participants of this research, as well as the professors and technicians of the Federal University of Northern Tocantins – UFNT, Tocantinópolis Campus, and the members of the Research Group on Physical Activity and Chronic Diseases (GEPAFD) and the Research Group on Functional Reeducation and Human Performance (ReDe) . Authors’ information Not applicable. References I. D. Federation, IDF Diabetes Atlas Eighth edition 2017 . 2017. doi: http://dx.doi. org/10.1016/S0140-6736(16)31679-8. S. A. 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Awotidebe et al. , “Relationship between functional capacity and health-related quality of life of patients with type—2 diabetes,” Diabetes and Metabolic Syndrome: Clinical Research and Reviews , 2017, doi: 10.1016/j.dsx.2016.06.004. A. Papadopoulos, N. Kontodimopoulos, A. Frydas, E. Ikonomakis, and N. Dimitris, “Predictors of health-related quality of life in type II diabetic patients in Greece,” BMC Public Health , vol. 7, no. 186, 2007. I. Bourdel-Marchasson et al. , “Correlates of health-related quality of life in French people with type 2 diabetes,” Diabetes Res Clin Pract , 2013, doi: 10.1016/j.diabres.2013.05.011. C. J. Correr, R. Pontarolo, A. C. Melchiors, P. Rossignoli, F. Fernández-Llimós, and R. B. Radominski, “Translation to Portuguese and validation of the diabetes quality of life measure (DQOL-Brazil),” Arq Bras Endocrinol Metabol , vol. 52, no. 3, pp. 515–522, Apr. 2008, doi: 10.1590/S0004-27302008000300012. A. M. Jacobson, M. De Groot, and J. A. 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Fox et al. , “Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association,” Diabetes Care , vol. 38, no. 9, pp. 1777–1803, 2015, doi: 10.2337/dci15-0012. H. Espírito-Santo and F. Daniel, “Calcular e apresentar tamanhos do efeito em trabalhos científicos (3): Guia para reportar os tamanhos do efeito para análises de regressão e ANOVAs,” 2018. M. R. Leite Ramalho, T. Fontenele Marques, J. M. Ferreira de Lima Silva, and G. Landim da Silva, “Qualidade de vida em pacientes diabéticos usuários de insulina na atenção secundária do Cariri cearense,” Revista Brasileira de Qualidade de Vida , 2017, doi: 10.3895/rbqv.v9n4.7302. P. Lou et al. , “Association of sleep quality and quality of life in type 2 diabetes mellitus: A cross-sectional study in China,” Diabetes Res Clin Pract , 2015, doi: 10.1016/j.diabres.2014.09.060. A. Pichon-Riviere, V. Irazola, A. Beratarrechea, A. Alcaraz, and C. Carrara, “Quality of life in type 2 diabetes mellitus patients requiring insulin treatment in Buenos Aires, Argentina: A cross-sectional study,” Int J Health Policy Manag , 2015, doi: 10.15171/ijhpm.2015.80. R. F. Lima, A. Fontbonne, E. M. F. de Carvalho, U. R. Montarroyos, M. N. S. de C. Barreto, and E. Â. P. Cesse, “Factors associated with glycemic control in people with diabetes at the Family Health Strategy in Pernambuco,” Revista da Escola de Enfermagem , 2016, doi: 10.1590/S0080-623420160000700009. L. S. Bernini et al. , “O impacto do diabetes mellitus na qualidade de vida de pacientes da Unidade Básica de Saúde,” Cadernos Brasileiros de Terapia Ocupacional , 2017, doi: 10.4322/2526-8910.ctoao0899. M. C. Adriaanse, H. W. Drewes, I. van der Heide, J. N. Struijs, and C. A. Baan, “The impact of comorbid chronic conditions on quality of life in type 2 diabetes patients,” Quality of Life Research , 2016, doi: 10.1007/s11136-015-1061-0. M. P. O’Shea, M. Teeling, and K. Bennett, “Comorbidity, health-related quality of life and self-care in type 2 diabetes: a cross-sectional study in an outpatient population,” Ir J Med Sci , 2015, doi: 10.1007/s11845-014-1190-4. Y. Zheng, S. H. Ley, and F. B. Hu, “Global aetiology and epidemiology of type 2 diabetes mellitus and its complications,” 2018. doi: 10.1038/nrendo.2017.151. B. Sañudo, R. M. Alfonso-Rosa, J. C. del Pozo, J. C. del Pozo, and B. C. del Pozo, “Influ ência do nível de atividade física sobre a aptidão física e qualidade de vida relacionada à saúde em idosos portadores ou não de diabetes mellitus tipo 2,” Revista Brasileira de Medicina do Esporte , 2013, doi: 10.1590/S1517-86922013000600006. T. O. Awotidebe, R. A. Adedoyin, A. O. Yusuf, C. E. Mbada, R. Opiyo, and F. C. Maseko, “Comparative functional exercise capacity of patients with type 2-diabetes and healthy controls: A case control study,” Pan African Medical Journal , 2014, doi: 10.11604/pamj.2014.19.257.4798. R. M. Alfonso-Rosa, B. del Pozo-Cruz, J. del Pozo-Cruz, J. T. Del Pozo-Cruz, and B. Sañudo, “The relationship between nutritional status, functional capacity, and health-related quality of life in older adults with type 2 diabetes: a pilot explanatory study,” J Nutr Health Aging , vol. 17, pp. 315–321, 2013. T. M. da C. Daniele, V. M. S. de Bruin, D. S. N. de Oliveira, C. M. R. Pompeu, and A. C. e Forti, “Associations among physical activity, comorbidities, depressive symptoms and health-related quality of life in type 2 diabetes,” Arquivos Brasileiros de Endocrinologia & Metabologia , 2013, doi: 10.1590/s0004-27302013000100006. M. C. Ferreira, J. Tozatti, S. M. Fachin, P. P. De Oliveira, R. F. Dos Santos, and M. E. R. Da Silva, “Redução da mobilidade funcional e da capacidade cognitiva no diabetes melito tipo 2,” Arq Bras Endocrinol Metabol , 2014, doi: 10.1590/0004-2730000003097. X. Jing et al. , “Related factors of quality of life of type 2 diabetes patients: a systematic review and meta-analysis,” Health Qual Life Outcomes , vol. 16, no. 189, 2018. A. F. Vitor, M. V. de O. Lopes, and T. L. Araújo, “Teoria do déficit de autocuidado: análise da suaimportância e aplicabilidade na prática de enfermagem,” Esc. Anna Nery , vol. 14, no. 3, pp. 611–616, 2010. A. K. O. T. Borba, M. C. da S. Silva, S. B. S. Santos, and M. C. R. Gomes, “Conhecimento e autocuidado de indivíduos com diabetes na Atenção Primária à Saúde,” Rev. APS , vol. 21, no. 4, pp. 516–533, 2018. K. O. C. de Souza, S. C. B. Oliveira, L. Miyar, M. F. C. Souza, and S. de O. Ribeiro, “Autocuidado de pacientes com Diabetes Mellitus tipo 2,” Semina: Ciências Biológicas e da Saúde , vol. 40, no. 1, pp. 75–88, 2019. M. C. Larré, L. M. Ottero, C. R. de S. Teixeira, M. L. Zanetti, A. D. de M. Inagaki, and A. C. F. Abud, “Autocuidado dos pacientes com diabetes mellitus tipo 2 em seguimento ambulatorial,” Revista Nursing , vol. 21, no. 245, pp. 2385–2390, 2018. R. P. McGrath et al. , “The Association Between Handgrip Strength and Diabetes on Activities of Daily Living Disability in Older Mexican Americans,” J Aging Health , vol. 30, no. 8, pp. 1305–1318, 2018. S. K. Kunutsor, N. M. Isiozor, H. Khan, and J. A. Laukkanen, “Handgrip strength—A risk indicator for type 2 diabetes: Systematic review and meta‐analysis of observational cohort studies,” Diabetes Metab Res Rev , vol. 37, no. 2, p. e3365, 2021. S. Y. Park and I. H. Lee, “Effects on training and detraining on physical function, control of diabetes and anthropometrics in type 2 diabetes; A randomized controlled trial,” Physiother Theory Pract , 2015, doi: 10.3109/09593985.2014.958265. B. M. Giglio, J. F. Mota, B. T. Wall, and G. D. Pimentel, “Low Handgrip Strength Is Not Associated with Type 2 Diabetes Mellitus and Hyperglycemia: a Population-Based Study,” Clin Nutr Res , vol. 7, no. 2, pp. 112–116, 2018. T. Nomura, T. Kawae, H. Kataoka, and Y. Ikeda, “Loss of lower extremity muscle strength based on diabetic polyneuropathy in older patients with type 2 diabetes: Multicenter Survey of the Isometric Lower Extremity Strength in Type 2 Diabetes: Phase 2 study.,” J Diabetes Investig. , vol. 12, no. 3, pp. 390–397, 2021. M. Vongsirinavarat, W. Mathiyakom, R. Kraiwong, and V. Hiengkaew, “Fear of Falling, Lower Extremity Strength, and Physical and Balance Performance in Older Adults with Diabetes Mellitus,” J Diabetes Res , 2020. R. Singla, Y. Gupta, and S. Kalra, “Musculoskeletal effects of diabetes mellitus,” J Pak Med Assoc , vol. 65, no. 9, pp. 1024–1027, 2015. Y. A. Murillo, R. M. Almagro, I. D. Campos-González, and M. H. Cardiel, “Health Related Quality of Life in Rheumatoid Arthritis, Osteoarthritis, Diabetes Mellitus, End Stage Renal Disease and Geriatric Subjects. Experience From a General Hospital in Mexico,” Reumatol Clin , vol. 11, no. 2, pp. 68–72, 2015. S. S. Mahmoud et al. , “Effects of a psychoeducational program on hemoglobin A1C level and health-related quality of life in patients with type 2 diabetes mellitus, Jazan, Saudi Arabia,” Biomed Res Int , vol. 2018, 2018. A. Elissen et al. , “Differences in biopsychosocial profiles of diabetes patients by level of glycaemic control and health-related quality of life: The Maastricht Study.,” PLoS One , vol. 12, no. 7, 2017. A. Jalving et al. , “Glycaemic control in the diabetes and Lifestyle Cohort Twente: A cross-sectional assessment of lifestyle and pharmacological management on Hba1c target achievement.,” Diabetes Obes Metab. , vol. 20, no. 10, pp. 2494–2499, 2018. A. Trikkalinou, A. K. Papazafiropoulou, and A. Melidonis, “Type 2 diabetes and quality of life,” World J Diabetes , vol. 8, no. 4, p. 120, 2017. A. M. Iwama, G. N. de Andrade, P. Shima, S. E. Tanni, I. de Godoy, and V. Z. Dourado, “The six-minute walk test and body weight-walk distance product in healthy Brazilian subjects,” Brazilian Journal of Medical and Biological Research , vol. 42, pp. 1080–1085, 2009. