Adherence to dietary recommendations in diabetes mellitus: disease acceptance as a potential mediator

Abstract

BackgroundAdherence by diabetic patients to dietary recommendations is important for effective therapy. Considering patients’ expectations in case of diet is significant in this regard. The aim of this paper was to analyze the relationship between selected independent variables (eg, regular blood glucose testing) and patients’ adherence to dietary recommendations, bearing in mind that the degree of disease acceptance might play a mediation role.Subjects and methodsA cross-sectional study was conducted in 91 patients treated for type 2 diabetes mellitus in a public medical facility. Paper-and-pencil interviewing was administered ahead of the planned visit with a diabetes specialist. Two measures were applied in the study: the Acceptance and Action Diabetes Questionnaire and the Patient Diet Adherence in Diabetes Scale. Additionally, data related to sociodemographic characteristics, lifestyle-related factors, and the course of the disease (management, incidence of complications, and dietician’s supervision) were also collected. The regression method was used in the analysis, and Cohen’s methodology was used to estimate partial mediation. Significance of the mediation effect was assessed by the Goodman test. P-values of <0.05 were considered statistically significant.ResultsPatients’ non-adherence to dietary recommendations was related to a low level of disease acceptance (standardized regression coefficient =−0.266; P=0.010). Moreover, failure to perform regular blood glucose testing was associated with a lack of disease acceptance (standardized regression coefficient =−0.455; P=0.000). However, the lack of regular blood glucose testing and low level of acceptance had only partially negative impacts on adherence to dietary recommendations (Goodman mediation test, Z=1.939; P=0.054). This dependence was not seen in patients treated with diet and concomitant oral medicines and/or insulin therapy.ConclusionEffective dietary education should include activities promoting a more positive attitude toward the disease. This may be obtained by individual counseling, respecting the patient’s needs, and focus on regular blood glucose testing.

The Relationship Between Self-Eficacy and Self-Care in Type 2 Diabetes Mellitus Patients

“…Diabetes mellitus patients generally do not complain regarding the management of their own diet (Jaworski et al, 2018). Sabbah & AlShehri (2014) in his research on the application of self-management of diabetic patients specifically to diets mentioned 41.7% followed the diet well, it was even reported that patients were more obedient to follow treatment compared to adherence to the diet.…”

Using health action process approach to determine diet adherence among patients with Type 2 diabetes

“…Barriers to diet adherence among patients include cost, lack of support and family issues, low quality of life, urbanization, lack of knowledge, social pressure on eating out, eating problems and negative perspective on diabetes, good support and dyadic adjustment, assessed by partners, poor self-discipline, financial restriction, lack of disease acceptance, and lack of regular blood glucose testing. [ 8 11 12 13 14 15 ] Diet regimens are different from patient to patient. [ 16 ] Hence, it is essential to consider theories and/or models to best fit the issue.…”

Disease Acceptance and Eudemonic Well-Being Among Adults With Physical Disabilities: The Mediator Effect of Meaning in Life

“…However, it would be interesting to verify whether this relationship is not bidirectional, that is, whether meaning in life is not an independent variable and illness acceptance acts as a potential mediator. In fact, some studies (Jaworski et al, 2018;Chen et al, 2019;Janiszewska et al, 2019) have confirmed that a proper attitude toward illness may be of particular importance in the context of giving meaning to disease and may lead to effective functioning.…”