The Practices and Glycated Hemoglobin Levels of Adults with Diabetic Neuropathy in Nakuru County, Kenya

Abstract

Diabetic neuropathy is a common complication of diabetes that can significantly impact patients’ quality of life. Practices play a crucial role in managing the condition and preventing further complications. This cross-sectional study examined the practices and glycated hemoglobin levels among adult patients with diabetic neuropathy. The study employed a cross-sectional design. A sample of adult patients diagnosed with diabetic neuropathy at Nakuru referral and teaching hospital was recruited. Data on dietary practices, including food choices, meal patterns, and dietary restrictions, were collected through structured interviews. Nutrient intake was assessed using dietary recall methods and analyzed using descriptive statistics. The chi-square test was used across the glycated hemoglobin (HbA1c) levels to compare categorical variables. Adherence to dietary recommendations was evaluated based on established guidelines for diabetic neuropathy management. Preliminary findings reveal sub-optimal practices in adults with diabetic neuropathy. Those with one or two daily 
meals reported significantly elevated HbA1c levels [χ2=11.808, p=0.008]. Skipping meals, especially breakfast and lunch, correlated with elevated HbA1c [χ2=17.622, p=0.001]. Smokers and alcohol consumers had a higher proportion of elevated HbA1c [χ2=7.269, p=0.007] and [χ2=15.610, p<0.001], respectively. Regular exercise, particularly daily or 1-3 times a week, is associated with lower HbA1c [χ2
=37.329, p<0.001]. Elevated HbA1c correlated significantly with daily intake of animal products [χ2
=18.931, p<0.001], fats and oils [χ2=12.211, p =0.00], fruits [χ2= 22.106, p<0.001], and cereals [χ2=21.728, p<0.001]. Conversely, daily consumption of vegetables [χ2=8.255, p=0.016], pulses, and legumes [χ2 =53.757, p<0.001] were associated with normal HbA1c. However, occasional sugar and honey intake did not significantly impact HbA1c [χ2=1.082, p=0.582]. In conclusion, our study highlights sub-optimal practices in adult diabetic neuropathy patients, particularly in those consuming one or two meals daily, skipping breakfast and lunch, and engaging in smoking or alcohol. Regular exercise correlates with lower HbA1c, while certain dietary habits influence glycemic control. These insights inform targeted interventions for improved patient care.