Main Article Content
Abstract
The study assessed nutritional knowledge and dietary compliance of type 2 diabetes mellitus (T2DM) patients in the context of diabetes self-care, and the association between nutritional knowledge and dietary compliance. A report from a recent population-based study indicates that between 3.3% and 6% of Ghanaian adults are living with diabetes mellitus (DM) and this is projected to reach 820,000 by 2035. Diet therapy and self-care form an integral part of T2DM management, however, little is known about the nutritional knowledge and dietary habit of DM patients accessing healthcare at the Bono Regional Hospital in Ghana. This study sought to fill the existing knowledge gap which is critical to addressing the challenges associated with the management of T2DM. A hospital-based, descriptive cross-sectional study design was employed to assess nutritional knowledge and dietary compliance of T2DM patients in the context of diabetes self-care, and the association between them. The study was carried out at the Bono Regional Hospital in Sunyani, Ghana. Respondents were recruited using systematic sampling and semi-structured, interview-administered questionnaires were used to collect data for the study. The primary data for the study were analyzed using Statistical Package for Social Sciences (SPSS) version 25. A total of 140 T2DM patients responded to our questionnaires. The majority of the respondents (98.6%) were above 35 years of age. Females constituted 66.4% of the total sample. About one-third of the respondents were farmers (36.4%). Based on our specified criteria, the majority of respondents (52.1%) demonstrated good nutritional knowledge, however, only 39.3% of them showed good dietary compliance. A Pearson’s chi-square test (with Yates’ Continuity Correction) showed a statistically significant association between nutritional knowledge and overall dietary compliance, χ2 (1, n = 140) = 10.23, P = .001, phi = .27. Also, nutritional knowledge was associated with consumption of complex carbohydrates χ2 (1, n = 140) = 7.43, P = .009, phi = -.23, low-fat diet χ2 (1, n = 140) = 8.51, P = .005, phi = -.274, and controlled portions of proteins χ2 (1, n = 140) = 10.67, P = .002, phi = .24. Dietary compliance was poor despite good nutritional knowledge. However, there was a significant association between good nutritional knowledge and overall dietary compliance. Therefore, comprehensive nutritional education, tailored to patients’ needs, and socio-cultural and economic situations could help to promote adherence to dietary recommendations among T2DM patients accessing healthcare at the Bono Regional Hospital.
Keywords
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
- Adeleye, C. O., Adeleye, T. E. & Joseph, K. (2019). Assessment of knowledge of drug and dietary regimen among diabetic client in endocrinology clinic at deferral medical centre Ido-Ekiti, Ekiti State Nigeria. Global Journal of Arts, Humanities and Social Sciences, 7 (1), 15–30.
- Agbogli, H. K. & Annan, R. (2017). Prevalence and Risk Factors of Diabetes Mellitus Among the Inhabitants of Kumasi Metropolis. Archives of Clinical and Biomedical Research, 1 (4), 224–234. https://doi.org/10.26502/acbr.50170025
- Annani-akollor, M. E., Addai-mensah, O., Fondjo, L. A., Sallah, L., Owiredu, E., Acheampong, E., & Akamugri, S. (2019). Predominant complications of Type 2 Diabetes in Kumasi: A 4-year retrospective cross-sectional study at a Teaching Hospital in Ghana. Medicina, 55, 1–11. https://doi.org/10.3390/medicina55050125
- Aryee, P. A., Helegbe, G. K. & Baah, J. (2013). Prevalence and risk factors for overweight and obesity among nurses in the Tamale Metropolis of Ghana. Journal of Medical and Biomedical Sciences, 2 (4), 13–23. https://doi.org/http://dx.doi.org/10.4314/jmbs.v2i4.3
- Ayele, A. A., Emiru, Y. K., Tiruneh, S. A., Ayele, B. A., Gebremariam, A. D. & Tegegn, H. G. (2018). Level of adherence to dietary recommendations and barriers among type 2 diabetic patients: a cross-sectional study in an Ethiopian hospital. Clinical Diabetes and Endocrinology, 4, 1–7. https://doi.org/10.1186/s40842-018-0070-7
- Breen, C., Ryan, M., Gibney, M. J. & Shea, D. O. (2015). Diabetes-related nutrition knowledge and dietary intake among adults with type 2 diabetes. British Journal of Nutrition, 14 (8), 439–447. https://doi.org/10.1017/S0007114515002068
- Caleb, K. S. (2020). Association between nutrition knowledge on diabetes and dietary practice of people living with diabetes mellitus in Nandi county. Acta Scientific Nutritional Health, 4(7), 18–27.
- Cochrane, W. G. (1977). Sampling techniques (3rd ed.). New York: John Wiley & Sons.
- Cohen, J. (1992). A power primer. Psychological Bulletin, 112 (1), 155–159.
