Association Between Dietary Adherence and Blood Glucose Levels Among Patients with Type 2 Diabetes Mellitus

Authors

  • Farida Latif Nursing Study Program, Institut Teknologi dan Kesehatan Avicenna, Kendari, Indonesia

Keywords:

Type 2 Diabetes Mellitus, Dietary Adherence, Blood Glucose Level, Glycemic Control

Abstract

Background: Type 2 Diabetes Mellitus (T2DM) is a major public health problem worldwide. Poor dietary adherence remains one of the leading causes of uncontrolled blood glucose levels, increasing the risk of both microvascular and macrovascular complications. Understanding the relationship between dietary adherence and glycemic control is essential for improving diabetes management in primary healthcare settings.

Research Objective: This study aimed to determine the association between dietary adherence and blood glucose levels among patients with Type 2 Diabetes Mellitus attending a primary healthcare center in Kendari City, Southeast Sulawesi, Indonesia.

Methods: This analytical observational study employed a cross-sectional design involving 40 patients with Type 2 Diabetes Mellitus selected using purposive sampling. Dietary adherence was assessed using a structured questionnaire based on national diabetes dietary guidelines, while blood glucose levels were obtained from patients' medical records. Descriptive statistics were used to summarize respondent characteristics, and the Chi-square test was performed to analyze the association between dietary adherence and blood glucose levels at a significance level of p<0.05.

Results: Among the respondents, 57.5% demonstrated poor dietary adherence, while 62.5% had uncontrolled blood glucose levels. Bivariate analysis revealed a significant association between dietary adherence and blood glucose levels (p=0.004). Patients with poor dietary adherence were 8.71 times more likely to have uncontrolled blood glucose levels than those with good dietary adherence (OR=8.71; 95% CI=1.95–38.91).

Conclusion: Dietary adherence is significantly associated with blood glucose control among patients with Type 2 Diabetes Mellitus. Strengthening nutrition education, individualized dietary counseling, and family-supported diabetes self-management programs is recommended to improve glycemic control and reduce diabetes-related complications in primary healthcare settings.

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References

Alkethiri, K., Almtroudi, T., Jurays, A. bin, Abanumay, F., Aldammas, M., AlKhodheer, M., Iqbal, M., Habib, S. S., & Bashir, S. (2021). The relationship between type 2 diabetes mellitus with cognitive functions. Heliyon, 7(3), e06358. https://doi.org/https://doi.org/10.1016/j.heliyon.2021.e06358

Alodhayani, A., Almutairi, K. M., Vinluan, J. M., Almigbal, T. H., Alonazi, W. B., Ali Batais, M., & Mohammed Alnassar, M. (2021). Association between self-care management practices and glycemic control of patients with type 2 diabetes mellitus in Saud Arabia: A cross –sectional study. Saudi Journal of Biological Sciences, 28(4), 2460–2465. https://doi.org/https://doi.org/10.1016/j.sjbs.2021.01.047

Bussière-Côté, S., Sieffien, W., Berger, H., Park, A. L., & Ray, J. G. (2020). Twice-Daily vs 4-Times-Daily Glucose Testing in Women With Gestational Diabetes Mellitus: A Pilot Study. Canadian Journal of Diabetes, 44(3), 274–279. https://doi.org/https://doi.org/10.1016/j.jcjd.2019.08.007

Chawla, R., Jaggi, S., Gupta, A., Bantwal, G., & Patil, S. (2022). Clinical Utility of a Digital Therapeutic Intervention in Indian Patients With Type 2 Diabetes Mellitus: 12-Week Prospective Single-Arm Intervention Study. JMIR Diabetes, 7(4). https://doi.org/https://doi.org/10.2196/41401

Choy, K. Y. C., & Louie, J. C. Y. (2023). The effects of the ketogenic diet for the management of type 2 diabetes mellitus: A systematic review and meta-analysis of recent studies. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 17(12), 102905. https://doi.org/https://doi.org/10.1016/j.dsx.2023.102905

