Adherence To Treatment Protocol Among Diabetics And The Impact On Nutritional Status

ABSTRACT Background: Diabetes is a chronic disease and has been found to be the fourth or fifth leading cause of death in most developed, developing and newly industrialized countries. The growing middle class and ever changing lifestyle in developing countries have led to the rapid increase in the burden of diabetes (Type 2) even among the poor. The epidemiological trend has caught up with Ghana. Medical research has found that dietary treatment is the best control for type 2 diabetes. However, little is known about patients’ adherence to treatment protocol and the management of the disease in Ghana. Aims: This research therefore sought to identify and evaluate the nutritional management procedures for diabetics in the Agona Swedru municipal and to assess the adherence to treatment protocol by diabetic patients as well as the effect of adherence on their nutritional status. Methods: There was an enquiry about the nutritional protocol for diabetics at the hospital and this was compared to the GHS protocol for evaluation. A total of 90 diabetics who were 40 years and older attending review at the Agona Swedru hospital were enrolled in the study. Questionnaire was used to collect data under the following sections; sociodemographic characteristics, nutritional knowledge, lifestyle practices, dietary habits and measurement. The data collected under the measurement section, represented the nutritional status of the diabetics. To describe the socio-demographic characteristics, descriptive analysis was employed, while all of the other various sections of the questionnaire were scored. Correlations were used to find out if the scores from nutritional knowledge, dietary and lifestyle practices had associations with the nutritional status score. Adherence was measured by looking at patients’ scores on both their lifestyle and dietary habits. Person’s correlation was used to find out if adherence had an association with nutritional status.  Results: The nutritional management procedures for the diabetics at Agona Swedru protocol was identified and found to be in need of updating as there were lapses when compared to the GHS protocol. More than half of the patients had a poor nutritional knowledge of diabetes though this did not have any association on nutritional status. More than half (82%) of total patients reported to be adhering to protocol; however more than half (71%) of total patients had poor nutritional status. Reported adherence for treatment did not improve the nutritional status of most of the diabetics in this study. Poor nutritional and health status was found to be high among more than half of sedentary group of patients. Conclusion: Generally, though most patients reported to be adhering to standard protocol, their nutritional statuses remained poor with inadequate physical activity level. It is therefore important that the Agona protocol is updated taking into consideration, the association between energy intake and energy expenditure in order to cause some weight loss (10%) during adherence for especially overweight and obese diabetics.