- Davidsson, J., & Fahlén, E. (2016). Factors that affect adherence to recommended treatment among diabetes patients in Kampala (Undergraduate thesis). Uppsala University, Kampala.
- de-Grafta, A. A., Awuah, R. B., Pera, T. A., Mendez, M., & Ogedegbe, G. (2015). Explanatory models of diabetes in urban poor communities in Accra, Ghana. Ethnicity & Health, 20, 391–408.
- Gatimu, S. M., Milimo, B. W. & Sebastian, M. S. (2016). Prevalence and determinants of diabetes among older adults in Ghana. BMC Public Health, 16 (1), 1–12. https://doi.org/10.1186/s12889-016-3845-8
- Ghana Health Service. (2016). Brong Ahafo Regional Hospital Profile. Accessed on June 9, 2020 via http://www.ghanahealthservice.org/categoryphp?hid=2&cid=8
- Han, C. Y., Geok, C., Chan, B., Lim, S. L., Zheng, X., Woon, Z. W., Chan, Y. T., Bhaskaran, K., Tan, K. F., Mangaikarasu, K. & Chong, M. F. (2020). Diabetes-related nutrition knowledge and dietary adherence in patients with type 2 diabetes mellitus: a mixed-methods exploratory study. Journal of Diabetes Research, 4 (2), 1–10. https://doi.org/10.1177/2010105820901742
- Kafle, N. K., Poudel, R. R. & Shrestha, S. M. (2018). Noncompliance to diet and medication among patients with type 2 diabetes mellitus in selected hospitals of Kathmandu, Nepal. J Soc Health Diab, 3 (1), 90–95. https://doi.org/10.1055/s-0038-1675687
- Katsaridis, S., Grammatikopoulou, M. G., Gkiouras, K., Tzimos, C., Papageorgiou, S. T., Markaki, A. G., Exiara, T., Goulis, D. G. & Papamitsou, T. (2020). Low reported adherence to the 2019 American Diabetes Association Nutrition recommendations among patients with type 2 diabetes mellitus, indicating the need for improved nutrition education and diet care. Nutrients, 12, 1–17. https://doi.org/10.3390/nu12113516
- Mogre, V., Nyaba, R., Aleyira, S., & Sam, N. B. (2015). Demographic, dietary and physical activity predictors of general and abdominal obesity among university students: a cross-sectional study. SpringerPlus, 4 (1), 1–8. https://doi.org/10.1186/s40064-015-0999-2
- Mohammed, A. S., Adem, F., Tadiwos, Y., Woldekidan, N. A., & Degu, A. (2020). Level of adherence to the dietary recommendation and glycemic control among patients with type 2 diabetes mellitus in Eastern Ethiopia: a cross-sectional study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 13, 2605–2612. https://doi.org/10.2147/DMSO.S256738
- Mugo, I. M. (2018). Compliance to recommended dietary practices among patients with type 2 diabetes mellitus attending selected hospital in Nakuru country (Master’s thesis). Kenyatta University, Nairobi, Kenya.
- Narh, C. T., Dera, J., Ofosuc, A., Blettnerb, M., & Wollschlaeger, D. (2021). Trends in hospitalization of patients with diabetes mellitus in Ghana from 2012 to 2017 with predictions to 2032. International Health, 1–9. https://doi.org/10.1093/inthealth/ihab076
- Peer, N., Kengne, A.-P., Motala, A. A., Mbanya, J. C. (2014). Diabetes in the Africa Region: an update. Diabetes Res. Clin. Pract, 103, 197–205.
- Sami, W., Alabdulwahhab, K. M., Rashid, M., Hamid, A., Alasbali, T. A., Alwadani, A., & Ahmad, M. S. (2020a). Dietary habits of type 2 diabetes patients: frequency and diversity of nutrition intake – Kingdom of Saudi Arabia. Journal of Community Medicine and Primary Health Care, 22 (2), 521–527. https://doi.org/10.23751/pn.v22i2.9239
- Sami, W., Alabdulwahhab, K. M., Rashid, M., Hamid, A., Alasbali, T. A., Alwadani, F. Al, & Ahmad, M.S. (2020b). Dietary knowledge among adults with type 2 diabetes—Kingdom of Saudi Arabia. International Journal of Environmental Research and Public Health, 17 (5), 1–8. https://doi.org/10.3390/ijerph17030858
- Shamsi, N., Shehab, Z., AlNahash, Z., AlMuhanadi, S., & Alnasir, F. (2013). Factors influencing dietary practice among type 2 diabetic patients in Bahrain. Bahrain Medical Bulletin, 35 (3), 130–135.
