Belew Makda Abate, Getu Rediet Akele, Getahun Sewunnet Azezew, Gemeda Belete Negese, Zergaw Melese Wagaye, Workie Sewnet Getaye
Department of Nursing, School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus Debre Berhan University Debre Berhan Ethiopia.
Department of Midwifery, School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus Debre Berhan University Debre Berhan Ethiopia.
Health Sci Rep. 2025 Aug 11;8(8):e71154. doi: 10.1002/hsr2.71154. eCollection 2025 Aug.
Dietary nonadherence remains a significant challenge in diabetes management, compromising glycemic control and increasing the risk of complications. In Ethiopia, particularly in the Amhara region, adherence to dietary recommendations is influenced by cultural, economic, and educational factors. Despite the critical role of diet in diabetes management, there is limited evidence regarding dietary nonadherence and its determinants in this setting. This study assessed the prevalence and factors associated with dietary nonadherence among diabetes patients attending follow-up care in the Amhara region comprehensive specialized hospitals of Ethiopia.
A multistage sampling technique was used to conduct an institution-based cross-sectional study among 497 diabetes mellitus patients attending follow-up care at Debre Berhan, Debre Markos, Felege Hiwot, and Dessie Comprehensive Specialized Hospitals. The Perceived Dietary Adherence Questionnaire (PDAQ) was used to assess Dietary adherence. Multivariable binary logistic regression analysis was conducted to identify determinants of dietary nonadherence, and findings were reported using adjusted odds ratios (AOR) with 95% confidence intervals (CI).
Among the 497 individuals studied (mean age: 56.2 ± 12.3 years), 41.6% (95% CI: 37.4-46.0) failed to adhere to dietary recommendations. The identified factors were being single (AOR = 2.518; 95% CI: 1.248-5.083), being a farmer (AOR = 5.032; 95% CI: 1.772-14.293), rural residence (AOR = 0.307; 95% CI: 0.144-0.658), low family income (AOR = 3.707; 95% CI: 1.623-8.465), poor social support (AOR = 2.535; 95% CI: 1.456-4.412), and moderate social support (AOR = 1.861; 95% CI: 1.118-3.097).
A high level of dietary nonadherence was observed among diabetic patients. To enhance dietary adherence, targeted nutritional education, community health promotion, and improved social support systems are recommended, especially in rural areas.
饮食不依从仍是糖尿病管理中的一项重大挑战，会影响血糖控制并增加并发症风险。在埃塞俄比亚，尤其是阿姆哈拉地区，对饮食建议的依从性受到文化、经济和教育因素的影响。尽管饮食在糖尿病管理中起着关键作用，但在这种情况下，关于饮食不依从及其决定因素的证据有限。本研究评估了埃塞俄比亚阿姆哈拉地区综合专科医院接受随访护理的糖尿病患者中饮食不依从的患病率及其相关因素。
采用多阶段抽样技术，对德布雷伯汉、德布雷马尔科斯、费莱格希沃特和德西综合专科医院的497名接受随访护理的糖尿病患者进行了一项基于机构的横断面研究。使用感知饮食依从性问卷（PDAQ）评估饮食依从性。进行多变量二元逻辑回归分析以确定饮食不依从的决定因素，并使用调整后的比值比（AOR）及95%置信区间（CI）报告研究结果。
在研究的497名个体中（平均年龄：56.2±12.3岁），41.6%（95%CI：37.4 - 46.0）未遵守饮食建议。确定的因素包括单身（AOR = 2.518；95%CI：1.248 - 5.083）、农民（AOR = 5.032；95%CI：1.772 - 14.293）、农村居住（AOR = 0.307；95%CI：0.144 - 0.658）、家庭收入低（AOR = 3.707；95%CI：1.623 - 8.465）、社会支持差（AOR = 2.535；95%CI：1.456 - 4.412）以及社会支持中等（AOR = 1.861；95%CI：1.118 - 3.097）。
糖尿病患者中观察到较高水平的饮食不依从。为提高饮食依从性，建议开展有针对性的营养教育、社区健康促进并改善社会支持系统，尤其是在农村地区。
