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Contributory Factors to Diabetes Dietary Regimen Non Adherence in Adults with Diabetes

Authors: Okolie Uchenna, Ehiemere Ijeoma, Ezenduka Pauline, Ogbu Sylvester


A cross sectional survey design was used to collect data from 370 diabetic patients. Two instruments were used in obtaining data; in-depth interview guide and researchers- developed questionnaire. Fisher's exact test was used to investigate association between the identified factors and nonadherence. Factors identified were: socio-demographic factors such as: gender, age, marital status, educational level and occupation; psychosocial obstacles such as: non-affordability of prescribed diet, frustration due to the restriction, limited spousal support, feelings of deprivation, feeling that temptation is inevitable, difficulty in adhering in social gatherings and difficulty in revealing to host that one is diabetic; health care providers obstacles were: poor attitude of health workers, irregular diabetes education in clinics , limited number of nutrition education sessions/ inability of the patients to estimate the desired quantity of food, no reminder post cards or phone calls about upcoming patient appointments and delayed start of appointment / time wasting in clinics.

Keywords: diabetes mellitus, Behavior change, dietarymanagement, diet adherence

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[1] Silinik, M. Impact of diabetes on health care and hospitalization. International. Hospital Federation reference book.. London: Pro-book Publishing Limited 2007;54-57.
[2] Jordan J., & Osborne R.H,. Chronic disease self management education programmes: Challenges ahead. World Hospitals and Health Services 2006; 43 (3):32-36
[3] Sobngwi E,, Maurvais-Jarvis, F, Mbanya, J.C. Diabetes in Africa: Part 1: epidemiology and clinical specifities in all
[4] Kolawale, B.A., Adegbenro, C., Ayoola, Z.O., & Opebiyi, B. Diabetes mellitus related treatment goals: awareness and attainment in the Ife- Ijesa zone of South-Western Nigeria. African Journal of Medicine & Medical Sciences 2005;34(4):389-394.
[5] Motilch, M.E . Meeting and Maintaining treatment goals for a patient with diabetic nephropathy. Diabetes Dialogue Winter 2005/2006. International Medical Press. USA.
[6] Kolyango J.N, Omino, E. Agatha & Nambuya, A.P; Nonadherence to diabetes treatment at Mulago Hospital in Uganda: Prevalence and associated factors. African Health Sciences Journal; 8(2): 67-73 Afr Health Sci. 2008 June;8(2): 67-73.
[7] Rubin, R & Peyrot, M. Patients ÔÇÿ and Providers- perspectives on Diabetes care. 2005. Practical Diabetology: 24 (4).
[8] Dey, J. Blonde,L. Guthrie, R . Factors influencing patients- acceptability of diabetes treatment regimens. 2000. Clinical Diabetes; 18(2). .htm.retrieved4/11/2008.
[9] Schechter, C. & Walker, E., Improving Adherence to Diabetes Self- Management Recommendations 2002.. Diabetes Spectrum, 15; 3: 170- 175.
[10] Franz MJ, Warshaw H, Daly AE, Green-Pastors J, Arnold MS, Bantle J.Evolution of diabetes medical nutrition therapy. Nutrition Concepts by Franz, Inc, Minneapolis, Minnesota 55439, USA .2003. [email protected];79(927):30-5.
[11] Delamater, A. M. Improving Patient Adherence. Diabetes Care. 2007 30:1107-1112
[12] Morisky, D.E. (2009). Adherence or compliance behavior. Encyclopedia of Public Health, May 2009.
[13] Kravitz RL, Hays, RD, Sherbourne CD, DiMatteo MR, Rogers WH, Ordway L, Green-field S: Recall of recommendations and adherence to advice among patients with chronic medical conditions. Arch Intern Med153 : 1869-1878,1993
[14] Anderson RM, Fitzgerald JT, Oh MS: The relationship of diabetesrelated attitudes and patients' self-reported adherence 1993. Diabetes Educ19 : 287-292.
[15] Mason BJ, Matsuyama JR, Jue SG: Assessment of sulfonylurea adherence and metabolic control. 1995 Diabetes Educ 21:52 -57.
