Association of household socioeconomic status, neighborhood support system and adherence to dietary recommendation among persons with T2DM, a facility-based cross-sectional study in Ghana

A Higher Adherence to the ALINFA Nutritional Intervention Is Effective for Improving Dietary Patterns in Children

Food patterns are deteriorating and, consequently, not meeting nutritional recommendations. Learning about the adherence to a diet is crucial for understanding children's dietary habits. The objective of the present analysis was to assess the degree of compliance with the ALINFA nutritional intervention and the effectiveness of adherence groups, and to evaluate potential baseline factors predicting a higher adherence to the intervention. A total of 44 children aged 6 to 12 years-old participated in the eight-week intervention. A two-week dietary plan was specifically designed, providing participants with food products, ready-to-eat dishes, and recipes. An intake of 75% of calories of the prescribed diet was defined to divide the participants into high- and low-adherence groups (HA/LA, respectively). From the 44 participants, 24 showed a LA to the intervention, whereas 20 of them were in the HA group. Diet quality improved in both groups (p < 0.001), mainly by increasing cereals and nuts, and reducing pastries. A decrease in BMI z-score was observed (LA: p < 0.001; HA: p = 0.021). Fat mass (p = 0.002), LDL-c (p = 0.036), and CRP (p = 0.023) reductions were only achieved in the HA group, whereas leptin decreased only in the LA group (p = 0.046). All participants ameliorated their dietary habits, but those with better diet quality at baseline experienced greater enhancements in their nutritional status.

Self-care behaviors and associated factors among individuals with type 2 diabetes in Ghana: a systematic review

BACKGROUND

Self-care remains an effective model for diabetes management and care in low-and-middle-income countries due to the limited resources available for the clinical management of the disease and its complications This study examined adherence to self-care behaviors and associated factors among people with type 2 diabetes in Ghana.

METHODS

PubMed, PsycINFO, Scopus, Web of Science, Embase and Google scholar were used to identify quantitative observational studies published between 1990 and September 30, 2023. Studies exclusive to persons with type 2 diabetes ≥ 18 years of age in a Ghanaian setting were included in this review. Findings of primary studies were analyzed using narrative synthesis.

RESULTS

Twelve studies, presenting data on a total of 2,671 persons with type 2 diabetes, were included. All the studies were published in the last decade (2015-2022) and a majority of them were from the Greater Accra Region. The mean number of days (per week) participants adhered to a self-care behavior were in the ranges of 3.9-4.4 for diet, 4.2-4.8 for physical activity, 0.5-2.2 for self-monitoring of blood glucose (SMBG), and 2.9-5.0 for foot care. Adherence rates for medication were in the range of 33.5-84.5%. Patient-related factors, sociodemographic/economic-related factors, condition-related factors, and healthcare system-related factors were associated with various self-care behaviors.

CONCLUSION

Adherence to self-care behaviors among persons with type 2 diabetes in Ghana remains an ongoing challenge with significant variations in adherence among patients with different characteristics.

A cross-sectional study on the association between varied social support modalities and glycemic levels amongst diabetic patients residing in Machakos County, Kenya

Introduction

diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. While there's increasing evidence that social support from caregivers improves health outcomes in chronic illness management, the potential associations of the different types of social support and glycemic control among Type II diabetes clients have largely been ignored in Kenya. This cross-sectional study sought to establish the association between tangible, emotional, and informational social support and glycemic levels among clients diagnosed with Type II diabetes in Machakos County, Kenya.

Methods

semi-structured interviews were conducted with 726 randomly selected Type II diabetes clients enrolled in diabetes care and treatment programs in government-owned public health facilities in Masinga and Matungulu sub-counties, Machakos, Kenya. Descriptive statistics and multinomial logistic regression were conducted to elucidate any associations.

