Dietary Adherence Pattern in the Context of Type 2 Diabetic Management within Clinical Setting, Kenya

Abstract

Background: There is a rise in prevalence of Type 2 diabetes in Kenya, and an increase in related complications, which lead to disability and death. Diet modification to control blood sugar, lipid levels and pressure are vital in lowering risk and complications development in the management of Type 2 diabetes. Studies indicate that adherence to diet therapy is below average, even when patients understand the importance of the therapy. Information on diet adherence in the management of Type 2 diabetes in Kenya is in most cases scanty, making it difficult to make focused recommendations. The objectives of this study were to assess the level of diet adherence in dietary management of Type 2 diabetes. Materials and Methods: Across sectional study analysis of a sample of 240 adult diabetics with 35 years and above and have managed the condition for at least six months was executed. Information on dietary behaviour was collected using a pre-tested dietary habit assessment survey tool. Hierarchical regression with preceding principle axis factoring was used to assess the relationship between the recommended diet and diet adherence with a preceding principal axis factoring. Results: The study revealed that majority of the participants (73.9%) had a diet adherence level of 80%, and only 22.3% had 100% diet adherence as per the recommendation of the health providers. An adherence pattern focused mainly on controlling blood glucose and reducing development of complications. It emerged that adherence category one was characterized by replacing cooking oils with fats (R 2 =0.976, ρ<0.001), category two characterized by reduced intake of sugar, margarine, butter and salt (R 2 =0.952, ρ<0.001) while category three was characterized by reduced salt and increase whole grain intake (R 2 =0.768, ρ<0.001). Conclusions: In conclusion, the study confirmed that three categories of adherence pattern could emerge with more concern put on replacing fat with cooking oil, followed by factors with emphasis on reduced intake of sugar, margarine, butter and finally a factor with more emphasis put on reduced salt along with increased grain intake. Efforts are required to improve diet adherence, which emerged to be inadequate even when patients receive diet advice and can afford the diet.