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7076089","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":490525180,"identity":"b6b3deb7-ea8d-4b18-965b-60a5432e3462","order_by":0,"name":"Joana Marcela Sales Lucena","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA80lEQVRIiWNgGAWjYBACxgYk9gGGCgZ+IIONaC0MBxjOMEg2ENKCAg4wthGhhbm9+dmDHwzb5M3bDx848HPeYQlz9ga2xxX4HNZzzNywh+G24ZwzaQkHe7cdlrDsOcBueAaflhkJZhI8DLcZZ0jwGBzg3Xa4zuBGAhvIdXi0pH+T/MNw236GBP+Hg3/nHJYwuP+AkJYcM2mgLYlAWxgO8zYAtdxgIKCl50yZtIzB7eQZPGkGh2WOpQP9kthuiE+LYXv7Nsk3FbdtZ7AffvjwTY01MMQOH3uIVwtY0gBJxAA1ejGBPIaIARZVo2AUjIJRMLIBAPBYT8jEbfVkAAAAAElFTkSuQmCC","orcid":"","institution":"Federal University of Pernambuco – UFPE","correspondingAuthor":true,"prefix":"","firstName":"Joana","middleName":"Marcela Sales","lastName":"Lucena","suffix":""},{"id":490525181,"identity":"4fef9b75-1fac-4c1b-8384-67587274bd25","order_by":1,"name":"Denise Maria Martins Vancea","email":"","orcid":"","institution":"University of Pernambuco – UPE, Higher School of Physical Education – ESEF","correspondingAuthor":false,"prefix":"","firstName":"Denise","middleName":"Maria Martins","lastName":"Vancea","suffix":""},{"id":490525182,"identity":"0d450efd-45b0-480c-9030-7688d4bbdbd6","order_by":2,"name":"Jorge Luiz de Brito Gomes","email":"","orcid":"","institution":"Federal University of the São Francisco Valley – UNIVASF","correspondingAuthor":false,"prefix":"","firstName":"Jorge","middleName":"Luiz de Brito","lastName":"Gomes","suffix":""},{"id":490525183,"identity":"205402de-ed2e-4bd9-a5e7-40ecde11205f","order_by":3,"name":"Sacha Clael","email":"","orcid":"","institution":"University of Brazilia – UnB","correspondingAuthor":false,"prefix":"","firstName":"Sacha","middleName":"","lastName":"Clael","suffix":""},{"id":490525184,"identity":"a32d66e2-38ea-4a69-8941-f45cecb6d7b0","order_by":4,"name":"Alexandre Lima Araújo Ribeiro","email":"","orcid":"","institution":"University of Brazilia – UnB","correspondingAuthor":false,"prefix":"","firstName":"Alexandre","middleName":"Lima Araújo","lastName":"Ribeiro","suffix":""},{"id":490525185,"identity":"9fe16c16-f05a-44c5-a155-02ba3e4890dc","order_by":5,"name":"Luiz Guilherme Grossi Porto","email":"","orcid":"","institution":"University of Brazilia – UnB","correspondingAuthor":false,"prefix":"","firstName":"Luiz","middleName":"Guilherme Grossi","lastName":"Porto","suffix":""},{"id":490525186,"identity":"df777dc0-742d-4c0b-9bf7-d8c566a0244c","order_by":6,"name":"Wagner Rodrigues Martins","email":"","orcid":"","institution":"University of Brazilia – UnB","correspondingAuthor":false,"prefix":"","firstName":"Wagner","middleName":"Rodrigues","lastName":"Martins","suffix":""}],"badges":[],"createdAt":"2025-07-08 14:53:34","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7076089/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7076089/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":87823766,"identity":"042ba608-71c4-4129-b297-5b73a6da9815","added_by":"auto","created_at":"2025-07-29 11:29:20","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":37398,"visible":true,"origin":"","legend":"\u003cp\u003eSelection of the sample of Brazilians with type 2 diabetes, in 2018. DM2: type 2 diabetes.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7076089/v1/fadc62d38229e478e61d6fc1.png"},{"id":87823765,"identity":"cbde4af0-ef82-4eeb-92f3-9db4bef660d9","added_by":"auto","created_at":"2025-07-29 11:29:20","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":54279,"visible":true,"origin":"","legend":"\u003cp\u003eMedications and insuline use in Brazilians with type 2 diabetes, in 2018.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7076089/v1/7a43b5e1dc8dd08c0a004d38.png"},{"id":87823768,"identity":"6ff589ca-00ee-4526-b530-50c9e6efc833","added_by":"auto","created_at":"2025-07-29 11:29:20","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":23652,"visible":true,"origin":"","legend":"\u003cp\u003eClassification of physical activity, body mass index and quality of life of Brazilians with type 2 diabetes, in 2018.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-7076089/v1/a820018b537e13d703530a11.png"},{"id":87824340,"identity":"87fd03e4-821a-4c5c-adbd-16e17691cd30","added_by":"auto","created_at":"2025-07-29 11:37:20","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":17132,"visible":true,"origin":"","legend":"\u003cp\u003eScore of the domains of health-related quality of life and their effects in the sample of Brazilians with type 2 diabetes, in 2018.\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-7076089/v1/babe2e81e37aeaf8820bdb8f.png"},{"id":87825556,"identity":"c2cfed39-a730-4271-b63a-387722f7f41e","added_by":"auto","created_at":"2025-07-29 11:45:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1648164,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7076089/v1/f658f729-e16a-44d7-8403-c355ccfeffb7.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Living with Diabetes: Quality of Life and Functional Impairment among Adults with Type 2 Diabetes in Northern Brazil","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eType 2 diabetes mellitus (T2DM) is a chronic disease with a major impact on global health and well-being, ranking among the ten leading causes of death worldwide. In 2024, the International Diabetes Federation (IDF) estimated that over 589\u0026nbsp;million adults aged 20\u0026ndash;79 were living with diabetes\u0026mdash;more than 90% of which were type 2 cases. Approximately 252\u0026nbsp;million people remain undiagnosed, and 81% of all diabetes cases are concentrated in low- and middle-income countries, such as Brazil. The global burden of the disease led to more than 3.4\u0026nbsp;million deaths in 2024\u0026mdash;equivalent to one death every nine seconds\u0026mdash;and annual healthcare costs exceeding US\u003cspan\u003e$\u003c/span\u003e1 trillion[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. This is alarming because it highlights the urgent need for preventive strategies and interventions to improve quality of life for people living with T2DM, especially in vulnerable contexts.\u003c/p\u003e\u003cp\u003eT2DM is associated with significant physical, psychological, and social consequences, including microvascular complications (retinopathy, nephropathy, neuropathy) and macrovascular complications (coronary artery disease, cerebrovascular disease, peripheral vascular disease), all of which can severely affect a patient's daily functioning and well-being[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Beyond its clinical manifestations, the diagnosis often requires major lifestyle changes\u0026mdash;such as dietary adjustments, glucose monitoring, and regular physical activity\u0026mdash;which may lead to emotional distress and reduced health-related quality of life (HRQoL).\u003c/p\u003e\u003cp\u003eQuality of life refers to an individual\u0026rsquo;s perception of well-being across multiple domains, including physical health, social relationships, and emotional state[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. HRQoL captures how individuals perceive the impact of health condition on their physical, psychological, and social functioning[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. This perception can influence personal decision-making and guide health professionals in tailoring patient-centered care strategies.\u003c/p\u003e\u003cp\u003eThere are few studies assessing the impact of type 2 diabetes mellitus (T2DM) on health-related quality of life (HRQoL) and its relationship with functional capacity[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Most existing research has examined isolated associations\u0026mdash;such as between HRQoL and reduced flexibility, cardiorespiratory fitness, or muscle strength\u0026mdash;without analyzing the combined effects of these factors[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e], [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Considering that HRQoL is multidimensional, assessing the interplay between disease characteristics and physical function may provide a more accurate understanding of how T2DM affects quality of life. In Brazil, as in many low- and middle-income countries, diabetes-related impairments in functional capacity and HRQoL remain under-addressed in primary care, particularly in remote regions with limited access to health services. Therefore, this study aimed to investigate whether functional capacity variables and glycemic control are predictors of HRQoL among individuals with T2DM living in a small town in northern Brazil.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1 Type of Study\u003c/h2\u003e\u003cp\u003e This is a cross-sectional predictive study approved by the Ethics Committee of the Federal University of Tocantins \u0026ndash; UFT (CAAE: 59157316.2.0000.5519).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2 Population and Sample\u003c/h2\u003e\u003cp\u003eThe study included adults with type 2 diabetes mellitus (T2DM) registered in primary care units in Tocantins, Brazil. Sample size was calculated using G-Power\u0026reg; with a minimum of 118 participants; however, convenience sampling was applied among eligible patients from all six basic health units. Inclusion criteria: age over 40, confirmed T2DM diagnosis, and SUS registration. Exclusion criteria included cognitive impairments or physical limitations that prevented participation.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3 Instruments and Variables\u003c/h2\u003e\u003cp\u003eParticipants were interviewed using a structured questionnaire (25\u0026ndash;30 minutes) covering sociodemographic data, health perception, physical activity (IPAQ, long version), and quality of life using the Diabetes Quality of Life questionnaire (DQOL), which has been validated for the Brazilian population [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. The calculation of HRQoL scores followed the method by Jacobson et al. (1994)[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Additional tests included anthropometry, blood pressure, and HbA1c. Functional capacity was assessed through validated protocols measuring strength (handgrip, sit-to-stand), flexibility, mobility (Timed Up and Go), and cardiorespiratory fitness (6-minute walk). Glycemic control was determined using HbA1c collected after fasting.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e2.4 Statistical Analysis\u003c/h2\u003e\u003cp\u003eDescriptive statistics (mean, SD, frequencies) and linear regression models were used to evaluate the association between HRQoL domains and independent variables (e.g., HbA1c, functional capacity). Assumptions were tested via Kolmogorov-Smirnov, VIF, Breusch-Pagan, and Durbin-Watson tests. Effect sizes were calculated using Cohen's f2. Variables with p-values\u0026thinsp;\u0026le;\u0026thinsp;0.20 were retained in the final model, as recommended for exploratory regression models [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], and those with a p-value greater than this were removed by the \u003cem\u003eBackward\u003c/em\u003e method. Analyses were conducted in R 3.6.2 and Excel. The dataset supporting the findings of this study is publicly available on Zenodo at the following DOI: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.5281/zenodo.15657420\u003c/span\u003e\u003cspan address=\"10.5281/zenodo.15657420\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e .