Nutritional status, Knowledge and Adherence to Dietary advice in Type-2 Diabetes Mellitus (T2DM) patients at a Tertiary care hospital, Peshawar-A case control study (N-KAD study)

Abstract

To develop the association between nutritional status, dietary intakes, knowledge and non-adherence to diet in patients with T2DM and their comparison with age-sex-BMI matched healthy non-diabetic individuals. This was a cross-sectional study with a case-control design. A total of 400 diabetic cases (200 males, 200 females) and 60 controls were selected and interviewed from OPD. Enrollment of cases was consisting of all those having confirmed T2DM either newly diagnosed or old diabetics that was confirmed by fasting blood sugar (FBS) and glycated haemoglobin level (HbA1c). The exclusion criteria for cases were un-well patient, patient with dementia, Alzymers disease, patient with type I diabetes (T1DM), diabetic ketoacidosis (DKA), gestational diabetes mellitus (GDM), myocardial infarction (MI) and carcinoma. The purpose of the study explained and informed consent were obtained. Subjects were selected with age as 55 ± 9 for the cases and 53.2 ± 7 for controls that was statistically non-significant. The most of subjects were from rural areas, illiterate; with large family size. Weight, BMI and WC of subjects were found to be significantly associated with the diabetic status of individuals. Physical activity was neglected by majority of diabetics. Most of subjects reported to have knowledge about high carb foods. Subjects from both group’s preferred refined wheat with increased portions than recommendations and total CHO intake was significantly different among the groups. It was concluded that using brown sugar, refined wheat, saturated type of fat and a total of increased carbohydrate intake with poor knowledge of low to moderate glycemic indexed foods were found to be associated with increased BMI and risk of cardiovascular diseases (CVD), and majority of controls exhibited a tendency towards obesity due to poor dietary adherence.