Dudzik, J. M., Senkus, K. E., Evert, A. B., Raynor, H. A., Rozga, M., Handu, D., & Moloney, L. M. (2023). The effectiveness of medical nutrition therapy provided by a dietitian in adults with prediabetes: a systematic review and meta-analysis. The American Journal of Clinical Nutrition, 118(5), 892–910. https://doi.org/https://doi.org/10.1016/j.ajcnut.2023.08.022

Elfios Endrias, E., & Gete Feleke, M. (2023). Magnitude of high body mass index and its associated factors among adult type 2 diabetes mellitus patients attending follow-up clinics at hospitals in Wolaita Zone, Southern Ethiopia, 2021. International Journal of Africa Nursing Sciences, 19, 100579. https://doi.org/https://doi.org/10.1016/j.ijans.2023.100579

Garnweidner-Holme, L., Henriksen, L., Torheim, L. E., & Lukasse, M. (2020). Effect of the Pregnant+ Smartphone App on the Dietary Behavior of Women With Gestational Diabetes Mellitus: Secondary Analysis of a Randomized Controlled Trial. JMIR MHealth and UHealth, 8(11). https://doi.org/https://doi.org/10.2196/18614

Gebermariam, A. D., Tiruneh, S. A., Ayele, A. A., Tegegn, H. G., Ayele, B. A., & Engidaw, M. (2020). Level of glycemic control and its associated factors among type II diabetic patients in debre tabor general hospital, northwest Ethiopia. Metabolism Open, 8, 100056. https://doi.org/https://doi.org/10.1016/j.metop.2020.100056

Gebrie, A., Tesfaye, B., & Sisay, M. (2020). Evaluation of glycemic control status and its associated factors among diabetes patients on follow-up at referral hospitals of Northwest Ethiopia: A cross-sectional study, 2020. Heliyon, 6(12), e05655. https://doi.org/https://doi.org/10.1016/j.heliyon.2020.e05655

Ghosh, A., Banerjee, S., Dalai, C. K., Chaudhuri, S., Sarkar, K., & Sarkar, D. (2023). Medication adherence and environmental barriers to self-care practice among people with diabetes: A cross-sectional study in a lifestyle clinic in eastern India. Journal of Taibah University Medical Sciences, 18(5), 909–916. https://doi.org/https://doi.org/10.1016/j.jtumed.2023.01.010

Gilbert, L., Nikolaou, A., Quansah, D. Y., Rossel, J.-B., Horsch, A., & Puder, J. J. (2021). Mental health and its associations with glucose-lowering medication in women with gestational diabetes mellitus. A prospective clinical cohort study. Psychoneuroendocrinology, 124, 105095. https://doi.org/https://doi.org/10.1016/j.psyneuen.2020.105095

Guo, S. H.-M., Hsing, H.-C., Lin, J.-L., & Lee, C.-C. (2021). Relationships Between Mobile eHealth Literacy, Diabetes Self-care, and Glycemic Outcomes in Taiwanese Patients With Type 2 Diabetes: Cross-sectional Study. JMIR MHealth and UHealth, 9(2). https://doi.org/https://doi.org/10.2196/18404

Ibrahim, S. A., El Hajj, M. S., Owusu, Y. B., Al-Khaja, M., Khalifa, A., Ahmed, D., & Awaisu, A. (2022). Adherence as a Predictor of Glycemic Control Among Adolescents With Type 1 Diabetes: A Retrospective Study Using Real-world Evidence. Clinical Therapeutics, 44(10), 1380–1392. https://doi.org/https://doi.org/10.1016/j.clinthera.2022.09.003

Johnson, C. M., D’Eramo Melkus, G., Reagan, L., Pan, W., Amarasekara, S., Pereira, K., Hassell, N., Nowlin, S., & Vorderstrasse, A. (2023). Learning in a Virtual Environment to Improve Type 2 Diabetes Outcomes: Randomized Controlled Trial. JMIR Formative Research, 7. https://doi.org/https://doi.org/10.2196/40359

