Document Type : Original Article

Authors

Hasheminejad Clinical Research Development Center, Hasheminejad Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

Abstract

Introduction: The aim of this study was to assess dietary habits and related factors
among type 2 diabetic mellitus patients for designing an effective nutrition intervention.
Materials and Methods: A descriptive–analytical study was performed on 480 diabetic
patients referred to four selected teaching hospitals affiliated to the Tehran University of Medical
Sciences (TUMS) in Tehran for a period of nine months in 2012. Patients’ dietary habits were
measured by a 51-item self-report instrument with four general questions about dietary habits
and four subscales reflecting domains including general diabetes information (12 items),
planning, shopping for, and preparing meals (6 items), eating meals (17 items), and family
influence on dietary habits (12 items). The collected data was analyzed by using SPSS
software version 11.5. Results were considered significant at a conventional P < 0.05 level.
Results: Mean age of the participants was 59.96 ± 11.53 years. Mean scores in the domains
were (53.72 ± 19.83), (57.31 ± 23.82), (52.27 ± 12.13), and (64.72 ± 14.3), respectively.
Family influence on dietary habits was highlighted as the most important domain in the dietary
habits instrument. Study results revealed that there was a significant association between
the four domains and socioeconomic and some variables related to dietary habits such
as dietary self-management, planned healthy lifestyle and attending diabetes educational
programs. Discussion: The important role of family on dietary habits among type 2 diabetic
patients highlighted the role of perceived social support from the family. The results of the
sociodemographic variables stressed the necessity of tailoring specific intervention programs
accordingly.

Keywords

1. Center for Disease Control and Prevention. 2005. National diabetes
fact sheet. Available from: http://www.cdc.gov. [Last accessed on
2005 Nov 1].
2. Spinaci S, Currat L, Shetty P, Crowell V, Kehler J. Tough Choices:
Investing in health for development: Experiences from national
follow- up to commission on macroeconomics and health. WHO
Report. 2006.
3. International Diabetes Federation. Diabetes Atlas. 4th ed. Brussels,
Belgium: IDF; 2009.
4. World Health Organization. 2005. Diabetes Programme. Available
from: http://www.who.int/diabetes/actionnow/en. [Last accessed on
2005 Nov 9].
5. Gerich JE. Matching treatment to pathophysiology in type 2 diabetes.
Clin Ther 2001;23:646-59.
6. Task Force on Community Preventive Services. Recommendations
for Health care system and self-management Education Interventions
to reduce morbidity and mortality from diabetes. Am J Prev Med
2002;22:10-4. Available from: http://www. thecommunityguide.
org. [Last accessed on 2013 Jun 2].
7. Esteghamati A, Gouya MM, Abbasi M, Delavary A, Alikhani S,
Alaedini F, et al. Prevalence of diabetes mellitus and impaired
fasting glucose in the adult population of Iran: The National survey
of risk factors for Non-Communicable disease of Iran. Diabetes Care
2008;31:96-8.
8. Azizi F, Hatemi H, Janghorbani M. Epidemiology and Communicable
disease control in Iran. Iran: Tehran Eshtiagh Publication; 2000.
p. 34-9.
9. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lanchin JM,
Walker EA, et al. Reduction in the incidence of type 2 diabetes with
lifestyle intervention or metformin. N Engl J Med 2002;346:393-403.
10. Tol A, Shojaeezadeh D, Sharifirad GH, Eslami AA, Alhani F, Mohajeri
Tehrani MR. Predictors of Self-Management Behaviors among
Type 2 Diabetes Patients. J Basic Appl Sci Res 2012;2:2270-4.
11. Vermeire E, Hearnshaw H, Van Royen P, Denekens J, Patient
adherence to treatment: Three decades of research. A comprehensive
review. J Clin Pharm Ther 2001;26:331-42.
12. Majlessi F, Mohebbi B, Tol A, Rhimi Foroshani A. Assessment of
knowledge and beliefs’ barriers to living with type 2 diabetes and its
related factors. J Nurs Educ 2013;1:28-34.
13. Nagelkerk J, Reick K, Meengs L. Perceived barriers and effective
strategies to diabetes self-management. J Adv Nurs 2009; 54:151-8.
14. Funnell MM, Brown T, Childs B, Hass L, Hoset G, Jensen B. National
Standards for Diabetes Self-Management Education. Diabetes Care
2010;33(Suppl 1):S89-96.
15. Collier LT. Dietary Routines and Diabetes: Instrument development.
Master thesis. Athens, Ohio: Ohio University, 2007.
16. Raberg Kjollesdal MK, Telle Hjellset V, Bjørge B, Holmboe-Ottesen G,
Wandel M. Barriers to healthy eating among Norwegian-Pakistani
women participating in a culturally adapted intervention. Scand J
Public Health 2010;38:52-9.
17. King D, Glasgow R, Toobert DR, Strycker L, Estabrooks P, Osuna D,
et al. Self-Efficacy, problem solving, and social-environmental support
are associated with diabetes self-management behaviors. Diabetes
Care 2010;33:751-3.
18. Nagelkerk J, Reick K, Meengs L. Perceived barriers and
effective strategies to diabetes self-management. J Adv Nurs
2006;54:151-8.
19. Yu R, Woo J, Chan R, Sham A, Ho S, Tso A, et al. Relationship
between dietary intake and the development of type 2 diabetes in
a Chinese population: The Hong Kong dietary survey. Public Health
Nutr 2011;14:1133-41.
20. Wolfram T, Ismail-Beigi F. Efficacy of high-fiber diets in the management
of type 2 diabetes mellitus. Endocr Pract 2011;17:132-42.
21. Mekary RA, Giovannucci E, Willett WC, van Dam RM, Hu FB. Eating
patterns and type 2 diabetes risk in men: Breakfast omission, eating
frequency, and snacking. Am J Clin Nutr 2012;95:1182-9. 22. Jaffiol C, Fontbonne A, Vannereau D, Olive JP, Passeron S. Diabetes
and social deprivation. Bull Acad Natl Med 2012;196:953-75.
23. Sumiyoshi K, Kawata C, Shikata K, Makino H. Influencing factors for
dietary behaviors of patients with diabetic nephropathy. Acta Med
Okayama 2010;64:39-47.
24. Schuster, L. Family support in dietary routines in Appalachians
with type 2 diabetes. Unpublished master’s thesis. Athens, Ohio:
Ohio University; 2005.
25. Yun JO, Kim KN. Relationships of family support, diet therapy
practice and blood glucose control in type II diabetic patients. Nutr
Res Pract 2009;3:141-8.
26. Murrock CJ, Taylor E, Marino D. Dietary challenges of managing
type 2 diabetes in African-American women. Women Health
2013;53:173-84.
27. Sharifirad G, Entezari MH, Kamran A, Azadbakht L. The effectiveness
of nutritional education on the knowledge of diabetic patients using
the health belief model. J Res Med Sci 2009;14:1-6.