Barriers to adherence to a nutritional plan and strategies to overcome them in patients with type 2 diabetes mellitus; results after two years of follow-up

Landa-Anell, María Victoria; Melgarejo-Hernández, Marco Antonio; García-Ulloa, Ana Cristina; Razo-Olvera, Fabiola Mabel Del; Velázquez-Jurado, Héctor; Hernández-Jiménez, Sergio

doi:10.1016/j.endinu.2019.05.007

Cited by 7 publications

(6 citation statements)

References 12 publications

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“…Failure to follow a strict diet plan is leading causes of complications among patients with type 2 diabetes. There are many misconceptions exist concerning nutrition and diabetes, for example (a) do not allocate enough time for baste buds to change; (b) too impatient to see results; (c) having the wrong mindset; (d) lack of support from family, friends and support groups; and (e) lack preparation and planning [ 9 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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

Abate

Tareke²,

Abate³

et al. 2022

PLoS ONE

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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.

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Section: Introductionmentioning

confidence: 99%

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

Abate

Tareke²,

Abate³

et al. 2022

PLoS ONE

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show abstract

“…Poor adherence to MNT is related to the presence of barriers that prevent patients from following a healthy diet [ 17 ]. Therefore, health providers can identify early barriers to follow a nutritional plan and design structured interventions to reduce those barriers [ 18 ]. Landa et al designed a survey to detect barriers to adherence during a nutritional intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Landa et al designed a survey to detect barriers to adherence during a nutritional intervention. By the end of their study, 42.8% of their participants reported a lack of barriers after a two-year follow-up period [ 18 ]. Our results concur with Landa et al At the beginning of our study, 20% of the patients did not recognize any barriers to following dietary recommendations.…”

Section: Discussionmentioning

confidence: 99%

Primary Barriers of Adherence to a Structured Nutritional Intervention in Patients with Dyslipidemia

et al. 2021

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Purpose: To describe the primary barriers to adequately adhering to a structured nutritional intervention. Patients and methods: A total of 106 participants diagnosed with dyslipidemia and without a medical nutrition therapeutic plan were included in this two-year study conducted at the INCMNSZ dyslipidemia clinic in Mexico City. All patients were treated with the same structured strategies, including three face-to-face visits and two telephone follow-up visits. Diet plan adherence was evaluated at each site visit through a 3-day or 24-h food recall. Results: Barriers to adhere to the nutritional intervention were: lack of time to prepare their meals (23%), eating outside the home (19%), unwillingness to change dietary patterns (14%), and lack of information about a correct diet for dyslipidemias (14%). All barriers decreased significantly at the end of the intervention. Female gender, current smoking, and following a plan of more than 1500 kcal (R2 = 0.18 and p-value = 0.004) were associated with good diet adherence. Participants showed good levels of adherence to total caloric intake at visit 2 and 3, reporting 104.7% and 95.4%, respectively. Adherence to macronutrient intake varied from 65.1% to 126%, with difficulties in adhering to recommended carbohydrate and fat consumption being more notable. Conclusion: The study findings confirm that a structured nutritional intervention is effective in reducing barriers and improving dietary adherence and metabolic control in patients with dyslipidemias. Health providers must identify barriers to adherence early on to design interventions that reduce these barriers and improve adherence.

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“…In fact, studies have shown that about 78% of patients reported barriers to adhering to nutrition plans, with "lack of information on an adequate diet" being the most common one. 25 In a 2012 study that assessed diabetes prevention programs, those with poor diet and activity levels were less likely to enroll into diabetes prevention programs that were offered to high risk individuals. 26 In our present study, current smokers made up about 14% of our study group which is an accurate representation of the 13.7% of all US adults who were current smokers in 2018.…”

Section: Discussionmentioning

confidence: 99%

A1C Reduction in Patients Who Declined Pharmacist-Led Diabetes Management Services

Ahmed

Hammad

Lin

et al. 2021

Journal of Pharmacy Practice

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Introduction: The purpose of this research is to assess the mean change in A1C associated with patients who declined a pharmacy-led diabetes management program and to evaluate effects of predictor variables on the odds of achieving improved A1C in these patients. Study design: Retrospective, single-center, single-group, cohort study. Methods: Patients 18 years or older with uncontrolled type 2 diabetes (defined as A1C ≥ 9%) who declined pharmacy-led diabetes management services were included in the study. The primary outcome of the study was to assess the mean change in A1C from time of phone call offering pharmacy management services (initial) to last observed A1C (final recorded A1C). Results: A total of 91 patients were included, 46 males and 45 females. The significant reduction in the mean change from baseline A1C to the final measured A1C was −0.59 (95% CI, −0.9327% to −0.2447%, P-value = 0.0010). This resulted in 8.79% of patients’ final A1C falling into the range of < 7%. Conclusion: Our study found a paradoxical reduction in A1C among patients who declined pharmacy-led diabetes management services, however, our study is limited by having no comparison group. Further research needs to be conducted to identify correlations between characteristics of patients declining diabetes management services in order to assist with identifying patient-specific methods for improving patient outcomes.

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Barriers to adherence to a nutritional plan and strategies to overcome them in patients with type 2 diabetes mellitus; results after two years of follow-up

Cited by 7 publications

References 12 publications

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

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

Primary Barriers of Adherence to a Structured Nutritional Intervention in Patients with Dyslipidemia

A1C Reduction in Patients Who Declined Pharmacist-Led Diabetes Management Services

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