Joshi, S., Verma, R., Lathia, T., Selvan, C., Tanna, S., Saraf, A., Tiwaskar, M., Modi, A., Kalra, S., K, V., Chitale, M., Malde, F., Abdul Khader, M., & Singal, A. K. (2023). Fitterfly Diabetes CGM Digital Therapeutics Program for Glycemic Control and Weight Management in People With Type 2 Diabetes Mellitus: Real-world Effectiveness Evaluation. JMIR Diabetes, 8. https://doi.org/https://doi.org/10.2196/43292

Krishnakumar, A., Verma, R., Chawla, R., Sosale, A., Saboo, B., Joshi, S., Shaikh, M., Shah, A., Kolwankar, S., & Mattoo, V. (2021). Evaluating Glycemic Control in Patients of South Asian Origin With Type 2 Diabetes Using a Digital Therapeutic Platform: Analysis of Real-World Data. Journal of Medical Internet Research, 23(3). https://doi.org/https://doi.org/10.2196/17908

Kulkarni, P., Babu, P. K., Rashmi, N., Sunil Kumar, D., & Narayana Murthy, M. R. (2020). “Does cost of care influence the glycemic control, psychosocial illness and quality of care among adolescents with type 1 diabetes?: A hospital based cross section study in Mysuru, Karnataka. Clinical Epidemiology and Global Health, 8(3), 879–883. https://doi.org/https://doi.org/10.1016/j.cegh.2020.02.016

Kumar, L., & Mohammadnezhad, M. (2022). Perceptions of patients on factors affecting diabetes self-management among type 2 diabetes mellitus (T2DM) patients in Fiji: A qualitative study. Heliyon, 8(6), e09728. https://doi.org/https://doi.org/10.1016/j.heliyon.2022.e09728

Liu, Y.-T., Wu, W.-H., Tseng, W.-T., Lin, H.-C., Wu, M.-S., Chen, P.-F., & Wu, I.-C. (2023). Lower HbA1C of glycemic control is associated with higher risk of depressive symptoms in elderly with type 2 diabetes mellitus–A Nationwide Community-based study. Journal of Psychosomatic Research, 174, 111492. https://doi.org/https://doi.org/10.1016/j.jpsychores.2023.111492

Marks, K. P., Birkebæk, N. H., Pouwer, F., Ibfelt, E. H., Thastum, M., & Jensen, M. B. (2023). Adherence in Diabetes Questionnaire (ADQ) score as predictor of 11-year HbA1c trajectories in children and adolescents with type 1 diabetes: A population-based longitudinal study. Diabetes Research and Clinical Practice, 197, 110558. https://doi.org/https://doi.org/10.1016/j.diabres.2023.110558

Mason, K. A., Marks, B. E., Wood, C. L., & Le, T. N. (2021). Cystic fibrosis-related diabetes: The patient perspective. Journal of Clinical & Translational Endocrinology, 26, 100279. https://doi.org/https://doi.org/10.1016/j.jcte.2021.100279

Mettananda, C., Chathuranga, U., Rathnayake, T., Luke, N., & Meegodavidanage, N. (2023). Glycaemic control and avenues for improvement among people with type 2 diabetes mellitus from rural Sri Lanka – a retrospective cohort study. The Lancet Regional Health - Southeast Asia, 12, 100169. https://doi.org/https://doi.org/10.1016/j.lansea.2023.100169

Montilva-Monsalve, J., Dimantas, B., Perski, O., & Gutman, L. M. (2023). Barriers and Enablers to the Adoption of a Healthier Diet Using an App: Qualitative Interview Study With Patients With Type 2 Diabetes Mellitus. JMIR Diabetes, 8. https://doi.org/https://doi.org/10.2196/49097