\u003c/p\u003e\u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e3.1 Descriptive results\u003c/h2\u003e\u003cp\u003eConsidering a population of 624 people with DM2 and hypertensive patients treated at Basic Health Units in the city, 373 visits were carried out, of which 261 were considered losses (people who were absent, who ignored the fact of having diabetes, or who had already died at the time of the visit by the data collection team), and 12 refusals. In total, 100 people with DM2 participated in the collection with the questionnaire, which corresponds to 16% of the total population of the city and 32 (5%) had complete data (questionnaire, blood collection, and functional tests) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eConsidering the results presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, most participants were female (67.7%), 56% of respondents are married, and the majority have non-white skin color and incomplete high school (88.89% are literate). In addition, the mean age of respondents is approximately 64 years, more than 50% of respondents are middle class, and the mean BMI of respondents is approximately 27 kg/m\u003csup\u003e2\u003c/sup\u003e. Not all had complete data, so the amount of variables changed in each variable.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSociodemographic characteristics of Brazilians with DM2, in 2018.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u003cp\u003eSample\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e67.68%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e32.32%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eSkin color\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWhite\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e22.11%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot white\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e77.89%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e\u003cb\u003eSchooling\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIlliterate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11.22%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eElementary*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e58.16%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHigh school*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16.33%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHigher*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14.29%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eClass A/B\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14.94%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSocioeconomic status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eClass C\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e54.03%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eClass D/E\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e31.03%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eMean\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eSD\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge (years)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e64.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11.88\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIncome (reais/month)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1085.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e385.65\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eBMI (kg/m\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27.47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.33\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"4\"\u003e* complete and incomplete. BMI: body mass index. SD: standard deviation.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the physical characteristics of the sample. The mean time of diagnosis of diabetes mellitus was approximately 6 years, the mean systolic pressure was approximately 130 mmHg, and the mean diastolic pressure of respondents was 79.5 mmHg. As for the anthropometric characteristics, the mean abdominal circumference was approximately 95 centimeters, indicating a high value and a greater risk of cardiovascular events[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]; the mean body mass of the interviewees was approximately 68kg and the average fat percentage of the individuals was 32.06%. Regarding the variables related to functional capacity, the average strength of the upper limbs was 21.45 kgf, considered an expected value for the mean age[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]; on the other hand, lower limb strength had a mean of nine repetitions per 30 seconds, which can be considered a lower value than expected [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The mean flexibility was 23.25 cm, considered a very good mean flexibility for the age group of this sample [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. The mobility of the group, measured by the TUG, presented a mean time of 26 seconds, a value classified as a moderate risk of falls [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], while cardiorespiratory fitness had an average of approximately 400 meters in 6 minutes, which can be considered a value below the expected for the mean age[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Regarding glycemic control, the mean capillary blood glucose was 237 mg/dL and the mean glycated hemoglobin was 8.84mg/dL (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e), these values are above those recommended for people with DM2, which are 115mg/dL and 7% for fasting glucose and glycated hemoglobin, respectively[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePhysical characteristics of Brazilians with type 2 diabetes, in 2018.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e\u003cp\u003eSample\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMinimum\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMedian\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMaximum\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eStandard deviation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eReference values\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDM2 diagnosis time (months)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e79.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e72.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e360.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e48.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSystolic pressure (mmHg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e98.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e131.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e129.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e197.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e17.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDiastolic pressure (mmHg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e56.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e78.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e79.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e107.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e9.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e80\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHeart rate (bpm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e52.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e77.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e79.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e150.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e12.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHeight (m)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBody mass (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e33.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e68.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e66.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e101.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e11.47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAbdominal circumference (cm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e66.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e95.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e97.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e119.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e9.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e88 (women)\u003c/p\u003e\u003cp\u003e102 (men) [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFat percentage (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e16.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e32.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e31.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e52.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e8.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUpper limb strength (Kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e11.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e21.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e21.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e42.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e6.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e33.14[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLower limb strength (repetitions/30 seconds)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e10.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e14.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e10.0[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFlexibility (cm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e23.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e24.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e44.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e10.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e10.0[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMobility (seconds)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e26.