- Sheikh, E. El, Alkhars, J. A., Mohammed, A., Albattat, F. S., Al-omran, Z. M., Alradhi, H. K., Almishal, S. M. & Alsultan, M. M. (2021). Knowledge, attitude, and practice of type 2 diabetic patients toward diabetes mellitus and its cardiovascular complications in Alahsa. International Journal of Medicine in Developing Countries, 5 , 494–502. https://doi.org/10.24911/IJMDC.51-1607691751
- Tan, S. L., Harith, S. & Shamsudin, J. (2011). Dietary compliance and its association with glycemic control among poorly controlled type 2 diabetic outpatients in Hospital Universiti Sains Malaysia. Malaysian Journal of Nutrition, 17 (3), 1–14.
- Tuoyire, D. A., Kumi-kyereme, A., & Doku, D. T. (2016). Socio-demographic trends in overweight and obesity among parous and nulliparous women in Ghana. BMC Obesity, 3 (1), 1–14. https://doi.org/10.1186/s40608-016-0124-2
- Whiting, D. R., Guariguata, L., Weil, C. & Shaw, J. (2011). IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Research and Clinical Practice, 94, 311–321.
- World Health Organization. (2021). Diabetes. Accessed on June 17, 2021, via https://www.who.int/news-room/facts-sheets/detail/diabetes
References
Adeleye, C. O., Adeleye, T. E. & Joseph, K. (2019). Assessment of knowledge of drug and dietary regimen among diabetic client in endocrinology clinic at deferral medical centre Ido-Ekiti, Ekiti State Nigeria. Global Journal of Arts, Humanities and Social Sciences, 7 (1), 15–30.
Agbogli, H. K. & Annan, R. (2017). Prevalence and Risk Factors of Diabetes Mellitus Among the Inhabitants of Kumasi Metropolis. Archives of Clinical and Biomedical Research, 1 (4), 224–234. https://doi.org/10.26502/acbr.50170025
Annani-akollor, M. E., Addai-mensah, O., Fondjo, L. A., Sallah, L., Owiredu, E., Acheampong, E., & Akamugri, S. (2019). Predominant complications of Type 2 Diabetes in Kumasi: A 4-year retrospective cross-sectional study at a Teaching Hospital in Ghana. Medicina, 55, 1–11. https://doi.org/10.3390/medicina55050125
Aryee, P. A., Helegbe, G. K. & Baah, J. (2013). Prevalence and risk factors for overweight and obesity among nurses in the Tamale Metropolis of Ghana. Journal of Medical and Biomedical Sciences, 2 (4), 13–23. https://doi.org/http://dx.doi.org/10.4314/jmbs.v2i4.3
Ayele, A. A., Emiru, Y. K., Tiruneh, S. A., Ayele, B. A., Gebremariam, A. D. & Tegegn, H. G. (2018). Level of adherence to dietary recommendations and barriers among type 2 diabetic patients: a cross-sectional study in an Ethiopian hospital. Clinical Diabetes and Endocrinology, 4, 1–7. https://doi.org/10.1186/s40842-018-0070-7
Breen, C., Ryan, M., Gibney, M. J. & Shea, D. O. (2015). Diabetes-related nutrition knowledge and dietary intake among adults with type 2 diabetes. British Journal of Nutrition, 14 (8), 439–447. https://doi.org/10.1017/S0007114515002068
Caleb, K. S. (2020). Association between nutrition knowledge on diabetes and dietary practice of people living with diabetes mellitus in Nandi county. Acta Scientific Nutritional Health, 4(7), 18–27.
Cochrane, W. G. (1977). Sampling techniques (3rd ed.). New York: John Wiley & Sons.
Cohen, J. (1992). A power primer. Psychological Bulletin, 112 (1), 155–159.
Davidsson, J., & Fahlén, E. (2016). Factors that affect adherence to recommended treatment among diabetes patients in Kampala (Undergraduate thesis). Uppsala University, Kampala.
de-Grafta, A. A., Awuah, R. B., Pera, T. A., Mendez, M., & Ogedegbe, G. (2015). Explanatory models of diabetes in urban poor communities in Accra, Ghana. Ethnicity & Health, 20, 391–408.