Noordam, R., van Heemst, D., Suhre, K., Krumsiek, J., & Mook-Kanamori, D. O. (2020). Proteome-wide assessment of diabetes mellitus in Qatari identifies IGFBP-2 as a risk factor already with early glycaemic disturbances. Archives of Biochemistry and Biophysics, 689, 108476. https://doi.org/https://doi.org/10.1016/j.abb.2020.108476

Numsang, P., Oumtanee, A., Kurat, S., Sananok, R., Kraichan, S., & Sarapoke, P. (2023). “Failure to control blood sugar” experiences of persons with type 2 diabetes mellitus. International Journal of Nursing Sciences, 10(4), 527–532. https://doi.org/https://doi.org/10.1016/j.ijnss.2023.09.004

Orozco-Beltrán, D., Morales, C., Artola-Menéndez, S., Brotons, C., Carrascosa, S., González, C., Baro, Ó., Aliaga, A., Ferreira de Campos, K., Villarejo, M., Hurtado, C., Álvarez-Ortega, C., Gómez-García, A., Cedenilla, M., & Fernández, G. (2022). Effects of a Digital Patient Empowerment and Communication Tool on Metabolic Control in People With Type 2 Diabetes: The DeMpower Multicenter Ambispective Study. JMIR Diabetes, 7(4). https://doi.org/https://doi.org/10.2196/40377

Paganoti, C. de F., da Costa, R. A., Oliveira, A. M. da S. S., Hoshida, M. S., & Francisco, R. P. V. (2021). Adiponectin does not improve the prediction of insulin need in pregnant women with gestational diabetes mellitus. Endocrine and Metabolic Science, 3, 100095. https://doi.org/https://doi.org/10.1016/j.endmts.2021.100095

Pigato, F., Candido, R., Zanette, G., Zamagni, G., Trojniak, M. P., Brunato, B., Fornasier, G., Specogna, E., Zenarola, M., Agus, S., Rossi, P., & Arbo, A. (2023). Gestational diabetes mellitus: Impact of adherence on patient management and maternal-neonatal complications. Primary Care Diabetes, 17(5), 486–492. https://doi.org/https://doi.org/10.1016/j.pcd.2023.07.003

Prasopthum, A., Insawek, T., & Pouyfung, P. (2022). Herbal medicine use in Thai patients with type 2 diabetes mellitus and its association with glycemic control: A cross-sectional evaluation. Heliyon, 8(10), e10790. https://doi.org/https://doi.org/10.1016/j.heliyon.2022.e10790

Rezki, A., Fysekidis, M., Chiheb, S., Vicaut, E., Cosson, E., & Valensi, P. (2021). Acute and long-term effects of saxagliptin on post-prandial glycemic response in obese patients with impaired glucose tolerance. Nutrition, Metabolism and Cardiovascular Diseases, 31(4), 1257–1266. https://doi.org/https://doi.org/10.1016/j.numecd.2020.12.025

Sánchez Conejero, M., González de Buitrago Amigo, J., Tejado Bravo, M. L., & de Nicolás Jiménez, J. M. (2022). Impact of COVID-19 lockdown on glucemic control in children and adolescents with type 1 diabetes mellitus. Anales de Pediatría (English Edition), 97(1), 22–29. https://doi.org/https://doi.org/10.1016/j.anpede.2020.12.022

Sriraman, S., Sreejith, D., Andrew, E., Okello, I., & Willcox, M. (2023). Use of herbal medicines for the management of type 2 diabetes: A systematic review of qualitative studies. Complementary Therapies in Clinical Practice, 53, 101808. https://doi.org/https://doi.org/10.1016/j.ctcp.2023.101808

Sukhato, K., Akksilp, K., Dellow, A., Vathesatogkit, P., & Anothaisintawee, T. (2020). Efficacy of different dietary patterns on lowering of blood pressure level: an umbrella review. The American Journal of Clinical Nutrition, 112(6), 1584–1598. https://doi.org/https://doi.org/10.1093/ajcn/nqaa252