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e25.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e45.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e7.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e10.01 and 20 s (low risk of falls)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCardiorespiratory fitness (meters)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e433.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e414.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e690.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e106.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e622 (\u0026plusmn;\u0026thinsp;80) (men)\u003c/p\u003e\u003cp\u003e551 (\u0026plusmn;\u0026thinsp;71) (women)[\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCapillary blood glucose (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e71.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e237.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e230.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e546.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e104.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGlycated hemoglobin (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e17.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e6.5\u0026ndash;7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"7\"\u003emmHg: millimeters of mercury; bpm: beats per minute (heart rate); m: meter. Kg: kilogram; Cm: centimeter; mg/dL: milligrams per deciliter.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAs shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, approximately 40% used at least 2 medications to control diabetes, only nine participants used insulin, 70% reported using other medications that were not for DM2, and almost 80% of the sample reported having some type of DM2 complication. However, when asked specifically about which complication (eye, kidney, heart, or foot problems) the majority reported not having the complication or any other health problem, with the exception of hypertension, which was the most commonly reported complication among the participants (63.54%) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). These data are important because they emphasize the importance of information for the patient during the consultations, as considering that the DM2 diagnosis time had an average of six years, it is possible that the patients already have some complications, but have no knowledge about them or have not been informed about them by the doctor.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCharacteristics of chronic complications of Brazilians with type 2 diabetes, in 2018.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eSample\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eItems\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eSelf-reported complications\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e79.17%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e20.83%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRetinopathy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e41.67%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e58.33%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDiabetic foot\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.21%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e94.79%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNephropathy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e17.71%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e82.29%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypertension\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e63.54%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e36.46%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHeart disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e12.50%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e87.50%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNeuropathy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e11.46%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e88.54%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOther health problems\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4.17%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e95.83%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eIn Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, approximately 41% of the participants are overweight and most of the participants were classified as physically inactive. Regarding the assessment of quality of life, and perception of their sleep health status, almost all participants perceived all these aspects as \u0026ldquo;regular\u0026rdquo;.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThe HRQoL of the sample is presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. The data show that the mean score of the general quality of life was 70.8 points, which indicates a high HRQoL, from a score of 0 to 100 points. Regarding domains, the social/vocational concerns domain received the highest score, followed by diabetes-related concerns and diabetes impact. The domain with the lowest score, indicating the lowest HRQoL, was the Satisfaction with treatment domain.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eWith respect to the association between HRQoL, DM2 characteristics, variables related to functional capacity, and glycemic control, Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e presents the linear regression models for each domain and the overall HRQoL score. Thirty-two observations that had complete data to compose the multiple linear regression model were considered for analysis. Considering the final sample size, the Effect Size was calculated using the Cohen test, and the result indicated an effect size of 1.09, considered high for the sample[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eLinear regression models (baseline and adjusted) between Health-Related Quality of Life (HRQoL) and independent variables of Brazilians with type 2 diabetes, in 2018.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDependent variables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIndependent variables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eβ\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eStandard error\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003et-value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e1. Satisfaction with treatment\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eBase model (R\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u0026thinsp;\u003cb\u003e=\u0026thinsp;11.8%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntercept\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-109.783\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e64.379\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.705\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.102 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDTDM2 (years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.907\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.118\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.811\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.426\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo complications from DM2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.785\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7.241\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.523\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.606\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStrength of upper limbs (Kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.273\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.690\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.397\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.695\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStrength of lower limbs (rep.)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.122\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.499\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.082\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.049 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFlexibility (cm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.271\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.287\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.945\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.355\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMobility (seconds)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.200\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.070\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.056\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.051 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCardiorespiratory fitness (m)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.161\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.084\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.914\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.068 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHbA1c (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.195\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.383\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.141\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.889\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFinal model\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e(R\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u0026thinsp;\u003cb\u003e=\u0026thinsp;12.5%)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e(ES\u0026thinsp;=\u0026thinsp;1.09)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntercept\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21.596\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14.551\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.484\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.149 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo complications from DM2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7.878\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.955\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.323\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.197 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStrength of upper limbs (Kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.489\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.342\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.855\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.074 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStrength of lower limbs (rep.)