Diet adherence and factors associated with nonadherence among Type 2 diabetics at an urban health center in Tamil Nadu, India

Abstract

Introduction: Diabetes is a slow epidemic causing threat to public health worldwide. Several studies have been done to assess the medication adherence among patients with diabetes. The present study has focused on dietary adherence and attempted to identify factors associated with nonadherence to a diabetic diet. Materials and Methods: A cross-sectional study was conducted among 284 patients with type 2 diabetes visiting the outpatient department of an urban health-care center in Tamil Nadu, India. A semi-structured questionnaire was used for data collection. Summary of Diabetes Self-Care Activities tool was used to assess adherence for medication and physical activity while Perceived Dietary Adherence Questionnaire tool was used to assess the adherence to diabetic diet. Results: The dietary adherence was high in only 4.2% (95% confidence interval [CI]: 2.20–7.26) of the patients with diabetes while 73.2% (95% CI: 67.69–73.30) and 22.5% (95% CI: 17.81–27.84) had medium and low adherence to diabetic diet, respectively. Adherence to medication and exercise were 91.5% and 63.4%, respectively. The duration of diabetes, higher body mass index, presence of comorbidity, history of diabetic complication, and adherence to exercise were associated with better compliance to diet while socioeconomic status was not. Conclusion: The present study has identified poor adherence to diabetic diet in spite of good medication adherence. The practice of spacing of carbohydrate food and intake of Omega-3 fats needs to be improved while the consumption of food rich in other fats should be decreased. Dietary fiber intake can also be better. The findings can help plan future study to identify barriers to diet adherence and also effective methods to improve dietary practices among the patients with diabetes. The following core competencies are addressed in this article: Medical knowledge, Patient care, Systems-based practice, Practice-based learning and improvement.