Compliance to recommended dietary practices among patients with type 2 diabetes mellitus attending selected hospitals in Nakuru County
Mugo, Irene Mugure
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ABSTRACT Type 2 Diabetes mellitus (formerly known as non-insulin-dependent or adult-onset diabetes mellitus) is a condition that results from the body’s ineffective use of insulin. Management of type 2 diabetes mellitus requires compliance to dietary regimen, lifestyle changes and drugs. The purpose of this study was to determine compliance to dietary recommendations among patients with type 2 diabetes mellitus attending selected hospitals in Nakuru County. Data was collected in 4 hospitals; 3 Sub-County Hospitals and Nakuru County Referral hospital using researcher administered questionnaires on a sample of 387 patients out of the targeted 403, which was calculated using Fisher et al as cited by Mugenda & Mugenda (2003). About 10% of the respondents were followed to their homes in order to administer a 24-hour dietary recall. Qualitative data was collected using focused group discussion (FGD) guides and key informant interviews (KII) guides on 4 FGD sites and 8 KII respondents respectively. Dietary intake data was analyzed using nutrisurvey software. The rest of the quantitative data was analyzed using Statistical Package for Social Sciences (SPSS Version 21) computer software. Qualitative data from the key informant interviews and focused group discussions was studied and analyzed thematically using the common themes and based on objectives of the study. Mean age of the respondents was 58.5 years. Half (50.1%) of the respondents were farmers and 75.2% of the respondents had attained at least primary level education. The study recorded high level of knowledge on dietary recommendations in management of type 2 DM at 76.2%. There was a strong association between the level of knowledge on the recommended dietary practices in management of type 2 DM and level of formal education (P<0.001). Mean level of compliance to recommended dietary practices in management of type 2 DM as reported by respondents was 59.6% and using 24 hour recall it was 57.5%. The study found no association between compliance to recommended dietary practices in management of type 2 DM and sex (P=0.938), age (0.914), or level of formal education (0.779). The study accepted the null hypothesis that compliance to recommended dietary practices among patients with type 2 DM was not influenced by the level of knowledge on the recommendations (P=0.872). Respondents reported financial constraints (47%) as a major hindrance to compliance to recommended dietary practices. Some of the facilitators to compliance were adequate finances and government support to diabetes care. Other facilitators included availability of a variety of food as well as family support. Diabetes is expensive to manage and it is even more expensive with the complications that accompany prolonged undiagnosed DM or long standing poorly managed DM. There is therefore need for government of Kenya, donors and other implementing partners to come up with ways that will ease the burden of diabetes mellitus care.