Gatimu, S. M., Milimo, B. W. & Sebastian, M. S. (2016). Prevalence and determinants of diabetes among older adults in Ghana. BMC Public Health, 16 (1), 1–12. https://doi.org/10.1186/s12889-016-3845-8
Ghana Health Service. (2016). Brong Ahafo Regional Hospital Profile. Accessed on June 9, 2020 via http://www.ghanahealthservice.org/categoryphp?hid=2&cid=8
Han, C. Y., Geok, C., Chan, B., Lim, S. L., Zheng, X., Woon, Z. W., Chan, Y. T., Bhaskaran, K., Tan, K. F., Mangaikarasu, K. & Chong, M. F. (2020). Diabetes-related nutrition knowledge and dietary adherence in patients with type 2 diabetes mellitus: a mixed-methods exploratory study. Journal of Diabetes Research, 4 (2), 1–10. https://doi.org/10.1177/2010105820901742
Kafle, N. K., Poudel, R. R. & Shrestha, S. M. (2018). Noncompliance to diet and medication among patients with type 2 diabetes mellitus in selected hospitals of Kathmandu, Nepal. J Soc Health Diab, 3 (1), 90–95. https://doi.org/10.1055/s-0038-1675687
Katsaridis, S., Grammatikopoulou, M. G., Gkiouras, K., Tzimos, C., Papageorgiou, S. T., Markaki, A. G., Exiara, T., Goulis, D. G. & Papamitsou, T. (2020). Low reported adherence to the 2019 American Diabetes Association Nutrition recommendations among patients with type 2 diabetes mellitus, indicating the need for improved nutrition education and diet care. Nutrients, 12, 1–17. https://doi.org/10.3390/nu12113516
Mogre, V., Nyaba, R., Aleyira, S., & Sam, N. B. (2015). Demographic, dietary and physical activity predictors of general and abdominal obesity among university students: a cross-sectional study. SpringerPlus, 4 (1), 1–8. https://doi.org/10.1186/s40064-015-0999-2
Mohammed, A. S., Adem, F., Tadiwos, Y., Woldekidan, N. A., & Degu, A. (2020). Level of adherence to the dietary recommendation and glycemic control among patients with type 2 diabetes mellitus in Eastern Ethiopia: a cross-sectional study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 13, 2605–2612. https://doi.org/10.2147/DMSO.S256738
Mugo, I. M. (2018). Compliance to recommended dietary practices among patients with type 2 diabetes mellitus attending selected hospital in Nakuru country (Master’s thesis). Kenyatta University, Nairobi, Kenya.
Narh, C. T., Dera, J., Ofosuc, A., Blettnerb, M., & Wollschlaeger, D. (2021). Trends in hospitalization of patients with diabetes mellitus in Ghana from 2012 to 2017 with predictions to 2032. International Health, 1–9. https://doi.org/10.1093/inthealth/ihab076
Peer, N., Kengne, A.-P., Motala, A. A., Mbanya, J. C. (2014). Diabetes in the Africa Region: an update. Diabetes Res. Clin. Pract, 103, 197–205.
Sami, W., Alabdulwahhab, K. M., Rashid, M., Hamid, A., Alasbali, T. A., Alwadani, A., & Ahmad, M. S. (2020a). Dietary habits of type 2 diabetes patients: frequency and diversity of nutrition intake – Kingdom of Saudi Arabia. Journal of Community Medicine and Primary Health Care, 22 (2), 521–527. https://doi.org/10.23751/pn.v22i2.9239
Sami, W., Alabdulwahhab, K. M., Rashid, M., Hamid, A., Alasbali, T. A., Alwadani, F. Al, & Ahmad, M.S. (2020b). Dietary knowledge among adults with type 2 diabetes—Kingdom of Saudi Arabia. International Journal of Environmental Research and Public Health, 17 (5), 1–8. https://doi.org/10.3390/ijerph17030858
Shamsi, N., Shehab, Z., AlNahash, Z., AlMuhanadi, S., & Alnasir, F. (2013). Factors influencing dietary practice among type 2 diabetic patients in Bahrain. Bahrain Medical Bulletin, 35 (3), 130–135.
Sheikh, E. El, Alkhars, J. A., Mohammed, A., Albattat, F. S., Al-omran, Z. M., Alradhi, H. K., Almishal, S. M. & Alsultan, M. M. (2021). Knowledge, attitude, and practice of type 2 diabetic patients toward diabetes mellitus and its cardiovascular complications in Alahsa. International Journal of Medicine in Developing Countries, 5 , 494–502. https://doi.org/10.24911/IJMDC.51-1607691751
Tan, S. L., Harith, S. & Shamsudin, J. (2011). Dietary compliance and its association with glycemic control among poorly controlled type 2 diabetic outpatients in Hospital Universiti Sains Malaysia. Malaysian Journal of Nutrition, 17 (3), 1–14.
Tuoyire, D. A., Kumi-kyereme, A., & Doku, D. T. (2016). Socio-demographic trends in overweight and obesity among parous and nulliparous women in Ghana. BMC Obesity, 3 (1), 1–14. https://doi.org/10.1186/s40608-016-0124-2
Whiting, D. R., Guariguata, L., Weil, C. & Shaw, J. (2011). IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Research and Clinical Practice, 94, 311–321.
World Health Organization. (2021). Diabetes. Accessed on June 17, 2021, via https://www.who.int/news-room/facts-sheets/detail/diabetes