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.360\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.276\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.303\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.200 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003e2. Impact of Diabetes\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eBase model\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e(R\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u0026thinsp;\u003cb\u003e=\u0026thinsp;0.8%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntercept\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e34.366\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e62.434\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.550\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.587\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDTDM2 (years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.511\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.084\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.471\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.642\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo complications from DM2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.186\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7.023\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.027\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.979\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStrength of upper limbs (Kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.422\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.669\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.632\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.534\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStrength of lower limbs (rep.)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.476\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.454\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.703\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.102 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFlexibility (cm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.233\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.278\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.839\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.410\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMobility (seconds)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.550\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.038\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.531\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.601\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCardiorespiratory fitness (m)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.052\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.082\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.638\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.530\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHbA1c (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-2.332\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.341\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.739\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.095 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFinal model\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntercept\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e72.475\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16.245\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.461\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001 *\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003e(R\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u0026thinsp;\u003cb\u003e=\u0026thinsp;14.4%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStrength of lower limbs (rep.)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.104\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.216\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.731\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.094 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003e(ES\u0026thinsp;=\u0026thinsp;1.07)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHbA1c (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-2.109\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.122\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.880\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.070 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003e3. Social/vocational concerns\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntercept\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003e(R\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u0026thinsp;\u003cb\u003e=\u0026thinsp;14.3%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDTDM2 (years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.829\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.557\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.489\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.150 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo complications from DM2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7.066\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3.604\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.960\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.062 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStrength of upper limbs (Kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.183\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.343\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.533\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.599\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStrength of lower limbs (rep.)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.652\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.746\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.874\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.391\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFlexibility (cm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.296\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.143\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.075\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.049 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMobility (seconds)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.605\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.533\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.135\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.268\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCardiorespiratory fitness (m)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.077\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.042\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.828\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.080 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHbA1c (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-1.435\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.688\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-2.086\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.048 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFinal model\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e(R\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u0026thinsp;\u003cb\u003e=\u0026thinsp;0.125%)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e(ES\u0026thinsp;=\u0026thinsp;0.14)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntercept\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e96.261\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6.893\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13.966\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001 *\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFlexibility (cm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.260\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.139\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.872\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.071 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHbA1c (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.955\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.626\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.525\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.138 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003e4. Diabetes-related concerns\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e(R\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u0026thinsp;\u003cb\u003e=\u0026thinsp;\u0026minus;\u0026thinsp;0.044%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntercept\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-18.018\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e98.268\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.183\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.856\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDTDM2 (years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.106\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.707\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.234\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.230\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo complications from DM2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14.331\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11.053\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.297\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.208\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStrength of upper limbs (Kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.550\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.053\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.522\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.607\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStrength of lower limbs (rep.)