Dietary practices of type 2 diabetes mellitus patients concerning Pender's health Promotion Model in Lalitpur district, Nepal

Background

Type 2 Diabetes Mellitus (T2DM) is one of the most prevalent Non Communicable Diseases (NCD) in Nepal. Nutrition plays a significant role in creating barriers to the development of NCDs like diabetes. The main objective of this study is to identify the factors that influence the dietary behaviors and practices among T2DM patients.

Methods

The study used quantitative method and a cross-sectional research design. The study was carried out in two centers: one in diabetes and another in thyroid care centers at the Lalitpur district, Nepal. A survey questionnaire based on Pender Health Promotion Model (PHPM) was developed, piloted, and administrated directly to 450 T2DM patients aged 40–65. Validity and reliability of the tools was ensured through reviewing panel of experts and using the coefficient and Cronbach's alpha test, respectively. Three sorts of statistical analysis; univariate, bivariate, and multivariate analysis were done using SPSS version 25.

Results

Respondents belonged to a joint family, no alcohol consumption, positive attitude towards a healthy diet (P < 0.05), no smoking habit, reminders for healthy food, and engaging in physical activity (P < 0.001) were significantly associated with good dietary practice. Higher odds of sufficient dietary practice were found in respondents who were from joint families (adjusted Odds Ratio (aOR = 2.332; 95 % Confidence Level (CI): 1.958–2.989, p < 0.01), literate (aOR = 1.783; 95 % CI: 1.256–2.531, p < 0.01), no smoking history (aOR = 0.935; 95 % CI: 0.609–1.434, p < 0.05), alcohol consumption history (aOR = 0.615, 95 % CI: 0.412–2.346, p < 0.05), had family support (aOR = 1.824, 95 % CI: 1.265–2.630, p < 0.01), availability of healthy foods (aOR = 2.26; 95 % CI: 1.453–3.517, p < 0.001), and those who preferred daily physical activities (aOR = 1.982, 95 % CI: 1.369–2.364, p < 0.001).

Conclusion

Nuclear family, illiteracy, lower income, smoking and consumption of alcohol, poor family support, poor access in healthy food, and low engagement in physical activities influenced dietary behavior among T2DM patients. Thus, PHPM based educational intervention needs essential to the T2DM patients and family members to ensure better life.