Prevalence and Predictors of Nonadherence to Diet and Physical Activity Recommendations among Type 2 Diabetes Patients in Southwest Ethiopia: A Cross-Sectional Study

Abstract

Background. Nonadherence to lifestyle modification recommendations is a major challenge in the management of diabetes mellitus. This study was conducted to measure the prevalence and predictors of nonadherence to diet and physical activity recommendations among type 2 diabetes patients (T2D). Methods. A cross-sectional study involving 322 type 2 diabetes patients was conducted from April 1 to June 30, 2019. Data were collected through face-to-face interviews using structured and pretested questionnaire. Data on sociodemographic, psychosocial, and clinical characteristics were collected. Descriptive analytical results were reported in text, tables, and figures. Logistic regression was conducted to identify predictors of nonadherence to diet and physical activity. Variables with p value ≤0.25 in bivariate logistic regression were considered as candidates for multivariable regression. Multivariate logistic regression was performed to identify independent predictors. Odds ratios and their 95% confidence intervals together with p value <0.05 were used to declare statistical significance. Result. The rate of nonadherence to physical activity and diet was 64.3% and 36%, respectively. Female gender (AOR: 2.6, 95% CI [1.52–4.56]), age > 60 years (AOR: 2.9, 95% CI [1.12–7.42]), being illiterate (AOR: 4.2, 95% CI [1.86–9.73]), diabetes duration of >5 years (AOR: 2.5, 95% CI [1.42–4.41]), and lack of social support (AOR: 2.4, 95% CI [1.42–4.35]) were independent predictors of nonadherence to physical activity recommendations. Factors associated with nonadherence to dietary recommendations were being male (AOR = 2.8, 95% CI: [1.35–5.65]), age > 60 years (AOR = 6.3, 95% CI: [2.21–18.17]), khat chewing (AOR = 8.0, 95% CI: [3.86–16.7]), lack of social support (AOR = 15.26, 95% CI = [7.45–32.8]), and doctor’s instructions or advice regarding diet (AOR = 8.9, 95% CI = [4.26–18.9]). Conclusion. The rate of nonadherence to diet and physical activity recommendations was high in the study area. Predictors of nonadherence to physical activity are female gender, age > 60 years, being illiterate, diabetes duration of >5 years, and lack of social support. Predictors of nonadherence to diet are being male, khat chewing, lack of social support, and doctor’s instructions or advice regarding diet.

Dietary Practice among Type 2 Diabetic Ppatients in Southern Ethiopia

“…The finding of this study was in line with studies performed in Botswana, Pakistan, and Jimma, which showed that the prevalence of poor dietary practice was 37.0%, 36.1%, and 36%, respectively [ 42 , 45 , 46 ]. But in some other studies from Ethiopia and elsewhere, the proportion of poor dietary practice was much higher than this study [ 25 , 30 , 47 – 49 ].…”

Poor Glycemic Control and the Contributing Factors Among Type 2 Diabetes Mellitus Patients Attending Outpatient Diabetes Clinic at Mbarara Regional Referral Hospital, Uganda

“…10 In the study by Zeleke Negera and Charles Epiphianio, 2020, females and patients of age >60 years were more likely to be nonadherent to physical activity recommendation than their male and younger counterparts respectively. 11 Given that majority (69.5%) of our participants were female and almost a third (31.8%) of our study participants were >60 years, this could partly explain why a large number of our study participants did not adhere to physical exercise recommendation and indeed a large proportion had poor glycemic control.…”

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

“…The finding was lower than the study conducted in Southern Ethiopia 64%, Ghana 65.1%, Surate city 76.2%, and Botswana 63% of the participants’ adhered to the dietary recommendation, respectively. 19 , 21 , 22 , 32 The possible explanations might be the time gap and the occurrence of COVID-19 which might affect the overall Socio-demographic activities as well as dietary servings. As evidence revealed that the COVID-19 pandemic has already changed the dietary pattern and habit of the people due to look down and decrease the supply of foods recommended to the diabetes patients by far.…”

“…The required sample size of the study was determined by using a single population proportion formula with the assumptions of a 95% of confidence interval, 4% margin of error(d), and prevalence of dietary adherence (P) was taken as 64.3% from the study conducted in Jimma 32 and adding 5% non-response rate. By using these all the final sample size was 582.…”

“…The questionnaire was adapted from related and previously published studies. 17 , 32 , 40 It included six sections ( Supplementary File1 ); the first sections include the socio-demographic-related information of the study participants. The second section included items that assessed the dietary adherence to the recommendations during the months preceding the study.…”