Ultra-Processed Food Consumption Is Independently Associated with Higher HbA1c and Poor Glycemic Control in Adults with Type 2 Diabetes

Background/Objectives: Ultra-processed food (UPF) consumption has been linked to type 2 diabetes mellitus (T2DM) incidence, but its association with glycemic control in individuals already living with T2DM remains less well characterized. We evaluated the relationship between UPF consumption, assessed with the Turkish version of the short Screening Questionnaire of Highly Processed Food Consumption (sQ-HPF), and HbA1c and poor glycemic control in adults with T2DM. Methods: In this single-centre, cross-sectional observational study, 425 adults aged 18–65 years with T2DM of at least 6 months’ duration were consecutively recruited at a tertiary general internal medicine outpatient clinic. UPF consumption was assessed with the Turkish sQ-HPF (range 0–11; scores ≥ 6 = high UPF consumption). HbA1c was the primary outcome (continuous and dichotomized at 7.0%). Multiple linear and binary logistic regression analyses were performed with hierarchical adjustment for age, sex, body mass index (BMI), diabetes duration, and insulin-based treatment. Results: Total UPF score was positively correlated with HbA1c (r = 0.423, p < 0.001). In the fully adjusted linear model, each one-point increase in total UPF score was associated with a 0.418% higher HbA1c (95% CI: 0.333–0.503; β = 0.413; p < 0.001), explaining 28.9% of HbA1c variance. In the fully adjusted logistic model, each one-point increase in total UPF score was associated with 25.0% higher odds of poor glycemic control (OR = 1.250, 95% CI: 1.110–1.408, p < 0.001). Insulin-based treatment and male sex were also independent predictors. UPF score was not significantly associated with lipid parameters or C-reactive protein. Conclusions: Higher UPF consumption, captured by a brief validated screener, was independently associated with poorer glycemic control in Turkish adults with T2DM. Brief UPF screening may help identify patients who would benefit from targeted nutritional intervention.