Adherence to Dietary Recommendation and Its Associated Factors among People with Type 2 Diabetes: A Cross-Sectional Study in Nepal

Abstract

Introduction. Intensive lifestyle modification including a healthy diet changes the diagnostic status of patient from prediabetes to nondiabetes. In type 2 diabetes, improper eating habits increase insulin resistance. This study is aimed at assessing adherence to the dietary recommendation and its associated factors among people with type 2 diabetes. Methods. A cross-sectional descriptive study was conducted among systematically sampled type 2 diabetic patients using interview on Gandaki Medical College Teaching Hospital and Diabetes, Thyroid, and Endocrinology Care Center, Pokhara. The Perceived Dietary Adherence Questionnaire was used to assess dietary adherence. Data was entered in EpiData version 3.1 and analyzed on SPSS version 20. Logistic regression with adjusted odds ratio and the corresponding 95% confidence intervals were used to find out significance of association. Results. Among 204 participants, only 15.7% of the participants had good dietary adherence. The mean age and standard deviation were 53.03 ± 11.90 years. Factors such as participants living in single family (AOR 2.7, 95% CI 1.0-7.4), participants who could afford recommended diet (AOR 2.9, 95% CI 1.0-8.3), participants having self-control on food (AOR 4.1, 95% CI 1.2-14.1), participants who were engaged in moderate to heavy physical activities (AOR 3.3, 95% CI 1.2-9.2), and participants who had adherence to medication (AOR 3.5, 95% CI 1.2-10.1) were significantly associated with adherence to dietary recommendation. Conclusions. Adherence to dietary recommendation among people with type 2 diabetes was low. Factors such as family type, affordability of recommended diet, self-control on food, physical activity, and medication adherence were significantly associated with adherence to dietary recommendations among people with type 2 diabetes. These factors should be considered by nutrition counselors and clinical decision-makers in patient counseling regarding dietary adherence.

Adherence of Diabetic Patients to Healthy Lifestyle and Medication and Its Impact on Glycemic Control, Complications of Diabetes and Quality of Life: A Hospital Based Cross-Section Study in Benha City, Egypt

“…They demonstrated that 78.8 % adhered to the diet prescribed by their physicians. Consistent with our results, a study [13] revealed that adherence to a restricted diet amounted to a mere 15.7%. An analogous result was observed in Kathmandu, where the rate of adherence was 12.9%, and Dhaka, Bangladesh, where it stood at 14.29% [14] .…”

“…According to Baral et al [13] no association was found between comorbidity and dietary adherence. In contrast, patients who did not have comorbidities were more likely to adhere to their diets, according to an Ethiopian study [16] .…”

“…A study reported that there was no relation between the type of treatment and adherence to diet [13] . However, according to a study conducted in Saudi Arabia, those who took oral medications adhere to their diets better than those who take both insulin and oral medications [18] .…”

“…A research study conducted by Baral et al [13] identified a significant association between family structure and dietary adherence. Specifically, the study found that individuals residing in single-parent households were 2.7 times more likely to adhere to their diets compared to those in joint-family households.…”

“…The results indicated that adherence to medication is more strongly related with the following variables: selfcontrol over food, affordability of diet, physical activity, and medication. A relationship exists between dietary adherence and the type of family (social factor), with single-parent households being more likely to adhere to a diet [13] .…”