Adherence of patients with type 2 diabetes mellitus with the SEMDSA lifestyle guidelines

Abstract

Background: Type 2 diabetes mellitus (T2DM) is considered to be the fastest growing chronic disease in the world and thus multi-sectoral, population-based strategies and approaches are needed to address the modifiable risk factors involved in the development and treatment of T2DM. Evidence-based nutrition principles and recommendations are summarised by the Society for Endocrinology, Metabolism and Diabetes in South Africa (SEMDSA) into guidelines for the management of T2DM. This study aimed to determine the adherence of patients with T2DM with the SEMDSA lifestyle guidelines. Methods: A cross-sectional study was conducted in a private practice (n = 50), during which an interviewer-assisted questionnaire related to socio-demographics, diet and lifestyle was completed with each participant. Participants were also weighed and measured. Results: 88% of participants were overweight (22%) or obese (66%). Diets consumed were generally high in total energy (TE) (median: 13 272 kJ), low in carbohydrates (CHO) (56% of participants consumed < 45% of CHO from TE), high in saturated fat (92% consumed ≥ 7% from TE) and high in sodium (74% of participants consumed ≥ 2 300 mg sodium daily). Exercise was not commonplace; 84% of participants did not meet the guideline for aerobic exercise and 92% did not meet the guideline for resistance training. Conclusion: The adherence of participants to the SEMDSA guidelines was poor, thus increasing the risk of long-term complications and poor glycaemic control.

Adhering to lifestyle change recommendations via the trans-theoretical model: a mixed-methods study among type 2 diabetes patients

“…Pragmatic evidence supports the efficiency of TTM on behaviour change (Hill et al, 2008), but there were mixed results found on adherence behaviour (Taylor et al, 2006;Han et al, 2020). The diabetes self-management education and support (DSMES) guidelines (Powers et al, 2015;Beck et al, 2017) and diabetes prevention program (DPP) (DPP, 2002) guidelines are freely available and reproducible for all educators' and patients' usage, yet the level of adherence to diet and physical activity remains poor among T2DM patients (Ganiyu et al, 2013;Birkinshaw et al, 2018;Aladhab and Alabbood, 2019). This situation identifies the need to investigate in-depth concerning diet and physical activity adherence further.…”

Factors influencing insulin initiation in primary care facilities in Cape Town, South Africa

“…18 In terms of clinical care, all clinicians interviewed were familiar with current guidelines on management of T2DM. 7,22 This was in contrast to other studies, where the lack of familiarity was one of the barriers to insulin initiation. 15,16 The guidelines are clear on when insulin should be initiated, but do not provide guidance on the content or timing of counselling.…”

A spotlight on the surfacing of self-management of employees with diabetes seen by professional nurses in selected occupational health clinics in Cape Town

“…Individuals could benefit from additional information about their medication, exercise and management of their stress. The SEMDSA made guidelines available for taking ownership of dietary management of patients with Type 2 diabetes (Birkenshaw, Nel & Walsh 2018 :39). The ability to appropriately accept the presence of the disease could influence the adherence to dietary recommendations and self-management practices.…”