Dietary knowledge, attitude and practice among type 2 diabetes mellitus patients in Sudan: a hospital-based cross-sectional study

Dietary practice and associated factors among patients with type 2 diabetes mellitus in the horn of Africa: a systematic review and meta-analysis

BACKGROUND

Dietary practices have a valuable impact on lowering the risk of complications associated with diabetes mellitus. The countries in the horns of Africa do not follow properly the approaches of dietary recommendation to prevent diet related complications among patients with type-2 diabetes mellitus. Numerous primary observational studies on the relationship between diabetes mellitus and dietary practices have been conducted in the horns of Africa up to this point. Inconsistent and variable findings across different countries in the Horn of Africa hinder the establishment of suitable intervention designs. To address this issue, this systematic review and meta-analysis was conducted.

METHOD

We searched PubMed, Medline, EMBASE, Google Scholar, and Google for studies that had been conducted in the Horn of Africa. Searches were using the English language. A preferred reporting item for systematic reviews and meta-analysis (PRISMA) checklist was used. Two authors independently reviewed the studies. The effect size of the meta-analysis was dietary practices and the adjusted odds ratio (AOR) of the associated factors. Studies were summarized on the use of dietary practices quantitatively and qualitatively. A random-effects model was conducted to obtain the pooled estimates.

RESULT

A total of twenty-one observational studies with 5,117 study participants were included 5,117 in this review. The pooled proportion of good dietary practices among patients with type 2 diabetes mellitus in the Horn of Africa was 44.0% (95% CI: 36.0-51.0). The pooled odds ratio showed that a significant association was found between educational status (AOR = 2.57; 95% CI: 1.79-3.70). Age of the patient (AOR = 2.59; 95% CI: 2.16-3.11), Wealth index status (AOR = 3.64; 95% CI: 2.71-4.89), nutrition education (AOR = 3.35; 95% CI: 2.50-4.49), knowledge about diabetes mellitus (AOR = 2.59; 95% CI: 1.18-3.59) and patients' attitude about diabetes mellitus (AOR = 2.64; 95% CI: 1.64-4.29).

CONCLUSION

The overall pooled proportion of good dietary practices among patients with type-2 diabetes mellitus was below half. Educational status wealth index, nutrition education, dietary knowledge and attitude about diabetes mellitus were significantly associated with good dietary practices. Therefore, establishing strategy to promote nutrition education at the health care facilities and raising awareness about the significance of healthy eating habits through various platforms can improve patients' eating behaviors.

Assessment of Diabetes-Related Knowledge and Dietary Patterns Among Type 2 Diabetes Mellitus Patients in Central Saudi Arabia: Insights for Tailored Health Education Strategies

Background and Objectives: Understanding the knowledge and dietary patterns of type 2 diabetes mellitus (T2DM) patients is essential to identify gaps and design tailored health education strategies to improve self-management and clinical outcomes. We assessed the diabetes-related dietary patterns, knowledge, and associated factors of T2DM patients. Methods: The study utilized a cross-sectional design, surveying 363 T2DM patients using a validated and pretested questionnaire. Knowledge levels were categorized as low (<50%), medium (50-75%), and high (>75%), and dietary patterns were classified as unhealthy (<34%), moderately healthy (34-67%), and healthy (>67%). We analyzed the data using the Statistical Package for the Social Sciences (SPSS, version 23.0). The authors tested the relationship between diabetes-related dietary patterns and knowledge with Spearman's analysis. The multivariate regression approach established the factors associated with these two components. Results: The findings revealed that 36.4% of participants had low knowledge, 34.4% had medium knowledge, and only 29.2% demonstrated high knowledge. Regarding dietary patterns, 34.4% were categorized as unhealthy, 33.3% as moderately healthy, and 32.3% as healthy. The authors found that these two domains were positively correlated (rho = 0.649, p = 0.001). Diabetes-related knowledge was significantly associated with gender (p = 0.018), duration of diabetes (p = 0.001), and patients with a family history of T2DM (p = 0.007). The dietary pattern was significantly associated with age (p = 0.001), duration of diabetes (p = 0.032), and presence of other chronic diseases (p = 0.028). Conclusions: The findings underscore the need for targeted health education strategies that address gaps in dietary knowledge and promote healthier eating behaviors among T2DM patients in Central Saudi Arabia.

