Evaluation Of Nutritional Status And Dietary Management Of In Patient Diabetics In University Of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria

Evaluation Of Nutritional Status And Dietary Management Of In Patient Diabetics In University Of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
Abstract
The study evaluated Nutritional status and dietary management of in-patient Diabetics in University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State. The targeted aims were to measure anthropometric indices, measure body mass index (BMI), measure dietary management practices and evaluate the correlations of socio-demographic, anthropometric and dietary factors. The study population consisted of male and female diabetic in-patients aged 18-65 years, confirmed to have fasting blood glucose ≥126 mg/dl, casual plasma glucose ≥200 mg/dl, or HbA1c ≥6.5% in order to use a cross-sectional survey design. A sample size of 130 was calculated using the Dobson formula and systematically random sample selection was done. A structured and pretested questionnaire was used to collect the socio-demographic and dietary data and anthropometric measurements, including weight, height, waist circumference, hip circumference, and mid-upper arm circumference. The Body Mass Index (BMI), Waist-to-Hip Ratio (WHR) and Waist-to-Height Ratio (WHtR) were calculated. The analysis was performed with the help of the SPSS version 20 application, applying descriptive statistics (means, standard deviations, frequencies, percentages) and inferential statistics (ANOVA, Duncan Multiple Range Test, Pearson correlation) with the significance level of p < 0.05. Findings indicated that three-quarters (75.0) of the patients were ≥148 cm tall with the mean weight 72.7 +- 16.88 kg. Waist circumference revealed that 41.7 percent of the respondents were in Class II obesity, with the women (67.2 percent) more victimized compared to the men (17.7 percent). Two-thirds (66.7) were at risk (high) according to WHR and BMI classification indicated that 52.5% were obese, 20.8% were overweight, 25.0% were normal and 1.7% were underweight. The correlation found by Pearson showed that gender and hip circumference (r = 0.224, p = 0.014) and MUAC and WHR (r = 0.214, p = 0.019) were significantly correlated. The research suggests that the measures to be taken by nurses and dieticians include organized nutritional education, regular anthropometric surveillance, customized meal planning in the hospital and the adoption of nutritional assessment in the routine diabetes care guidelines.
Table of Content
Chapter One
Introduction
- 1.1 Background Of The Study
- 1.2 Statement of the Problem
- 1.3 Objectives of the Study
- 1.4 Research Questions
- 1.5 Significance of the Study
- 1.6 Scope of the study
- 1.7 Operational Definition of Terms
Chapter Two
Review of Literature
- 2.0 Introduction
- 2.1 Conceptual Review
- 2.2 Theoretical Framework
- 2.3 Empirical Review
- 2.4 Summary of Literature Review
Chapter Three
Methodology
- 3.0 Introduction
- 3.1 Research Design
- 3.2 Study Area
- 3.3 Population of the Study
- 3.4 Sample Size Determination and Sampling Technique
- 3.5 Instrument for Data Collection
- 3.6 Validity and Reliability of Instrument
- 3.7 Method of Data Collection
- 3.8 Method of Data Analysis
- 3.9 Ethical Consideration
Chapter Four
Data Presentation and Analysis
- 4.0 Introduction
- 4.1 Socio-Demographic Characteristics of In-Patient Diabetics
- 4.2 Anthropometric Characteristics of In-Patient Diabetics
- 4.3 Nutritional Status of Diabetic In-Patients
- 4.4 Analysis of Dietary Management Practice of In-Patient Diabetics
- 4.5 Pearson’s Correlation Analysis between Socio-Demographic, Anthropometric and Dietary Practices of the Respondents
Chapter Five
Summary, Conclusions and Recommendations
- 5.0 Introduction
- 5.1 Key Findings
- 5.1.1 Finding on Nutritional Status of In-Patient Diabetics
- 5.1.2 Findings on Dietary Management Practice of In-Patient Diabetics
- 5.1.3 Findings on between Socio-Demographic, Anthropometric and Dietary Practices of the Respondents
- 5.2 Implications of the Findings to Nursing Practice
- 5.3 Summary of the Study
- 5.4 Conclusion
- 5.5 Limitations of the Study
- 5.6 Recommendations
- 5.7 Suggestions for Further Studies
- References
- Appendix
- Questionnaire
Chapter One
Introduction
1.1 Background of the Study