[16] Blanca RD, Blanca RC, Ernesto FG. Pharmacological therapy compliance in diabetes. Salud Publica de Mexico 2001;43:233-236.
[17] Lo R. Correlates of expected success at adherence to health regimen of people with IDDM. J Adv Nurs. 1999;30(2):418-424.]
[18] Harris MI: Frequency of blood glucose monitoring in relation to glycemic control in patients with type 2 diabetes 2001. Diabetes Care24 : 979-982.
[19] Harris MI, Cowie CC, Howie LJ. Self monitoring of blood glucose by adults with diabetes in the United States population. Diabetes Care 1993;16:1116-1123.
[20] Rasaq A., Martins B. Alutundu, O. Fakeye, T. 30Factors contributing to nonadherence to oral hypoglycemic medications among ambulatory type 2 diabetes patients in Southwestern Nigeria. 2009:55-60 Centro de Investigaciones PublicacionesFarmacéuticasR├║adasRegateiras.Journalpharmacypractice. org 55
[21] Linda CC. Health education and Health promotion (In): Suzame CS & Brenda GB. (Eds) Brunner and Sudddarth's textbook of medical surgical nursing (10th edition), Lippincott William and Wilkins; 2004 Pp 46-47.
[22] Montague MC. Psychosocial and functional outcomes in African Americans with diabetes mellitus. ABNF J. 2002 Sep;13(5):103-109.
[23] Hernandez-Ronquillo L, Tellez-Zenteno JF, Garduno-Espinosa J, Gonzalez-Acevez E. Factors associated with therapy noncompliance in type 2 diabetes patients. Salud Publica de Mexico. 2003;45(3)
[24] Bhrett A, McCabe BS. Louisiana State University; 1999. Barriers to adherence in a free medication program for low income individuals with type 2 diabetes Unpublished.
[25] Travis, T. (1997) Patient perceptions of factors that affect adherence to dietary regimens for diabetes mellitus; Joslin Center for Diabetes, Pittsburgh, Pennsylvania 15224, USA. Diabetes Educ. Mar- Apr;23(2):152-6.
[26] Paes AHP, Bakker A, Soe-Agnie CJ: Impact of dosage frequency on patient compliance , 1997. Diabetes Care 20:1512 -1517.
[27] International Diabetes Federation. Diabetes Prevalence 2005.
[28] Ohene Buabeng K, Motowel L, Plange-Rhule J. Unaffordable drug prices: the major cause of noncompliance with hypertensive medication in Ghana. J Pharm Sci. 2004;7:350-352
[29] Schlundt DG, Rea MR, Kline SS, Pichert JWSituational obstacles to dietary adherence for adults with diabetes. Diabetes Research and Training Center, Vanderbilt University Medical Center, Nashville, TN 37212.1994. J Am Diet Assoc. 94(8):874-6, 879.
[30] Richard, R.R (2005) Counselling and Psychotherapy in Diabetes Mellitus.Psychology in Diabetes Care. John Wiley & Sons; 3: 45-49
[31] Chida. Y. and Hamer, M. An association of adverse psychosocial factors with diabetes mellitus: a meta-analytic review of longitudinal cohort studies London.2008.
[32] Polonsky WH, Anderson Bj, Lohrer PA et al. Assessment of diabetesrelated distress. Diabetes Care 1995; 18: 754-760.
[33] Ciechanowski PS, Katon WJ, Russo JE. Depression and diabetes: impact of depressive symptoms on adherence, function, and costs. Arch Intern Med 2000; 160: 3278-3285
[34] American Diabetes Association. National standards for diabetes selfmanagement education. Diabetes Care 2000; 23: 682-689.
[35] Follansbee DJ, La Greca AM, Citrin WS. Coping skills training for adolescents with diabetes. Diabetes 1983; 32 (Suppl. 1): 37A.
[36] Boardway RH, Delameter AM, Tomankowsky J et al. Stress management training for adolescents with diabetes. J Pediatr Psychol 1993: 18: 29-45.
[37] Yung C, Tse S, Chan K, Chow C, Yau C, Chan T, et al. Age-related decline in the knowledge of diabetes mellitus and hypoglycaemic symptoms in non-insulin-dependent diabetes patients in Hong Kong. Age and Ageing. 1998;27:327-332.
[38] Larme A, Pugh J: Attitudes of primary care providers toward diabetes: barriers to guideline implementation. Diabetes Care21 : 1391- 1396,1998
[39] Funnell MM, Anderson RM: The problem with compliance in diabetes 2000; JAMA 284:1709 ,
[40] Mason BJ, Matsuyama JR, Jue SG: Assessment of sulfonylurea adherence and metabolic control 1996. Diabetes Educ 21:52 -57.