EXPLORING BARRIERS TO DIETARY COMPLIANCE IN TYPE 2 DIABETIC PATIENTS IN PAKISTAN: A SNAP CHAT STUDY
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Keywords
Type 2 diabetes mellitus, Dietary adherence, Barriers to compliance, Non- adherence, Patient education, Psychosocial factors, Pakistan
Abstract
Objective: The study aimed to explore the key barriers that prevent patients with type 2 diabetes mellitus (T2DM) from adhering to dietary recommendations. Understanding these challenges is crucial for improving patient compliance and ultimately enhancing diabetes management outcomes.
Methods: Between March and July 2024, we conducted a cross-sectional study at Ayub Teaching Tertiary Care Hospital in Abbottabad, Pakistan. We recruited 450 T2DM patients, aged between 18 and 80, all of whom had received dietary recommendations prior to the study.
Participants completed a 27-item questionnaire designed to assess barriers to dietary adherence.1They were categorized based on their age and how long they had been living with diabetes. To provide a well-rounded view of their health, we also collected BMI and other relevant lab data. The results were analyzed using Stata version 17, and we used Cronbach’s alpha to measure reliability2. Factor analysis helped us identify the major barriers these patients faced.
Methods: Of the 450 participants, 306 (68%) were women, with an average age of 52.2 years and a mean BMI of 28.2 kg/m². The reliability of the questionnaire was strong, showing a Cronbach’s alpha of 0.89. From the factor analysis, we identified eight key barriers to dietary adherence. The most prominent barrier was a lack of understanding of dietary guidelines, accounting for 13.5% of the total variance. Other significant barriers included situational difficulties (11.4%), insufficient family support (10.2%), stress-related eating habits (9.0%), dissatisfaction with the diet’s monotony (7.8%), concerns over the cost and perceived ineffectiveness of recommended diets (7.1%), work-related challenges (6.0%), and hunger or feelings of weakness (4.9%). Altogether, these barriers explained 69.9% of the variance.
Conclusion: Our findings highlight the need for better education on dietary guidelines, which was the most significant barrier to adherence. Addressing these gaps with tailored education and support systems could improve dietary compliance and positively impact the overall management of type 2 diabetes.
References
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Waqar Ahmad
Post Graduate Resident, Internal Medicine, Ayub Teaching Hospital Abbottabad, KPK, Pakistan.
Fazleamin
Post Graduate Resident, Internal Medicine, Ayub Teaching Hospital Abbottabad, KPK, Pakistan.
Muhammad Noman Khalil
Medical Officer, Kanwal Medical Center, Abbottabad, KPK, Pakistan.
Ahmad Zeb
Post Graduate Resident, Internal Medicine, Ayub Teaching Hospital Abbottabad, KPK, Pakistan
Muhammad Sohail
Medical Officer, DHQ Hospital, Chakwal, Pakistan
Sahib ur Rahman
PGR Emergency Medicine, Pak Emirates Military Hospital. Rawalpindi, Pakistan.
Muhammad Firdous Khan
PGY - II, Internal Medicine, MTI, Ayub Teaching Hospital, Abbottabad, KPK, Pakistan.
Areej Khalid
Intern (SHO), Ayub Teaching Hospital, Abbottabad, KPK, Pakistan.
Asifa Irfan
Intern (HO), Ayub Teaching Hospital, Abbottabad, KPK, Pakistan.
Haris Wazir Khan
Post Graduate Resident, Internal Medicine, Ayub Teaching Hospital Abbottabad, KPK, Pakistan.