The concept of health and well-being has played a central role in the human life, and it has touched various spheres, including physical, emotional, and social. Throughout history, different civilizations have acknowledged the need to stay healthy by eating balanced diets, exercising and engaging in preventive health care. The cultural changes, development of technology and the changes in the economy changed the eating habits over the years. Certain cultures have been founded on the entire natural foods, others have resorted to processed and convenience foods with severe health implications. Chronic diseases are also a primary issue of concern among all the various problems related to diet as diabetes has now become a widespread problem. One of the most notable health challenges that affect populations across the globe is diabetes mellitus which is a metabolic disorder that entails hyperglycaemia in the blood (Ezekwe & Abodunrin, 2021). The trend has been towards an increase in diabetes over the years and there has been the need to learn more about the disease and its implications to the lives of people living with it particularly to the adult patients who find it so difficult to manage the disease.
Diabetes is a long term illness whereby the body is unable to produce sufficient insulin, or in instances where insulin is produced the insulin is no longer able to function in a normal manner leading to a high blood sugar level. As a rule, diabetes is divided into type 1 and type 2, the latter is more prevalent among adults (Nwakamma & Olusile, 2022). Diabetes type 2 is a problem of the modern world and it is associated with the genetic factor, obesity, and inactivity. Adults with Diabetes have immense health needs such as susceptibility to cardiovascular diseases and neuropathy, retinopathy, and renal failure (Omeke & Fadeyi, 2023). Besides, dealing with the disease causes more stress and results in anxiety and depression, also impacting on mental health. Having commitments to take care of every day, diabetes management among the adult population, including medication consumption, lifestyle modifications, and dietary adaptation, could be a burden (Ikpeazu et al., 2021). All these complications underscore the importance of proper nutritional data and dietary options in order to maximize the health of diabetic patients.
Glycemic control entails dietary management which is part of the knowledge associated with dietary patterns that is also major in managing diabetes. Food education, meal structure, and timing also allow a diabetic to understand the food intake (Ajagbe and Nwoke, 2023). The consumption of foods rich in fiber, lean proteins, healthy fats, and complex carbohydrates and the avoidance of processed sugars and unhealthy fats is the signature of healthy diet control. However, a number of adults with diabetes report the inability to adhere to balanced diets in large part because of food misinformation, cultural aspects, and economic hardship (Kuforiji and Onyekwere, 2022). The disease diabetes is chronic, hence the need to offer diabetes care education that would help in controlling diabetes in patients by giving them information on the kind of food they consume. Studies have proposed that nutritional counseling and customized meal planning in the life of the diabetic adult positively influences blood sugar levels and general health results (Folarin et al., 2023). Therefore, it is important to have a proper grasp of nutrition in order to establish healthier eating habits and avoid diabetes complications.
Dietary management is a component of diabetes management offered in health locations where they are taught the competencies that are necessary in introducing sustainable lifestyle change. Clinically speaking, hospitals and clinics also play a central role in providing nutritional education, where dietitians and other health providers offer particular therapeutic strategies to a patient (Oluwagbemi and Arowolo, 2024). Organized nutrition programs have been linked to better glycemic control, fewer medication dependencies and better life quality among diabetic adults. Nutrition Programs Overview Travels have impacted disease transmission negatively, so the obesity epidemic is not solely individual and instead covers all age groups, which complicates overcoming the most effective interventions (Ugochukwu & Fasasi, 2021). Beyond official healthcare environments, the concept of digital health has emerged as an innovative and unexplored path to providing dietary information, as people can now self-track their food consumption and promptly get feedback on their food-related habits (Akano et al., 2023). With the growing attention to providing people with nutritional education, it is essential to consider how well the adults affected by diabetes know and adhere to the dietary changes in their daily life.