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.736\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.289\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.196\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.244\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFlexibility (cm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.219\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.438\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.501\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.621\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMobility (seconds)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.521\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.633\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.931\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.361\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCardiorespiratory fitness (m)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.041\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.128\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.317\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.754\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHbA1c (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-2.950\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.110\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.398\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.176 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFinal model*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003e5. Overall HRQoL score\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eBase model\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e(R\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u0026thinsp;\u003cb\u003e=\u0026thinsp;11.8%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntercept\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-2.448\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e49.861\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.049\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.961\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDTDM2 (years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.236\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.866\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.272\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.788\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo complications from DM2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.637\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.608\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.648\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.523\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStrength of upper limbs (Kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.019\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.534\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.035\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.972\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStrength of lower limbs (rep.)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.432\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.161\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.094\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.048 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFlexibility (cm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.254\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.222\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.143\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.265\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMobility (seconds)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.997\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.829\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.203\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.241\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCardiorespiratory fitness (m)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.067\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.065\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.029\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.314\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHbA1c (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-1.425\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.071\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.331\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.196 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFinal model\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e(R\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u0026thinsp;\u003cb\u003e=\u0026thinsp;12.5%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntercept\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e53.617\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14.777\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.628\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.001 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003e(ES\u0026thinsp;=\u0026thinsp;1.09)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDTDM2 (years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.524\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.724\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.723\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.476\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStrength of lower limbs (rep.)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.932\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.013\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.906\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.067 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFlexibility (cm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.318\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.210\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.513\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.142 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHbA1c (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-1.307\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.990\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.321\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.198 *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e\u003cp\u003e* A model was not found in which the independent variables had an influence on the dependent variable and the assumptions of linear regression were met. N: Newtons; DTDM2: DM2 diagnosis time; rep: repetitions for 30 seconds; m: meters; kg: kilogram; cm: centimeter; m: meter; HbA1c (%) \u0026ndash; glycated hemoglobin percentage. ES: effect size according to the calculation of Cohen's f\u003csup\u003e2\u003c/sup\u003e value. Total observations in each model (n): 32 participants.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eObserving the results of Table \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, several variables placed in the model were significant, considering a 20% level of significance. Below, five multiple linear regression models will be presented, covering the associations between the HRQoL and its respective domains, the characteristics of DM2, the variables related to functional capacity, and glycemic control.\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eSatisfaction with treatment domain\u003c/span\u003e\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003eModel 1 analyzed the associations between independent variables and satisfaction with treatment domain. Not having DM2 complications (β\u0026thinsp;=\u0026thinsp;7.9; p\u0026thinsp;=\u0026thinsp;0.197), upper limb strength (β\u0026thinsp;=\u0026thinsp;2.5; p\u0026thinsp;=\u0026thinsp;0.074), and lower limb strength (β\u0026thinsp;=\u0026thinsp;0.360; p\u0026thinsp;=\u0026thinsp;0.2) were associated with this domain. The adjusted model showed that these variables predict 12.5% of the HRQoL satisfaction with treatment domain. Participants who reported no complications had seven points more on the HRQoL than those who had some type of complication resulting from DM2. In addition, those with more strength in the upper and lower limbs also had a better perception of satisfaction with the treatment (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eImpact of diabetes mellitus\u003c/span\u003e \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003edomain\u003c/span\u003e\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003eConsidering the impact of DM2, the results shown in model 2 indicated a positive association with lower limb strength (β\u0026thinsp;=\u0026thinsp;2.104; p\u0026thinsp;=\u0026thinsp;0.094) and an inverse association with glycated hemoglobin (β = -2.109; p\u0026thinsp;=\u0026thinsp;0.070). The final model explained 14.4% (R\u003csup\u003e2\u003c/sup\u003e) of the variation in the dependent variable. With each addition of one unit in the sit to stand test, the HRQoL score increased by 2.104 points; whereas with each addition of one unit in glycated hemoglobin, there was a decrease of 2 points in terms of the impact of the disease on the HRQoL.\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eSocial/vocational concerns domain\u003c/span\u003e\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003eModel 3 demonstrates the associations of independent variables with the social/vocational concerns domain. Only flexibility had a positive association with this HRQoL domain (β\u0026thinsp;=\u0026thinsp;0.260; p\u0026thinsp;=\u0026thinsp;0.071), while the association with glycated hemoglobin was inverse (β = -0.955; p\u0026thinsp;=\u0026thinsp;0.138), and R\u003csup\u003e2\u003c/sup\u003e was 0.125%.