Adherence to dietary guidelines and dietary patterns of type 2 diabetic patients in Moi teaching and Referral hospital, Kenya

Abstract

Background: Diabetes is a challenging disease to manage successfully. It is estimated that the prevalence of diabetes in Kenya is at 4.6% among adult patients. Although the care regimen is complex, patients with good diabetes self-care behaviors can attain excellent glycemic control. It is vital that patients adhere to their stipulated routines to minimize the burden of the disease on the health care systems. The purpose of this study was to determine adherence to dietary guidelines and dietary patterns among type 2 diabetic patients at Moi Teaching and Referral Hospital (MTRH), Kenya. Methods: A cross sectional research design with mixed methods approach was used and included a total of 313 respondents with type 2DM at MTRH. Systematic random sampling was used to select type 2 diabetic patients from the outpatient clinic while purposive sampling was used to select key informants and patients for Focus Group Discussion. Descriptive and inferential statistics was used to analyze the quantitative data while qualitative data was analyzed thematically. Results: Majority (80%) of the patients followed diet recommendations as per the counseling given by the hospital nutritionist. The patients had reduced sugar and alcohol intake, consumed foods rich in starch and had reduced intake of salt and processed food. Beef and fish was consumed at least once monthly by 31.3% and 34.2% of patients respectively. Fresh milk and fermented milk was consumed daily by 52% and 38% of patients respectively while chicken was consumed 1 to 3 times monthly by 54% of the respondents. Fruits and nuts were rarely consumed. Fruits were the least frequently eaten. Bananas (5.1%), mangoes (5.8%), pawpaw (18.2%, avocado (8.3%) and oranges (5.8%) were eaten once a week . However, there was increased intake of milk and meat products. Conclusions: Type 2 diabetes mellitus patients had high levels of adherence to dietay guidelines. However, the patients had high intake of foods that are high in saturated fat that is not suitable for the management of diabetes. A more personalized dietary counselling is recommended to enhance adherence to dietary guidelines for type 2DM patients. We recommend a revision of the guidelines to inform patients of foods high in saturated fats.