The University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria is one of the largest hospitals in Nigeria that admits individuals with diabetes. The rising cases of diabetes diagnosis have seen the hospital act as a central point of service to adults with diabetes with clinical consultations, health education, and diet counseling services (Badmus & Ige, 2023). Having had a considerable amount of emphasis on providing dietary guidance to patients with diabetes, the organization has played a vital role in adjusting the dietary requirements to individual patients. These preventive measures and management however, fundamentally rely on the education of the patients in terms of nutrition and their capacity to take dietary precautions. It will be based on the assets and the weaknesses of the diabetes nutritional education in the environment of the hospital, in which this work will be organized.
1.2 Statement of the Problem
The rising cases of diabetes among the adult population in Nigeria constitute a critical challenge to the public health and dietary management is an essential aspect of controlling the disease. Although the condition is well-known, individuals are not able to make informed decisions regarding their diets because of poor nutrition knowledge and misinformation regarding food consumption (Ezeokafor and Salawu, 2022). The prevailing circumstances indicate that a significant percentage of diabetic adults do not follow recommended nutritionary habits, and as a result, they have an inadequately regulated blood sugar and have an increased risk of developing complications including cardiovascular diseases, kidney dysfunction and neuropathy (Kuforiji & Onyekwere, 2022). Healthcare facilities (such as University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria) offer nutritional counseling and dietary advice, but it is still unclear how much adults with diabetes comprehend and adopt the guidelines. Ideally, persons who have been diagnosed with diabetes, ought to have a thorough grasp of nutrition, which will ensure that they make informed choices that will lead to optimal glycemic regulation and general well-being. But the difference between what we are advised to do and what we do shows that there is a very critical issue that requires further research.
A number of researches have underscored the significance of nutritional education in the treatment of diabetes, but very little empirical evidence exists on the success of existing dietary interventions in hospitals (Oluwagbemi & Arowolo, 2024). Although dietary counseling might be available to certain adults with diabetes, the variability of the quality of the information they receive, as well as variations in their understanding of the information, create an obstacle on the way to the effective utilization of dietary principles (Badmus & Ige, 2023). In addition, dietary preferences and financial limitations tend to affect cultural food preferences, and patients find it hard to keep healthy culture of eating (Ajagbe & Nwoke, 2023). The best would be a systematic and formal method of dietary education so that every patient with diabetes would be given specific advice based on his or her needs. Also, an educated group of patients would be in a position to incorporate nutrition information into their lives and eventually minimize the costs of diabetes complications. Nonetheless, current knowledge gaps on the degree of nutritional awareness and diet habits of adults with diabetes do not allow conducting more effective interventions.
The absence of information on the level of understanding and implementation of nutritional advice among patients in the University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria is a major gap in the research. The past research analysed diabetes management in Nigeria in a broad manner, and minimal studies have concentrated on developing an evaluation of the direct connection between nutritional knowledge and dietary compliance in narrow hospital settings (Folarin et al., 2023). Such research gap brings about uncertainties on whether the dietary interventions offered at the hospital are enough to equip the patient with skills that will enable them to effectively control diabetes. Also, the barriers that hamper dietary adherence are a crucial factor that should be explored, including whether their causes are either poor knowledge, socioeconomic factors, or personal choices (Ugochukwu and Fasasi, 2021). The study will fill these gaps by performing a detailed evaluation of the nutrition knowledge and dietary habits of adults with diabetes in this institution, and by providing insights that will be valuable in creating more specific and effective dietary interventions. Thus, this research aims to present evidence-based results that can enhance the process of diabetes care through finding out the strong and weak aspects of the existing dietary education model.