\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eDiabetes-related concerns domain\u003c/span\u003e\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003eModel 4 refers to the association between the independent variables and the diabetes-related concerns domain. Initially, the base model was analyzed, but a model was not found in which the independent variables had an influence on the dependent variable and the assumptions of linear regression were met, even though all possible combinations between the variables were tested for the realization of the model, however none of the combinations were significant. Thus, the normal linear model is not suitable for thwaw data.\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eOverall HRQoL score\u003c/span\u003e\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003eLower limb strength (β\u0026thinsp;=\u0026thinsp;1.932; p\u0026thinsp;=\u0026thinsp;0.067), flexibility (β\u0026thinsp;=\u0026thinsp;0.318; p\u0026thinsp;=\u0026thinsp;0.142), and glycated hemoglobin (β = -1.307; p\u0026thinsp;=\u0026thinsp;0.198) were associated with the overall HRQoL score in model 5; this final model predicts 12.5% of the variation in HRQoL. With each increase of one unit in the sit to stand test, the overall quality of life increased by almost two points, and with each increase of one unit in glycated hemoglobin, the general quality of life decreased by 1.307 points.\u003c/p\u003e\u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThis study aimed to examine whether characteristics of type 2 diabetes mellitus (T2DM), functional capacity, and glycemic control are predictors of health-related quality of life (HRQoL) among Brazilian adults living with T2DM. Our findings indicate that a shorter duration of diagnosis (less than ten years), absence of diabetes-related complications, greater upper and lower limb strength, and higher levels of flexibility were positively associated with better HRQoL and its domains, including satisfaction with treatment (R2\u0026thinsp;=\u0026thinsp;12.5%), impact of diabetes (R2\u0026thinsp;=\u0026thinsp;14.4%), social/vocational concerns (R2\u0026thinsp;=\u0026thinsp;0.125%), and diabetes-related concerns. Conversely, higher levels of glycated hemoglobin were inversely associated with HRQoL (β = -1.307; p\u0026thinsp;=\u0026thinsp;0.198), suggesting that poor glycemic control may negatively influence individuals' perception of the disease and their social well-being.\u003c/p\u003e\u003cp\u003ePrevious studies have consistently identified several predictors of HRQoL in patients with T2DM, including female sex [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e], advanced age [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e], [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], and lower socioeconomic status [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Additional negative predictors include insulin use [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], complex pharmacological treatment [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], longer disease duration [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], presence of comorbidities or complications [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e], and hospitalization history [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Psychosocial stressors such as limited social support, negative coping mechanisms, and low cognitive appraisal also appear to be associated with diminished HRQoL.\u003c/p\u003e\u003cp\u003ePhysical health factors\u0026mdash;frequently exacerbated by T2DM\u0026mdash;such as elevated body mass index [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], reduced flexibility [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], poor cardiorespiratory fitness [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], diminished muscle strength[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e], metabolic syndrome [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], chronic pain [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e], and fall risk [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e], have also demonstrated negative associations with HRQoL. These findings have been replicated across various regions, including Europe, Asia, and Latin America.\u003c/p\u003e\u003cp\u003eThe heterogeneity of instruments used in HRQoL assessment complicates cross-study comparisons. Each tool is grounded in different theoretical frameworks and captures distinct domains, limiting generalizability. The present study addressed this limitation by employing the DQOL, a validated instrument specifically designed for individuals with diabetes and culturally adapted for the Brazilian population [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eOur data indicates that functional capacity variables exert considerable influence on HRQoL in individuals with T2DM. These relationships are further shaped by sociodemographic and cultural contexts, especially in a country as diverse as Brazil.\u003c/p\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003e4.1 HRQoL and Diabetes Complications\u003c/h2\u003e\u003cp\u003eAbsence of chronic complications was associated with an increase of up to seven points in the satisfaction with treatment domain (R2\u0026thinsp;=\u0026thinsp;12.5%). Previous research has shown that complications such as retinopathy, nephropathy, and neuropathy triple the likelihood of poor HRQoL [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. This finding supports the notion that awareness of one's complication status may enhance engagement in preventive behaviors and disease management, generating a positive feedback loop.\u003c/p\u003e\u003cp\u003eDrawing on Orem's Self-Care Theory [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e], self-care comprises basic capabilities, health knowledge, and action. In T2DM management, self-care is essential for preventing complications and improving HRQoL. In this sample, self-care practices such as medication adherence, dietary regulation, and foot self-examination were relatively common [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e], [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e], [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. However, practices like blood glucose monitoring and physical activity remain insufficient, indicating gaps in comprehensive self-management.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003e4.2 HRQoL and Muscle Strength\u003c/h2\u003e\u003cp\u003eGreater upper limb strength was associated with better satisfaction with treatment (R2\u0026thinsp;=\u0026thinsp;12.5%), although mean grip strength in the sample was below normative values for the age group [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. T2DM is known to impair protein metabolism, accelerating muscle loss. This condition, combined with disease duration and age, may lead to sarcopenia, reduced functionality, and lower HRQoL [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e], [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e], [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eWhile some studies suggest that improved muscle strength reduces insulin resistance [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e], others, such as Giglio et al. (2018)[\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e], found no significant relationship between grip strength and hyperglycemia. In this study, despite reduced strength, participants reported satisfaction with care, possibly reflecting the perceived adequacy of care provided by the Brazilian Unified Health System (SUS).\u003c/p\u003e\u003cp\u003eLower limb strength also emerged as a key factor influencing the impact of diabetes on HRQoL (R2\u0026thinsp;=\u0026thinsp;14.4%) and the overall HRQoL score (R2\u0026thinsp;=\u0026thinsp;12.5%). Given the relationship between muscle weakness, decreased mobility, and fall risk [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e], [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e], promoting muscle strength may mitigate negative health outcomes and enhance well-being.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003e4.3 HRQoL and Flexibility\u003c/h2\u003e\u003cp\u003eFlexibility was positively associated with better HRQoL, especially in the social/vocational domain (β\u0026thinsp;=\u0026thinsp;0.260; p\u0026thinsp;=\u0026thinsp;0.071). Hyperglycemia-induced collagen glycation can increase joint stiffness and contribute to musculoskeletal complications such as tendinopathies and capsulitis [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. These conditions limit daily function and can affect mental health [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. Despite this, participants in our study demonstrated good flexibility levels, which may help explain their relatively positive HRQoL assessments.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003e4.4 HRQoL and Glycemic Control\u003c/h2\u003e\u003cp\u003eElevated HbA1c levels were inversely related to both overall HRQoL and the social/vocational concerns domain (β = -1.307 and \u0026minus;\u0026thinsp;0.955, respectively). These findings are aligned with prior literature indicating associations between poor glycemic control and cardiovascular risk, increased BMI, insulin resistance, and reduced treatment responsiveness [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e], [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e], [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eA psychoeducational intervention conducted in Saudi Arabia demonstrated improvements in both HbA1c and HRQoL scores following education on diabetes management [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. These results underscore the importance of patient understanding in fostering effective self-care and emotional well-being. The ADA (2000) also identifies the burdens of self-management, symptom vigilance, and fear of complications as key determinants of HRQoL. A bidirectional relationship appears to exist as glycemic control deteriorates, HRQoL worsens; conversely, enhanced well-being may promote adherence and metabolic stability [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003e4.5 Limitations and Strengths\u003c/h2\u003e\u003cp\u003eA primary limitation of this study was the substantial loss of participants due to registration issues in local health units, which restricted the sample size for multivariate analysis. Nonetheless, the study's strengths include the use of a diabetes-specific, culturally validated HRQoL instrument, detailed characterization of a remote Brazilian population, and the integration of multiple physical and clinical variables. As the first Brazilian investigation to examine the relationship between functional capacity and HRQoL among individuals with T2DM, this study provides foundational insights to inform future research and public health strategies.