Level of dietary adherence and determinants among type 2 diabetes population in Ethiopian: A systemic review with meta-analysis

Abstract

Background The beneficial effect of the dietary practice is significant reduction in the risk of developing diabetes related complication. Dietary practice among type 2 diabetes is not well-implemented in Ethiopia. Up to now, in the nation, several primary observational studies have been done on dietary adherence level and its determinants among type 2 diabetes. However, a comprehensive review that would have a lot of strong evidence for designing intervention is lacking. So, this review with a meta-analysis was conducted to bridge this gap. Methods A systematic review of an observational study is conducted following the PRISMA checklist. Three reviewers have been searched and extracted from the World Health Organization- Hinari portal (SCOPUS, African Index Medicus, and African Journals Online databases), PubMed, Google Scholar and EMBASE. Articles’ quality was assessed using the Newcastle-Ottawa Scale by two independent reviewers, and only studies with low and moderate risk were included in the final analysis. The review presented the pooled proportion dietary adherence among type2 diabetes and the odds ratios of risk factors favor to dietary adherence after checking for heterogeneity and publication bias. The review has been registered in PROSPERO with protocol number CRD42020149475. Results We included 19 primary studies (with 6, 308 participants) in this meta-analysis. The pooled proportion of dietary adherence in the type 2 diabetes population was 41.05% (95% CI: 34.86–47.24, I2 = 93.1%). Educational level (Pooled Odds Ratio (POR): 3.29; 95%CI: 1.41–5.16; I2 = 91.1%), monthly income (POR: 2.50; 95%CI: 1.41–3.52; I2 = 0.0%), and who had dietary knowledge (POR: 2.19; 95%CI: 1.59–2.79; I2 = 0.0%) were statistically significant factors of dietary adherence. Conclusion The overall pooled proportion of dietary adherence among type 2 diabetes in Ethiopia was below half. Further works would be needed to improve dietary adherence in the type 2 diabetes population. So, factors that were identified might help to revise the plan set by the country, and further research might be required to health facility fidelity and dietary education according to diabetes recommended dietary guideline.

Prevalence and factors associated with dietary adherence in individuals with type 2 diabetes mellitus in Brazil: a systematic review with meta-analysis

“…29 However, as observed in our review, the prevalence of adherence to T2DM treatment in Brazil is not ideal for any of the three pillars. In a systematic review with a meta-analysis conducted in Ethiopia, 30 the combined prevalence of diet adherence by people with T2DM was 41.05% (95% CI: 34.86-47.24, I 2 = 93.1%), showing similarity with this meta-analysis carried out in Brazil, which can be explained by the fact that low income and lower education were determinants of adherence in both countries. In a meta-analysis carried out in the United States, 31 the combined prevalence of adherence to physical activity was 77% (95% CI= 0.68; 0.84), which is higher than that performed with Brazilians.…”

“…Some authors observed that low income, 11,14,15,19 low educational level and multimorbidities were associated with poor adherence to the diet. 11,12,14,17 The meta-analysis by Abate et al 30 showed that income and education were determinants of this low adherence. The authors observed that individuals with greater monthly financial availability had a more balanced diet, as it is possible that they are more likely to acquire healthy foods.…”

“…The authors observed that individuals with greater monthly financial availability had a more balanced diet, as it is possible that they are more likely to acquire healthy foods. 30 On the other hand, higher levels of education seem to promote greater knowledge and awareness about healthy habits and eating behavior, in addition to providing better salary opportunities. 30 In addition, multimorbidity reduces quality of life and functional capacity, causing physical and mental disorders, which impairs adherence to treatment.…”

“…30 On the other hand, higher levels of education seem to promote greater knowledge and awareness about healthy habits and eating behavior, in addition to providing better salary opportunities. 30 In addition, multimorbidity reduces quality of life and functional capacity, causing physical and mental disorders, which impairs adherence to treatment. 17,36 This review carried out a comprehensive search, selecting articles from the main databases…”

Association Analysis of Individual Characteristics with Dietary Adherence of T2DM Patients as an Effort to Control Blood Glucose Levels

“…Someone with a higher level of education can make better judgments and decisions about choosing a healthy diet and eating behavior [18]. In line with this theory, research regarding the factors that influence diet adherence in T2DM patients at the Kedungmundu Public Health Center in Semarang City shows that there is a relationship between education level and adherence to diet in T2DM patients as evidenced by the results of the chi-square test obtained p = 0.046 [19].…”