1.3 Objectives of the Study
The specific objectives for the study will cover;
- To assess the socio-demographic characteristics of in-patient diabetics in University of Nigeria Teaching Hospital, Ituku-Ozalla.
- To determine the nutritional status of in-patient diabetics using anthropometric indices, and body mass index.
- To evaluate the dietary management pattern of in-patient diabetics in University of Nigeria Teaching Hospital, Ituku-Ozalla.
- To assess the relationship between sociodemographic, anthropometric and dietary management practices of in-patient diabetics in University of Nigeria Teaching Hospital, Ituku-Ozalla.
1.4 Research Questions
The following research questions which are in line with the objectives of this study will be answered:
- What are the socio-demographic characteristics of in-patient diabetics in University of Nigeria Teaching Hospital, Ituku-Ozalla?
- What is the nutritional status of in-patient diabetics using anthropometric indices, and body mass index?
- What are the dietary management pattern of in-patient diabetics in University of Nigeria Teaching Hospital, Ituku-Ozalla?
- What is the relationship between sociodemographic, anthropometric and dietary management practices of in-patient diabetics in University of Nigeria Teaching Hospital, Ituku-Ozalla?
1.5 Significance of the Study
The research is going to shed light on the nutritional awareness and eating habits of diabetic adults in University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria. The knowledge of these factors will guide healthcare professionals make specific educational programs to enhance the management of diabetes.
The results will help dietitians and health care givers to develop effective nutritional counseling programs that will be used in increasing dietary adherence in diabetic patients. This will help in the improvement of the glycemic control and decrease complications of diabetes.
This study will be valuable to policymakers and public health authorities as it will provide them with data-based interventions to leverage nutrition-based mechanisms. This will aid in formulation of policies that will encourage healthier eating habits among diabetic people.
Lastly, the study will be considered as a source of future researches on managing diabetes, which will guide upcoming researches on how nutritional knowledge influences health conditions among diabetic community members.
1.6 Scope of the Study
Broadly, this study will focus on assessing evaluation of nutritional status and dietary management of in patient diabetics in University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria. Empirically, the study will assess the socio-demographic characteristics of in-patient diabetics in University of Nigeria Teaching Hospital, Ituku-Ozalla, determine the nutritional status of in-patient diabetics using anthropometric indices, and body mass index, evaluate the dietary management pattern of in-patient diabetics in University of Nigeria Teaching Hospital, Ituku-Ozalla, and assess the relationship between sociodemographic, anthropometric and dietary management practices of in-patient diabetics in University of Nigeria Teaching Hospital, Ituku-Ozalla..
Geographically, This study will be delimited to University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria.
1.7 Operational Definition of Terms
Nutritional status:
The degree of awareness and knowledge of how to make right choices in diet, nutrient intake, and how it affects the management of diabetes in adults with Diabetes.
Dietary management:
The food intake, dietary choices and adherence to advised dietary regimens to which adults with diabetes adhere to control their disease.
Diabetes:
This is also referred to as diabetes mellitus. It is a long term, metabolic condition that is associated with an elevation in the amount of glucose (or blood sugar) in the blood, which causes chronic, severe damage to the heart, blood vessels, eyes, kidneys and nerves.
Diabetes Management:
A combination of medical therapy, lifestyle changes, and dieting practices with the aim of managing the extent of sugar in the blood and thwarting illnesses in diabetics.
Chapter Five
Summary, Conclusions and Recommendations
5.0 Introduction
This chapter presents a summary of the study, its implications for nursing practice, conclusions, limitations of the study, recommendations, and suggestions for further studies.
