Dietary non-adherence and associated factors among individuals with diabetes who are on treatment follow up at Felege-Hiwot Referral Hospital, Northwest Ethiopia

Abstract

Difficulty in adhering to the recommended diet is a common problem in individuals with diabetes mellitus (DM). Dietary non-adherence among diabetic individuals leads to diabetes related complication and death. As far as our search established, there is a scarcity of scientific evidence of dietary non-adherence of individuals with diabetes to the recommended diet in Ethiopia, specifically in the Northwest part of the country. Hence, this study aims to assess the dietary non-adherence and associated factors among individuals with diabetes at Felege-Hiwot Referral Hospital, Bahir Dar city, Northwest Ethiopia. An institution-based cross-sectional study was conducted on 385 systematically selected individuals with diabetes following their treatment from March to April 2017. Quantitative data were collected using a pre-tested and structured questionnaire. The dependent variable association with explanatory variables was determined using logistic regression. Statistical significance was considered at p-value <0.05 with 95% CI. The overall proportion of dietary non-adherence among participants was 46.8% (95% CI: 41.1–52.0). Living rurally (AOR = 3. 75; 95% CI: 2.12–6.63), duration of diabetes less than 5 years (AOR = 2. 81; 95% CI: 1.22–6.50), did not receive nutritional education (AOR = 5. 88; 95% CI: 3.30–10.48), poor social support (AOR = 3. 84; 95% CI: 1.74–8.46) and did not make choices when eating out (AOR = 3. 49; 95% CI: 2.09–5.81) were significantly associated with dietary non-adherence. Nearly half of the individuals with diabetes involved in this study did not adhere to the recommended diet. This problem could be addressed through the provision of nutritional education and strengthening social support to adhere to diabetes dietary recommendations. Therefore, health professional and nutritional educators should take appropriate action to increase the proportion of dietary adherence of individuals with diabetes.

Determinants of Dietary Adherence Among Type 2 Diabetes Patients Aimed COVID-19 at the University of Gondar Comprehensive Specialized Hospital

“…The finding was supported by the studies conducted in Bahir Dar. 25 Knowledge related to COVID-19 was found to be 4.33 times more to adhere to the dietary recommendation compared to its counterparts. The possible explanation might be those who aware of the COVID-19 impact on diabetes give great self-care that of dietary adherence than a low level of awareness.…”

“… 43 The finding was in line with the study conducted in Bahir Dar in which 53.2% of the participants’ adhered to a dietary recommendation. 25 In multivariable analysis, being college and above educational level was 3.64 times more to adhere to dietary recommendations compared to its counterparts. The possible explanation might be because having a higher education level would probably like with higher information and awareness about diabetes control as well as COVID-19 pandemic than lower educational level.…”

“…17 , 20 , 21 , 23 , 29 Dietary adherence was influenced by the factors like residence, occupation, duration of illness, living distance from the hospital, sex, age, marital status, patients advice by a physician, family/social support, patient perception on the role of diet, level of education, diabetes education, duration of illness, nutritional education, social support, make choices when eating out, co-morbidities, wealth status were factors of dietary non-adherence. 17 , 19–21 , 23 , 25 , 27 , 29–32 To overcome such types of non-adherence problems; health professionals’ were struggling by providing continuous health education on lifestyle modification. But still, we do not achieve the desired outcome.…”

Systematic review of perception of barriers and facilitators to chronic disease self‐management among older adults: Implications for evidence‐based practice

“…Among culture‐related elements, food in some cultures presented as a significant factor that challenged older adults to follow dietary recommendations. Research indicates that dietary recommendation non‐adherence is significantly associated with nutrition education (Tirfie et al, 2020). This review reinforces the need for a collaborative team approach involving dieticians who can provide tailored nutrition education for older adults living with chronic disease.…”

Undertaking Healthy Nutrition Behaviors by Patients with Type 1 Diabetes as an Important Element of Self-Care

“…According to research, numerous patients failed to adhere to the recommended diet [ 7 , 8 ]. In the case of type 2 diabetes, the level of non-adherence to the diet was largely variable and ranged from 2.2% to 87.5% [ 9 , 10 , 11 ].…”