Endocrine Abstracts

Introduction: Nutrition is a cornerstone of the adequate management of Type 2 diabetes mellitus (T2DM). The aims of our work are to evaluate the degree of observance of dietary rules in T2DM patients, and the factors that influence this observance.

Methods: Cross-sectional study including 84 type 2 diabetic patients followed up in the outpatient endocrinology department of Taher Sfar university hospital from September to November 2021. The data was collected in face-to-face interviews with patients.

Results: The average age was 59 ± 12 years, with a male predominance (58% of cases). The mean duration of diabetes was 9.4 ± 6.4 years. The mean HbA1c was 9.9% ± 2.4. Compliance to dietary recommendation was reported by less than half of patients (46% of respondents). Taking meals based on a dietary plan was reported in 15% of patients, having 3 meals plan per day in 88% of cases, with a regular meal time in 84% of cases, and all these factors were significantly associated to a better glycemic control (P < 10^-3). Cutting down sweets and sugary was reported in 57%, and fried food and fat intake in 71% of cases and both were significantly associated to a better glycemic control (P < 10^-3 and P = 0.04 respectively). Men and women were comparable in the degree of application of dietary rules. Besides, urban residents had better dietary practice than rural residents. Barriers for adherance to dietary recommendations were: cultural backround and communal network in 86% of cases, poor self-discipline and lack of motivation in 70% of cases, poor dietary knowledge and lack of education in 67% of cases, financial constraints in 51% of cases, lack of awareness in 33% of cases, lack of self-control in 21% of cases, fear of hypoglycemia in 19% of cases and eating outside home (in work) in 9% of cases.

Conclusion: Dietary compliance in T2DM patients is still far below the objectives. It is determined by several factors, in particular dietetic education which proves to be insufficient. Through the mutual efforts, health-care professionals can help their patients in achieving health goals by individualizing their nutrition interventions.