5.1 Key Findings
5.1.1 Finding on Nutritional Status of In-Patient Diabetics
The anthropometric parameter analysis indicated significant differences in the nutritional condition of diabetic in-patients with most of the respondents falling within the overweight and obese category and more specifically, obesity with 53.5% prevalence (46.8% in males and 58.6% in females). This is consistent with the distribution of waist circumference with 41.7% of all participants classified as Class II obese with the female population dominating at 67.2% as compared to 17.7% of males. The average male waist circumference was 84.5 +- 9.24 cm in normal group with the Class II obesity increasing to 111.3 +- 11.45 cm, and females of the same group had an average of 100.9 +- 9.06 cm. The results imply that central adiposity is more predominant among the female respondents in line with the hip circumference averages of 102.0 +- 13.1 cm and 107.5 +- 10.9 cm in both males and females respectively, which proves that women have more fat deposition. These differences were further supported by the waist-to-hip ratio (WHR) which identified 81.0% of females, and 53.2% of males as high-risk with a mean of 0.89 +- 0.05 and 0.98 +- 0.08 respectively, and represented sex-specific differences in fat distribution. The outcomes of these results are similar to the t-test results which showed that hip circumference is significantly different (t = -2.499, p = 0.014) and WHR (t = 3.245, p = 0.002), which proves that sex has a strong impact on fat distribution in diabetic patients. Similar trends were also reported by Lartey and Chikonde (2022) who reported that 54.9% of diabetic women were obese, compared to 43.1% of men, and that there are significant differences in WHR (p = 0.001), with females more likely to have central obesity. On the same note, the study by Tadesse et al. (2023) in Ethiopia revealed that 51.7 percent of diabetic in-patients were obese, and the WHR among men (0.97 +- 0.06) and women (0.89 +- 0.05) showed significant differences in the results, which is similar to the findings of the current study in terms of gender-based adiposity trends. In India, Basumatary and Keot (2021) discovered that 49.3% of diabetic in-patients were Class I or II obese with a mean BMI of 29.8 +- 4.5 kg/m2, which is comparable to the mean overweight prevalence and obesity prevalence in this country. The uniformity of these results in various studies shows the universal obesity and overweight of diabetics patients contributing to the increased risks of cardiovascular disease, insulin resistance, and metabolic syndrome. The current results highlight the necessity of emergency hospital-based dietary and lifestyle interventions to manage weight gain in diabetic in-patients, particularly, female patients who were more likely to be obese.
5.1.2 Findings on Dietary Management Practice of In-Patient Diabetics
The results of dietary management practices analysis showed that in-patient diabetics tended to follow suggested dietary patterns but with certain deviation across food groups. Cereals were daily and frequently eaten, 40.0% and 45.0% respectively, indicating that they are still a staple and the consumption of processed cereals was moderate, 15.0% daily, 62.5% often and 7.5% never. Dietary compliance was also relatively low with only 8.3% of the people consuming sugar daily, 15.0% frequently, 43.3% infrequently and 33.3% never consuming sugar. Similar trends were observed in beverages where 14.2 percent consumed daily, 42.5 percent frequently, and 8.3 percent did not consume it at all, probably because of sugar content. Protein sources were inconsistently consumed: legumes were reported every day by 25.8% and frequently by 61.7, and vegetables were reported every day by 42.5% and frequently by 54.2, and fruits were reported every day by 40.8% and frequently by 48.3, which means that there was consistency in the intake of plant-based proteins. Foods of animal origin were less regularly eaten; meat was eaten daily by 36.7% and frequently by 54.2% compared to milk and eggs, where 26.7 and 33.3% often ate milk and rarely ate eggs respectively. These findings are in line with those of Aduku and Ndueso (2022), who found that Nigerian diabetic in-patients were more prone to eating cereals (78.6%), legumes (65.4%), but less prone to milk and egg consumption (34.2% and 29.5% respectively). Likewise, Kebede and Fufa (2021) have discovered that in Ethiopia, 81.1% of diabetic patients ate vegetables either daily or frequently, 77.2% ate fruits, and sugar-sweetened foods were consumed infrequently at 52.3% indicating careful food management. Haque et al. (2023) demonstrated in Bangladesh that 46.3 percent of diabetic patients followed the daily intake of fruits and vegetables, and 61.8 percent reduced sugar, which is quite consistent with this study. Notably, Alarape and Uwah (2024) emphasized that dietary adherence was closely correlated with the improved glycemic control of Nigerian diabetics (p < 0.01), and the dietary intake of legumes and vegetables per day was significantly lower in HbA1c levels (mean 6.8 +- 1.3) than the irregular intake (mean 8.4 +- 1.9%). The similarity of the results between African and Asian studies prove that diabetic patients usually change their diets to restrict sugar and feed more on the foods rich in fibers, but the variation remains with the sources of proteins, including milk and eggs, which may be due to their affordability or diet habits. These results support the need to have organized dietary counseling in hospitals to enhance diabetic dietary adherence and minimize the variability in food group intake.
