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.