Factors associated with diet barriers in patients with poorly controlled type 2 diabetes

Abstract

BackgroundThe study was conducted to investigate the diet barriers perceived by patients with poorly controlled type 2 diabetes and examine the associations between diet barriers and sociodemographic characteristics, medical condition, and patient-centered variables.MethodsSecondary subgroup analyses were conducted based on the responses of 246 adults with poorly controlled type 2 diabetes from a multicenter, cross-sectional study. Diet barriers were captured by the Diet Barriers subscale of the Personal Diabetes Questionnaire. Participants also completed validated measures of diet knowledge, empowerment level, and appraisal of diabetes. Multiple regression techniques were used for model building, with a hierarchical block design to determine the separate contribution of sociodemographic characteristics, medical condition, and patient-centered variables to diet barriers.ResultsDiet barriers were moderately evident (2.23±0.86) among Chinese patients with poorly controlled type 2 diabetes. The feeling of deprivation as a result of complying with a diet was the most recognized diet barrier (3.24±1.98), followed by “eating away from home” (2.79±1.82). Significantly higher levels of diet barriers were observed among those with lower levels of diet knowledge (β=−0.282, P<0.001) and empowerment (β=−0.190, P=0.015), and more negative appraisal (β=0.225, P=0.003).ConclusionCulturally tailored, patient-centered intervention programs that acknowledge individuals’ preferences and allow for flexibility in diet management should be launched. Interventions programs that could enhance diet knowledge, promote positive appraisal, and improve empowerment level might effectively address diet barriers perceived by patients with poorly controlled type 2 diabetes.

Distress and its association with self-care in people with type 2 diabetes

“…Besides, failures in the provision of information were associated to low adherence to drug treatment, lack of regular physical exercise, and consumption of foods with high sugar content. These findings are coherent with previous studies which mentioned that not having received or understood the information about portions and the frequency of meals may be associated with low adherence to diet in diabetic patients (Ranasinghe et al, 2015;Cheng et al, 2016;Parajuli, Saleh, Thapa & Ali, 2014). Thence, it is important that the information provided to the diabetic patient has clear recommendations for self-care, expressed in a kind of language that the patient may fully understand.…”

“…Thence, it is important that the information provided to the diabetic patient has clear recommendations for self-care, expressed in a kind of language that the patient may fully understand. Myths or erroneous beliefs regarding self-care may increase due to lack of information, provoking the sensation of being deprived and denied medical recommendations (Cheng et al, 2016). The high prevalence of distress in type 2 diabetes patients compared to general population and its association with self-care suggests the importance of its screening and care in family practice.…”

Factors associated with glycaemic control in patients with diabetes mellitus: A systematic literature review

“…Gao et al () also reported that self‐efficacy affected glycaemic levels indirectly through the mediation of self‐care behaviours among Chinese patients with type 2 DM. Greater self‐efficacy led to better self‐management and improved glycaemic control (Beard, Clark, Hurel, & Cooke, ; Cheng et al, ). Hence, these studies concluded that self‐efficacy affected glycaemic levels among adults with type 2 DM.…”

“…Despite the availability of many primary studies that have investigated the factors associated with glycaemic control among patients with type 1 or 2 diabetes, attempts to amalgamate these evidences have been methodologically limited. According to a preliminary literature review (Ahola & Groop, ; Cattaneo & Chapman, ; Cheng et al, ; Cheng, Wu, Dawkes, Lim, & Wang, ; Ho, Berggren, & Dahlborg‐Lyckhage, ; Peyrot et al, ; Strychar, Elisha, & Schmitz, ), 10 factors (age, ethnicity, socio‐economic status, duration of disease, medication usage, comorbidity, body mass index, diet knowledge, self‐efficacy and level of empowerment) were proposed as the influencing factors. The systematic literature review sought to provide a robust review of the evidence to explore these influencing factors on glycaemic control in patients with DM.…”

Levels and Barriers of Glycemic Control and Self-Management Among Diabetic Patients in Primary Health Care in Jeddah: A Cross-Sectional Study.

“…Aljabri reported that only 9.5% of patients with type I diabetes in Jeddah achieved glycemic control (19), while another study found that10.5% of participants achieved glycemic control (13). Worldwide, comparable findings have been reported in both developed and developing countries, with up to38.7% of patients achieving optimal glycemic control, with some variation between different populations and settings (22,24,26,(42)(43)(44)(45)(46). Consistent with our findings, a range of demographic and clinical factors affect glycemic control, with varying levels of significance.…”