Association of Adherence to Diabetics Feeding Recommendation with Glycaemic Control and with Malnutrition Risk Among Normal Weight Persons with Type 2 Diabetes in Ghana

Abstract

Background: Diabetes mellitus (DM) is public health problem. Feeding-recommendations help persons with diabetes control glycaemia. The aim was to access the association between adherence to diabetics’ feeding recommendation with glycaemic control and with malnutrition risk. Methods: Cross-sectional study was conducted among 530 baseline normal weight (body mass index [BMI] 18.5 kg/m2–24.9 kg/m2) persons with type 2 diabetes (T2DM) in Brong Ahafo region of Ghana, from August 2018 to September 2019. Adherence to feeding recommendation was evaluated with perceived dietary adherence questionnaire (PDAQ). Malnutrition-risk was assessed using malnutrition universal screening tool. Multinomial logistics regression models were used to assess the association between adherence to diabetics’ feeding recommendation with glycaemic control and with malnutrition risk. Results: Participants were generally healthy. Weight (P = 0.011), total cholesterol (P = 0.003) and glycated haemoglobin (HbA1c)% (P < 0.001) were significant with adherence to diabetics feeding recommendation. Low adherence to diabetics’ feeding recommendation (adjusted odds ratio [AOR] 2.56; 95% CI: 1.44, 4.56; P < 0.001), low adherence to fruit and vegetables (AOR 2.71; 95% CI: 1.48, 4.99; P < 0.001), low adherence to whole grain, beans, starchy- fruits and plantain (AOR 3.29; 95% CI: 1.81, 6.02; P < 0.001), and low adherence to foods prepared with walnut, canola, sunflower, cotton seed and fish oils (AOR 2.62; 95% CI: 1.49, 4.58; P < 0.001) were significant with poor glycaemic control. Furthermore, low adherence to food prepared with walnut, canola, sunflower, cotton seed, fish or soy oils (AOR 0.54; 95% CI: 0.31, 0.95; P = 0.034) and low adherence to fish and lean meat (AOR 2.09; 95% CI: 1.14, 3.86; P = 0.017) were significant with moderate malnutrition risk. Conclusion: This study demonstrates that poor adherence feeding recommendation could be related to glycaemic control and malnutrition risk.