The Impact of the Clinical Pharmacist-Led Diabetes Education on the Knowledge and Attitude of Individuals with Type II Diabetes Mellitus: An Interventional Study

BACKGROUND

Diabetes mellitus is a complex condition to manage. Patients with a greater understanding and knowledge of their condition might achieve better glycemic control than others. This study aimed to evaluate the impact of clinical pharmacist-led diabetes education on the knowledge and attitude of individuals with type II diabetes mellitus (T2DM).

METHODS

This study was a quasi-experimental study which was conducted at a diabetes clinic in Khartoum, Sudan. The study population was adult individuals with T2DM who attended the diabetes clinic. The estimated sample size was 182 participants. The participants were selected randomly by a simple random sampling method. The knowledge and attitudes of the participants were assessed at baseline and at the end of the study after 12 months. The intervention was carried out through educational materials about diabetes and medications for its treatment.

RESULTS

The majority of the participants were females. The mean age was 54.5 (±10) years. Most participants had a family history of diabetes (69.2%). The mean knowledge score after the intervention was increased by 1.4 (±0.1) from baseline, p value (<0.001), while the mean attitude score was increased by 1.7 (±0.2) from baseline, p value (<0.001). At baseline, 14.8% of the participants had a high level of knowledge and 18.7% had a negative attitude, while after intervention for 12 months, 28.5% of them had a high level of knowledge and 16.8% had a negative attitude (p values < 0.001, 0.032, respectively).

CONCLUSIONS

The knowledge of and attitudes towards diabetes differed significantly as a result of the educational program provided by the clinical pharmacist.

Dietary adherence among persons with type 2 diabetes: A concurrent mixed methods study

BACKGROUND

Poor adherence to dietary recommendations among persons with type 2 diabetes (T2D) can lead to long-term complications with concomitant increases in healthcare costs and mortality rates. This study aimed to identify factors associated with dietary adherence and explore the barriers and facilitators to dietary adherence among persons with T2D.

METHODS

A concurrent mixed methods study was conducted in two hospitals in the Ashanti Region of Ghana. One hundred and forty-two (142) persons with T2D were consecutively sampled for the survey. Dietary adherence and diabetes-related nutritional knowledge (DRNK) were assessed using the Perceived Dietary Adherence Questionnaire (PDAQ) and an adapted form of the General Nutritional Knowledge Questionnaire (GNKQ-R) respectively. A purposive sample of fourteen participants was selected for interviews to explore the factors that influence dietary adherence. Qualitative data were analysed using NVivo version 20 software and presented as themes. Furthermore, binary logistic regression was performed using IBM SPSS version 29.0 to identify the factors associated with dietary adherence.

RESULTS

Nearly fifty-one percent (50.7%) of the participants in this study had good dietary adherence. In multivariable logistics regression, it was found that increase in DRNK (AOR = 1.099, 95% CI: 1.001-1.206, p = 0.041) score and living in an urban area (AOR = 3.041, 95% CI: 1.007-9.179, p = 0.047) were significantly associated with good dietary adherence. Inductive thematic analysis revealed four facilitators of dietary adherence (access to information on diet, individual food preferences and eating habits, perceived benefits of dietary adherence, and presence of social support) and four barriers (inability to afford recommended diets, barriers related to foods available in the environment, conflict between dietary recommendations and individual eating habits, and barriers related to the social environment).

CONCLUSION

The findings support the need for interventions including continuous dietary education tailored to individual preferences and dietary habits, expansion of poverty reduction social interventions and formulation of policies that will improve access to healthy foods in communities.

Dietary Knowledge and Eating Habits among Patients with Type 2 Diabetes in Lebanon

Little is known about the dietary knowledge (DK) and eating habits (EHs) of patients with type 2 diabetes (T2D) in Lebanon. Therefore, the aim of this study was to assess the DK and EH of the population with T2D and determine their associated factors. A cross-sectional survey enrolling 351 patients with T2D was carried out, using the snowball sampling technique. The survey used the UK Diabetes and Diet Questionnaire and the Dietary Knowledge questionnaire to assess participants' EH including the frequency of consumption of certain foods and their knowledge of food groups and food choices. While a higher DK index indicated better knowledge, a higher EH index indicated less healthy EH. Independent sample T-test and Mann-Whitney test were used for dichotomous variables, and ANOVA and Kruskal-Wallis tests were used for polytomous variables. Correlation analysis tested the association between two continuous variables. Two multiple linear regression models were used to identify factors associated with DK and EH. Overall, 67% of participants had good or adequate DK, and around 25% and 75% of them had healthy and less healthy EH, respectively. Better knowledge was significantly related to occupation, BMI, presence of comorbidities, and HbA1c testing during the last 3 months. Higher family income, physical activity, family history of diabetes, receiving help in medication administration from family or friends, and higher DK level were factors associated with healthier EH. Nutrition education and awareness campaigns aimed at patients and their families are needed to empower patients with adequate DK and skills to facilitate the adoption of healthy EH.