5.1.3 Findings on between Socio-Demographic, Anthropometric and Dietary Practices of the Respondents
Pearson correlation analysis showed that there are significant interrelations between the chosen socio-demographic, anthropometric, and dietary parameters. Household size was positively related to age (r = 0.222, p = 0.020), indicating that older diabetic patients were more likely to have more people in their household, which could have an impact on food distribution and diet. Gender had a significant positive correlation with hip circumference (r = 0.224, p = 0.014), which was in line with the observation that females had a larger mean hip measurement (107.5 +- 10.9 cm) than males (102.0 +- 13.1 cm). Mid-upper arm circumference (MUAC), was positively correlated with waist-to-hip ratio (r = 0.214, p = 0.019), meaning higher values of MUAC were positively correlated with central adiposity. These findings mirror the interrelationship between demographic and anthropometric factors in the development of nutritional profiles of diabetic in-patients. Similar results were also described in a study by Abiola and Okafor (2022), who discovered that age and household size were significantly correlated in terms of diabetics in Nigeria (r = 0.241, p = 0.018), indicating that household-related factors play a role in determining dietary access. Equally, Teshome and Megersa (2023) found that there was a significant positive correlation between gender and hip circumference (p = 0.011), with women having higher mean hip sizes compared with men, which is similar to the findings of the current study. Rao and Thongbam (2021) in India identified that MUAC was significantly correlated with WHR (r = 0.261, p = 0.021), which confirms that the higher the upper arm adiposity, the greater the central obesity, which is also the same case with the current findings (r = 0.214, p = 0.019).
Additionally, Mbogo and Chukwuma (2024) showed that higher household size among diabetic patients was linked to a worse dietary diversity (p = 0.026), which may indirectly influence anthropometric results. Put together, these studies support the finding that socio-demographic variables, especially age, family size, and gender, have quantifiable impact on the anthropometric measures and eating habits of diabetic in-patients. The interdependence of these two factors highlights the essence of taking demographic contexts into account when planning nutritional interventions because the age and gender trends are the direct determinants of body composition and the household size can influence the division of food and compliance with the recommended diet.
5.2 Implications of the Findings to Nursing Practice
The results of the research indicate the importance of the nurses in the nutritional status and dietary control of diabetic in-patients. Since a high rate of overweight, obesity, and central adiposity has been recorded among the participants, nurses need to step up the activities in nutritional assessment, personalized dietary counseling, and lifestyle education as an inseparable part of regular care. Nurses are best placed to encourage patients to follow the dietary guidelines, check the anthropometric index, and offer their patients consistent support with a view of preventing diabetes-related complications and enhancing the quality of life.
5.3 Summary of the Study
This study on Nutritional Status and Dietary Management of In-Patient Diabetics in University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria. The research was guided by specific objectives which included evaluating the anthropometric indices of the respondents, assessing their body mass index (BMI) to determine nutritional status, examining their dietary management practices, and analyzing correlations between socio-demographic, anthropometric, and dietary factors.
