Dietary Practices of Patients with Type 2 Diabetes Attending Clinic at Nakuru Level 6 Hospital, Kenya

Abstract

Global diabetes mellitus (DM) prevalence is 425 million cases, 16 million of which emanate from Africa, and 458,900 from Kenya. The prevalence is expected to rise by 48% and 156% globally and in Africa by 2045 respectively. The disease complications are severe and increase the risk of death, with one death reported every eight seconds across the world. The financial implications are adverse, with $825 billion spent globally and $3.3 billion in Africa. In Kenya, $234 is currently spent on each diagnosed case of DM. Of the cost-effective interventions, the dietary intervention has been shown to be the most effective. Despite dietary practices being effective in the management of the disease, DM still represents a fundamental public health challenge in Kenya. Against this backdrop, it was reasonable to determine the type 2 diabetes mellitus (T2DM) patients’ dietary practices in order to develop an effective intervention strategy. This study adopted a descriptive cross-sectional study design. Fishers’ formula, was used to determine the sample size. Pretest was carried out at Naivasha Hospital where 10% of the respondents participated. Data were analyzed using SPSS version 25 and Nutri-survey. Statistical parameters used were Mean, standard deviation (SD), Percentages, and Chi-square. All research and ethical approvals and permits were obtained before the commencement of the study. About 262(96%) T2DM patients participated in the study. The majority were male (58.8%), aged 41-50 years (35.9%), married (79.8%), and had secondary education (42.7%). The main source of income was business (31.7%), they earned a household income of between KES 10001-20000; (31.3%), and had a family history of DM 59.9%. Starches (40.3%) and cooking oil (96.9%) were consumed daily. Most participants (71.8%) had a high dietary diversity score (DDS). Most participants exceeded their adequacy levels for energy, carbohydrates, and proteins. Furthermore, adequacy levels for fats and fiber were low.  Most respondents had three meals (55.3%) per day. About (48.1%) of the respondents’ RBS was >11.0 mmol/l. Household income and DDS (P≤0.018) had a significant correlation. On the other hand, respondents' RBS had a significant association with carbohydrate (P≤0.034) and Fiber consumption (P≤0.016).  Type 2 diabetes mellitus patients consume a highly diverse diet with carbohydrates and fats being the most consumed nutrients. Adequacy levels for fiber were poor.  The patients had poor glycemic control. Household income for most of the patients with T2DM was a predictor of dietary diversity while; carbohydrate and fiber intake correlated with the patients’ random blood sugar (RBS) levels. More emphasis should be placed on the quantity of the macronutrients consumed by encouraging the patients to consume a moderate amount of carbohydrates and proteins, but increase their consumption of a fiber-rich diet; this is beneficial in glycemic control.