Teachers' Perceptions of Their Influence on Student Practices to Enhance the School Environment: A Cross-Sectional Study in Governmental General Education Schools in Al-Ahsa Province, Kingdom of Saudi Arabia

Background The school environment plays a significant role in shaping the well-being of students, as it encompasses various relationships that occur within the school community. Teachers, in particular, possess knowledge and perceptions that greatly influence their students' behavior. This study aims to examine the perceptions of teachers regarding their impact on student practices and their efforts to enhance the school environment. Methodology The study employed a cross-sectional design involving general education teachers in Al-Ahsa, Saudi Arabia. Data were collected from a sample of 305 teachers through face-to-face interviews utilizing a structured questionnaire. A multistage probability sampling technique was employed to select a representative sample from the pool of school teachers. Descriptive statistics were utilized for continuous variables, while inferential statistics, such as logistic regression analyses, were employed to explore the factors influencing student practices. Results Overall, 264 (86.6%) school teachers had good knowledge of the school environment, and 225 (73.8%) had positive perceptions toward the school environment. The study also showed that more than two-thirds of teachers perceived that students had good practices to improve their school environment. Teachers with positive perceptions were found to be 2.84 times more likely to have positive perceptions toward students' practices (odds ratio (OR) = 2.84, 95% confidence interval (CI) = 1.59-5.08). Teachers who had a good level of general information about the school environment were 1.6 times more likely to have positive perceptions toward students' practices (OR = 1.63; 95% CI =1.94-2.85). Moreover, teachers who held managerial positions were 2.46 times more likely to have positive perceptions toward students' practices (OR = 2.46; 95% CI = 1.30-4.65) when compared to those who did not hold managerial positions. The results also illustrated that high school teachers were 1.75 times more likely (OR = 1.75; 95% CI = 1.90-3.39) to have good perceptions toward students' practices. Likewise, teachers who taught natural sciences courses had a significantly positive perception toward students' practices to improve the school environment (p = 0.029). Conclusions School teachers in Saudi Arabia demonstrated a commendable level of knowledge and held a positive perception regarding school environment practices. The study findings indicate that teachers who possess a positive perception and a good level of knowledge are more inclined to harbor positive perceptions toward student practices that contribute to enhancing the school environment. Therefore, it is advisable to incorporate school environment components into the school curriculum and integrate them into teacher preparation programs.

Determinants of knowledge, attitude, and practice among patients with type 2 diabetes mellitus: A cross-sectional multicenter study in Tanzania

Improvement of primary care for patients with type 2 diabetes mellitus (T2DM) through the promotion of good knowledge, attitude, and practice is of paramount importance for preventing its related complications. This study aimed to assess the levels of knowledge, attitude, and practice and associated factors among patients with T2DM. This was a cross-sectional multicenter hospital-based study that included 979 patients from 8 health facilities in Tanzania. A standardized semi-structured interviewer-administered questionnaire was used to extract the required data. Factor analysis was used to determine the level of knowledge, attitude, and practice. Multivariable analysis under binary logistic regression analysis was used to determine the predictors of knowledge, attitude, and practice. P<0.05 was considered significant. The levels of adequate knowledge, positive attitude, and appropriate practice were 62.1%, 54%, and 30.9%, respectively. Being self-employed (AOR = 1.74, 95% CI = 0.28-0.91, p = 0.040) predicted adequate knowledge. Being male (AOR = 1.46, 95% CI = 1.06-2.01, p = 0.021 and visiting regional hospitals (AOR = 2.17, 95% CI = 1.33-2.51, p = 0.013) were predictors of positive attitude. Residing in rural areas and not having adequate knowledge of diabetes were less likely associated with appropriate practice. This study has shown a significantly low level of appropriate practice among patients with T2DM towards general issues on diabetes, risk factors, and related complications. Therefore, emphasis should be placed on improving good practices that can help prevent related complications.

Non communicable diseases persist despite being overshadowed by Covid-19 globally

Nil