Diet quality of adults with poorly controlled type 2 diabetes mellitus at a tertiary hospital outpatient clinic in Tshwane District, South Africa

Objective: To describe the dietary intake and its quality of patients with poorly controlled type 2 diabetes mellitus (T2DM) by assessing the dietary variety (DVS), dietary diversity (DDS), nutrient adequacy ratio (NAR) and mean nutrient adequacy ratio (MAR). Design: This was a descriptive, cross-sectional study. Setting: Diabetes outpatient clinic at a tertiary hospital in Tshwane district, Gauteng province, South Africa. Subjects: Adults, aged 40–70 years, with poorly controlled T2DM (HbA1c ≥ 8%). Outcome measures: Dietary intake data were obtained through two, multi-pass, 24-hour recalls. Individual food items were used to determine the DVS and DDS. The SAMRC FoodFinder III software was used to analyse the macro- and micronutrients, from which the NAR and MAR scores were determined. Descriptive statistics were used to analyse the data. Results: Seventy-seven patients (60 females) participated. Their mean age was 57.2 (±6.6) years. The DDS was adequate at 4.99 (out of a possible 7 food groups); however, the DVS was low (16%) as well as the consumption of vegetables, fruits and legumes. Mean NAR scores indicated insufficient energy intake. Intakes of vitamin D, calcium, folate and iron were below 50% of the recommended daily intake. MAR scores indicated unsatisfactory micronutrient intake at 0.63 (ideal ≥ 1). Conclusions: In this tertiary healthcare setting, T2DM patients with poor glycaemic control had sub-optimal dietary quality. Interventions such as nutrition education programmes that provide simple and factual information on the benefits of healthy eating and practical ways of achieving healthy diets among people with T2DM are needed.