# Comorbidities, level of education, and alcohol consumption are predictive factors of undernutrition among adult outpatients living with diabetes: a case at Hawassa governmental hospitals in Ethiopia

## TL;DR

This study finds that comorbidities, low education, and alcohol use are linked to undernutrition in diabetic outpatients in Ethiopia.

## Contribution

The study identifies specific predictive factors for undernutrition among diabetic patients in a low-resource setting.

## Key findings

- Undernutrition occurred in 15.2% of diabetic outpatients.
- Comorbidities were present in 57.8% of participants.
- Alcohol consumption, comorbidities, and education level were significant predictors of undernutrition.

## Abstract

Comorbidities, which are additional health conditions that occur alongside diabetes, can have a significant effect on blood sugar control. These conditions often complicate the management of diabetes and worsen overall health. Malnutrition, on the other hand, is a common concern for people with diabetes due to difficulties with food intake and metabolism. Proper nutrition is crucial for maintaining general health and effectively managing the disease. However, the extent of comorbidities and malnutrition within this group is not well understood in the study area. A cross-sectional study was conducted at Hawassa governmental hospitals between April and May 2023, involving 422 adult outpatients living with diabetes. The study aimed to evaluate their comorbidities, nutritional status, and associated factors. The required data were collected using structured and semi-structured questionnaires. Bivariate and multivariate logistic regression analyses were conducted using SPSS version 25.0. Undernutrition and concordant comorbidities were prevalent in the study population, occurring at rates of 15.2% and 57.8%, respectively. Additionally, 18.5% of participants were classified as overweight and obese with a BMI greater than 25 kg/m2. Three significant predictors of undernutrition among adult outpatients living with diabetes were identified: alcohol intake (P < 0.05), comorbidities (P < 0.01), and educational status (P < 0.05). Concordant comorbidity was notably common in these patients. It is recommended that the healthcare system consider comorbid conditions when managing diabetes. A longitudinal study is suggested to provide stronger evidence on these findings.