The research design utilized the cross-sectional survey type that allowed gathering data at a given time to evaluate anthropometric and dietary trends of the study participants. The sample was made of adult male and female in-patients aged 18-65 years who were diagnosed with diabetes mellitus at the University of Nigeria Teaching Hospital, Ituku Ozalla. Using a non-response rate of 7.5 per cent and the design effect of 1.0, Dobson came up with a sample size of 130 participants. To sample the respondents in the study population, a systematic random sampling method was used to identify the eligible respondents. The structured questionnaire, direct anthropometric measure including weight, height, waist circumference, hip circumference, and mid-upper arm circumference (MUAC) were used in data collection. They included standard procedures and tools of SECA UNICEF weighing scales, stadiometers, non-stretchable measuring tapes, and Shakir strips. To establish the nutritional status of the participants, Body Mass Index (BMI), Waist-to-Hip Ratio (WHR) and Waist-to-Height Ratio (WHtR) were calculated.
The statistical package used to analyze the obtained data was the Statistical Package of Social Sciences (SPSS) version 20. The data were summarized using descriptive statistics using means, standard deviations, frequencies and percentages. Hypotheses and associations were tested using inferential statistics such as one way analysis of variance (ANOVA), Duncan Multiple Range Test and Pearson correlation. The level of significance of p was taken to be p < 0.05. The findings were in tables and were discussed in correlation to the study objectives. Results indicated that obesity was dominant in the study participants especially in females, moderate adherence to dietary advice like low sugar and non-alcoholic drinks and regular intake of vegetables, fruits, and legumes..
5.4 Conclusion
The researchers conclude that diabetic in-patients in the University of Nigeria Teaching Hospital, Ituku Ozalla, show high rates of obesity and central adiposity, which predisposes them to subsequent diabetes complications. Even though eating habits were somewhat in accordance to the recommended eating patterns, especially with lower sugar and higher intake of fruits, vegetables, and legumes, the differences in intake patterns of the cereal, meat, milk, and eggs indicate areas where dietary adherence was not met. The results highlight the pressing necessity of the enhanced nutritional education, dietary follow-up, and intervention of the healthcare providers aimed at decreasing the risk of complications and enhancing the overall outcomes of the patients.
5.5 Limitations of the Study
The research had a number of limitations. To begin with, the cross-sectional design imposed some restrictions on setting a cause-effect relationship between nutritional status and dietary practices. Secondly, use of self-reported dietary consumption raised the chances of recall bias and under- or over-reporting of respondents. Thirdly, the research was done in one tertiary hospital, which restricted the extrapolation of results to other populations. Lastly, the logistical issues like non-cooperation of patients during anthropometric measurements and the interruption of routine activities in the hospitals were limiting in the collection of data.
5.6 Recommendations
Based on the findings, the following recommendations are made:
- Nutritional education programs should be put in place in hospital wards by nurses and dieticians to enhance the knowledge of diabetic in-patients on proper diets and the effects of non-compliance.
- To ensure that overweight, obesity, and central adiposity are timely detected to implement interventions, regular anthropometric monitoring must become a part of the diagnostics of diabetic care.
- Hospitals are expected to offer personalized meal plans based on the nutritional requirements of diabetic in-patients based on gender-specific differences in fat distribution and caloric requirements.
- Healthcare policy makers ought to incorporate a daily assessment of nutrition and counseling in the care of diabetes so that no in-patients are not provided with a standardized dietary care in addition to pharmacological therapy.
5.7 Suggestions for Further Studies
A longitudinal study with a causal nature ought to be conducted to determine causal relationships between dietary habits and alterations in nutritional status of diabetic patients. It is also advisable to conduct comparative study in several hospitals and geographical areas in Nigeria to promote the external validity of results. Moreover, in the future, it might be necessary to use biochemical indicators of nutrition status along with anthropometric indicators to present a more detailed evaluation of the diet of diabetic patients.


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