Results

seventy-three percent (73%) of the respondents were female, and 27% were male, with the majority (77.9%) being above 50 years and having lived with diabetes for over 3 years (61.5%). Opportunities for social support existed, with 62% of the respondents living with more than 2 persons above 18 in their households. From the Random Blood Glucose test analysis, 38.9% of the clients had high glycemic levels, partly because the majority (66.9%) of the respondents did not practice good diabetes self-management practices at the time of the study. While all three types of social support were reported as provided, only 30.6% reported receiving adequate social support. An association was found between social support and glycemic levels with respondents receiving adequate informational- P<0.05, OR 1.92, emotional -P<0.05, OR 3.7, and tangible support -P<0.05, OR 4.1 more likely to have better glycemic control than those with inadequate support.

Conclusion

clients receiving adequate informational, emotional, and tangible social support were 2, 4, and 4 times, respectively, likely to have better glycemic control than those with inadequate support. Of the three types of social support, tangible support was most needed. Ultimately, a greater understanding of these interactions through longitudinal studies is required to identify solutions and optimize glycaemic control for diabetes clients in Kenya and beyond.

Interactions between Vitamin D Genetic Risk and Dietary Factors on Metabolic Disease-Related Outcomes in Ghanaian Adults

The Ghanaian population is experiencing an upsurge in obesity and type 2 diabetes (T2D) due to rapid urbanization. Besides dietary factors, vitamin D-related genetic determinants have also been shown to contribute to the development of obesity and T2D. Hence, we aimed to examine the interactions between dietary factors and vitamin D-related genetic variants on obesity and T2D related outcomes in a Ghanaian population. Three hundred and two healthy Ghanaian adults (25-60 years old) from Oforikrom, Municipality in Kumasi, Ghana were randomly recruited and had genetic tests, dietary consumption analysis, and anthropometric and biochemical measurements of glucose, HbA1c, insulin, cholesterol, and triglycerides taken. A significant interaction was identified between vitamin D-GRS and fiber intake (g/day) on BMI (pinteraction = 0.020) where those who were consuming low fiber (≤16.19 g/d) and carrying more than two risk alleles for vitamin D deficiency (p = 0.01) had a significantly higher BMI. In addition, an interaction between vitamin D-GRS and fat intake (g/day) on HbA1c (total fat, pinteraction = 0.029) was found, where participants who had a lower total fat intake (≤36.5 g/d), despite carrying more than two risk alleles, had significantly lower HbA1c (p = 0.049). In summary, our study has identified novel gene-diet interactions of vitamin D-GRS with dietary fiber and fat intakes on metabolic traits in Ghanaian adults.

The potential role of plantains, moringa, plantain-moringa combined diets, and other plant-based dietary patterns in controlling glycaemia among T2DM persons, a hospital based cross sectional survey in Ghana

Background

Diabetes mellitus (DM) is an independent risk-factor for cardiovascular diseases. Plant-based dietary-patterns have been shown to reverse the effects of these cardiovascular risk-factors. Our study therefore aimed to investigate the potential roles moringa, moringa-plantain combined, and other plant based dietary-patterns could play in controlling glycaemia among persons with type-2-diabetes Mellitus (T2DM).

Methods

Facility-based cross-sectional-study was conducted among 530 T2DM patients from August 2018 to September 2019 in Ghana. Structured-questionnaires were used to collect demographic, anthropometric, and clinical variables. Adherence to plant-based dietary-patterns were assessed using 3-day food record. SPSS version-20 was used to analyse the data.

Results

BMI, HbA1c%, HDL-cholesterol and LDL-cholesterol were significantly correlated with adherence to plant-based dietary-patterns (p-value < 0.05). After adjusting for physical activity, adherence to plantain diets Standardized regression coefficient β (95%CI): -0.098 (-0.321, -0.022), yam β (95%CI): 0.148 (0.066, 0.496), moringa diets β (95%CI): -0.095 (-0.325,-0.011) and bean-diets β (95%CI): -0.112 (-0.577, -0.007) were significantly associated with glycemic control. Adherence to plantain-moriga combined diets β (95%CI): -0.406 (-0.413, -0.049) and plantain-beans combined diets β (95%CI): -0.128 (-0.188, -0.038) were also significantly associated with glycemic control.

Conclusion

Adherence to plantain, yam, beans, plantain-moriga combined diets, and plantain-beans combined diets could be associated with glycemic-control. Health care workers should prioritize these plant-based dietary-patterns for disease prevention and health promotion.