Summers, C., Tobin, S., & Unwin, D. (2021). Evaluation of the Low Carb Program Digital Intervention for the Self-Management of Type 2 Diabetes and Prediabetes in an NHS England General Practice: Single-Arm Prospective Study. JMIR Diabetes, 6(3). https://doi.org/https://doi.org/10.2196/25751

Tian, Y., Zhang, S., Huang, F., & Ma, L. (2021). Comparing the Efficacies of Telemedicine and Standard Prenatal Care on Blood Glucose Control in Women With Gestational Diabetes Mellitus: Randomized Controlled Trial. JMIR MHealth and UHealth, 9(5). https://doi.org/https://doi.org/10.2196/22881

Tiwari, A., Kumar, D., Ansari, M. S., Chaubey, S. K., Gupta, N. R., Agarwal, V., Chandra, K. P., Pande, A. r, Awasthi, R., Gupta, M., & Chowdhary, S. (2021). Impact of lockdown on self-care management among patients with type 2 Diabetes Mellitus residing in Lucknow city, India – A cross-sectional study. Clinical Epidemiology and Global Health, 10, 100703. https://doi.org/https://doi.org/10.1016/j.cegh.2021.100703

Vluggen, S., Candel, M., Hoving, C., Schaper, N. C., & de Vries, H. (2021). A Web-Based Computer-Tailored Program to Improve Treatment Adherence in Patients With Type 2 Diabetes: Randomized Controlled Trial. Journal of Medical Internet Research, 23(2). https://doi.org/https://doi.org/10.2196/18524

Wang, Y., Xu, W., Mak, I. L., Chin, W. Y., Yu, E. Y. T., Lam, C. L. K., & Wan, E. Y. F. (2023). Trends of clinical parameters and incidences of diabetes mellitus complications among patients with type 2 diabetes mellitus in Hong Kong, 2010–2019: a retrospective cohort study. EClinicalMedicine, 60, 101999. https://doi.org/https://doi.org/10.1016/j.eclinm.2023.101999

Wong, M. K., Cheng, S. Y. R., Chu, T. K., Lam, F. Y., Lai, S. K., Wong, K. C., & Liang, J. (2020). Impact of Motivational Interviewing on Self-Management in Patients With Type 2 Diabetes: Protocol for a Pilot Randomized Controlled Trial. JMIR Research Protocols, 9(3). https://doi.org/https://doi.org/10.2196/15709

Yang, Y., Lee, E. Y., Kim, H.-S., Lee, S.-H., Yoon, K.-H., & Cho, J.-H. (2020). Effect of a Mobile Phone–Based Glucose-Monitoring and Feedback System for Type 2 Diabetes Management in Multiple Primary Care Clinic Settings: Cluster Randomized Controlled Trial. JMIR MHealth and UHealth, 8(2). https://doi.org/https://doi.org/10.2196/16266

Yousef, C. C., Thomas, A., Matar, M. Al, Ghandoura, L., Aldossary, I., Almuhanna, S. M., Alhussain, F., AL Bisher, F. B., Aljohani, R. M., Balubaid, A. N., Nouh, M. I., Almurashi, A., & AlAmoudi, R. (2021). Liraglutide effects on glycemic control and weight in patients with type 2 diabetes Mellitus: A real-world, observational study and brief narrative review. Diabetes Research and Clinical Practice, 177, 108871. https://doi.org/https://doi.org/10.1016/j.diabres.2021.108871

Zhang, Y., Han, H., & Chu, L. (2022). Effectiveness of restricted diet with a plate in patients with type 2 diabetes: A randomized controlled trial. Primary Care Diabetes, 16(3), 368–374. https://doi.org/https://doi.org/10.1016/j.pcd.2022.03.007

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Published

2024-08-31

How to Cite

Farida Latif. (2024). Association Between Dietary Adherence and Blood Glucose Levels Among Patients with Type 2 Diabetes Mellitus . Jurnal Ilmu Kesehatan Nusantara, 1(3), 21–32. Retrieved from https://jurnal.nasyahmedikacare.com/index.php/jiken/article/view/50