\u003c/p\u003e\u003c/div\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eVariables related to disease characteristics (diagnosis time of less than ten years and no DM2 complications) and variables related to functional capacity (upper and lower limb strength and flexibility) were positively associated with better HRQoL and its domains (satisfaction with treatment, DM2 impact, social/vocational concerns, and DM2-related concerns). On the other hand, glycated hemoglobin demonstrated an inverse association with HRQoL, indicating that poor glycemic control can worsen the perception of the Impact of the disease and the social concerns of people with diabetes.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the \u003cem\u003eComit\u0026ecirc; de \u0026Eacute;tica em Pesquisa com Seres Humanos da Universidade Federal do Tocantins (CEP/UFT)\u003c/em\u003e \u0026ndash; Ethics Committee for Research Involving Human Subjects at the Federal University of Tocantins, under protocol CAAE: 59157316.2.0000.5519.\u003c/p\u003e\n\u003cp\u003eThe research complied with the ethical principles outlined in Resolution No. 466/2012 of the Brazilian National Health Council and the Declaration of Helsinki.\u003cbr\u003e\u0026nbsp;All participants were fully informed about the aims, procedures, potential risks, and benefits of the study. Participation was voluntary, and all individuals provided written consent by signing a Free and Informed Consent Form (FICF) prior to inclusion.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll participants provided written informed consent (\u003cem\u003eTermo de Consentimento Livre e Esclarecido \u0026ndash; TCLE\u003c/em\u003e) authorizing the use and publication of anonymized data collected for the purposes of this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are publicly available in the Zenodo repository at: https://doi.org/10.5281/zenodo.15657420.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was carried out with the author\u0026rsquo;s own funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eJMSL and WRM participated in the conception, planning, execution of the research, data analysis, and writing of the manuscript. DMMV, SCRR, ALAR, JLBG, and LGGP participated in the analysis of the results, writing of the manuscript, and critical review of the discussion.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank the participants of this research, as well as the professors and technicians of the Federal University of Northern Tocantins \u0026ndash; UFNT, Tocantin\u0026oacute;polis Campus, and the members of the \u003cem\u003eResearch Group on Physical Activity and Chronic Diseases (GEPAFD)\u003c/em\u003e and the \u003cem\u003eResearch Group on Functional Reeducation and Human Performance (ReDe)\u003c/em\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eI. D. 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Ribeiro, \u0026ldquo;Autocuidado de pacientes com Diabetes Mellitus tipo 2,\u0026rdquo; \u003cem\u003eSemina: Ci\u0026ecirc;ncias Biol\u0026oacute;gicas e da Sa\u0026uacute;de\u003c/em\u003e, vol. 40, no. 1, pp. 75\u0026ndash;88, 2019.\u003c/li\u003e\n\u003cli\u003eM. C. Larr\u0026eacute;, L. M. Ottero, C. R. de S. Teixeira, M. L. Zanetti, A. D. de M. Inagaki, and A. C. F. Abud, \u0026ldquo;Autocuidado dos pacientes com diabetes mellitus tipo 2 em seguimento ambulatorial,\u0026rdquo; \u003cem\u003eRevista Nursing\u003c/em\u003e, vol. 21, no. 245, pp. 2385\u0026ndash;2390, 2018.\u003c/li\u003e\n\u003cli\u003eR. P. McGrath \u003cem\u003eet al.\u003c/em\u003e, \u0026ldquo;The Association Between Handgrip Strength and Diabetes on Activities of Daily Living Disability in Older Mexican Americans,\u0026rdquo; \u003cem\u003eJ Aging Health\u003c/em\u003e, vol. 30, no. 8, pp. 1305\u0026ndash;1318, 2018.\u003c/li\u003e\n\u003cli\u003eS. K. Kunutsor, N. M. Isiozor, H. Khan, and J. A. Laukkanen, \u0026ldquo;Handgrip strength\u0026mdash;A risk indicator for type 2 diabetes: Systematic review and meta‐analysis of observational cohort studies,\u0026rdquo; \u003cem\u003eDiabetes Metab Res Rev\u003c/em\u003e, vol. 37, no. 2, p. e3365, 2021.\u003c/li\u003e\n\u003cli\u003eS. Y. Park and I. H. Lee, \u0026ldquo;Effects on training and detraining on physical function, control of diabetes and anthropometrics in type 2 diabetes; A randomized controlled trial,\u0026rdquo; \u003cem\u003ePhysiother Theory Pract\u003c/em\u003e, 2015, doi: 10.3109/09593985.2014.958265.\u003c/li\u003e\n\u003cli\u003eB. M. Giglio, J. F. Mota, B. T. Wall, and G. D. Pimentel, \u0026ldquo;Low Handgrip Strength Is Not Associated with Type 2 Diabetes Mellitus and Hyperglycemia: a Population-Based Study,\u0026rdquo; \u003cem\u003eClin Nutr Res\u003c/em\u003e, vol. 7, no. 2, pp. 112\u0026ndash;116, 2018.\u003c/li\u003e\n\u003cli\u003eT. Nomura, T. Kawae, H. Kataoka, and Y. 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Jalving \u003cem\u003eet al.\u003c/em\u003e, \u0026ldquo;Glycaemic control in the diabetes and Lifestyle Cohort Twente: A cross-sectional assessment of lifestyle and pharmacological management on Hba1c target achievement.,\u0026rdquo; \u003cem\u003eDiabetes Obes Metab.\u003c/em\u003e, vol. 20, no. 10, pp. 2494\u0026ndash;2499, 2018.\u003c/li\u003e\n\u003cli\u003eA. Trikkalinou, A. K. Papazafiropoulou, and A. Melidonis, \u0026ldquo;Type 2 diabetes and quality of life,\u0026rdquo; \u003cem\u003eWorld J Diabetes\u003c/em\u003e, vol. 8, no. 4, p. 120, 2017.\u003c/li\u003e\n\u003cli\u003eA. M. Iwama, G. N. de Andrade, P. Shima, S. E. Tanni, I. de Godoy, and V. Z. Dourado, \u0026ldquo;The six-minute walk test and body weight-walk distance product in healthy Brazilian subjects,\u0026rdquo; \u003cem\u003eBrazilian Journal of Medical and Biological Research\u003c/em\u003e, vol. 42, pp. 1080\u0026ndash;1085, 2009.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Type 2 Diabetes Mellitus, Health-Related Quality of Life, Functional Capacity, Glycemic Control, Self-Care, Rural Health","lastPublishedDoi":"10.21203/rs.3.rs-7076089/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7076089/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eType 2 diabetes mellitus (T2DM) is a growing public health concern in Brazil, especially in underserved regions where social and geographic barriers may affect disease management and quality of life. Functional capacity and health-related quality of life (HRQoL) are critical dimensions often overlooked in primary care approaches.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eTo assess the functional capacity and HRQoL of individuals with T2DM receiving care in primary health units in Tocantin\u0026oacute;polis, Northern Brazil, and to explore associations with sociodemographic and clinical variables.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eThis is a cross-sectional, descriptive, and analytical study involving 99 adults diagnosed with T2DM. Functional capacity was evaluated using the International Physical Activity Questionnaire (IPAQ), and HRQoL was assessed through the WHOQOL-bref. Sociodemographic and clinical data were also collected. Statistical analysis included descriptive statistics and correlation tests.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eMost participants were women (71%), with a mean age of 58.7 years. The physical and psychological domains of WHOQOL-bref presented the lowest scores, while the social domain had the highest. Functional capacity was low for the majority of participants. There were significant associations between low physical activity levels and poorer HRQoL scores in the physical and psychological domains.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eIndividuals with T2DM in this sample presented reduced functional capacity and compromised HRQoL, particularly in domains related to physical and psychological well-being. These findings highlight the urgent need for integrated health strategies in primary care that address physical activity and emotional support for people living with diabetes in remote and low-resource settings.\u003c/p\u003e","manuscriptTitle":"Living with Diabetes: Quality of Life and Functional Impairment among Adults with Type 2 Diabetes in Northern Brazil","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-29 11:29:16","doi":"10.21203/rs.3.rs-7076089/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-10-16T23:47:05+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-16T15:00:55+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"120481888544264480338071049460557510212","date":"2025-10-14T19:59:54+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-30T23:07:17+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"316293942073770693114947919183791548452","date":"2025-07-24T21:11:23+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-07-24T04:52:19+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-07-10T09:42:24+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-09T06:00:19+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-09T03:13:09+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2025-07-08T14:43:47+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6d548f78-79c4-41ad-9eeb-de9078f63b83","owner":[],"postedDate":"July 29th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":52085260,"name":"Health sciences/Diseases"},{"id":52085261,"name":"Health sciences/Endocrinology"},{"id":52085262,"name":"Health sciences/Health care"},{"id":52085263,"name":"Health sciences/Medical research"}],"tags":[],"updatedAt":"2026-01-22T07:44:03+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-29 11:29:16","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7076089","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7076089","identity":"rs-7076089","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}