# Dietary Nonadherence and Its Determinants Among Diabetes Mellitus Patients in Comprehensive Specialized Hospitals, Amhara Region, Ethiopia: A Cross‐Sectional Study

## TL;DR

This study finds that over 40% of diabetes patients in Ethiopia's Amhara region do not follow dietary recommendations, with factors like low income and rural living playing a role.

## Contribution

The study provides new insights into dietary nonadherence and its determinants among diabetes patients in the Amhara region of Ethiopia.

## Key findings

- 41.6% of diabetes patients in the Amhara region failed to adhere to dietary recommendations.
- Factors like being a farmer, rural residence, and low income were strongly associated with dietary nonadherence.
- Poor or moderate social support significantly increased the likelihood of dietary nonadherence.

## Abstract

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.