Nutritional Practices And Challenges Among Diabetes Patients In LAUTECH Teaching Hospital Ogbomoso Oyo State
Nutritional Practices And Challenges Among Diabetes Patients In LAUTECH Teaching Hospital Ogbomoso Oyo State
Abstract
This study was carried out on the nutritional practices and challenges among diabetes patients in Lautech Teaching Hospital Ogbomoso Oyo State. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprised of patients in Lautech Teaching Hospital Ogbomoso Oyo State. In determining the sample size, the researcher purposefully selected 39 respondents and 35 were validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using frequency tables, and mean scores. The result of the findings reveals that diabetes patients in Lautech Teaching Hospital Ogbomoso Oyo State does not have an adequate nutritional knowledge.The study also revealed that the forms of dietary intake among the diabetes patients for effect nutritional practices include; oat, brown rice, wheat bread, millet, okra, unripe plantain, bitter leaf. Furthermore, the study revealed that the challenges affecting the nutritional practices of diabetes patients in among the diabetes patients include; lack of adequate nutritionist’s advice, poor nutritional and physical activity lifestyle, inappropriate adherence to nutritionist’s advice, scarcity of healthy diets and fats, physicians are not trained in nutritional interventions, and poor affordability of healthy diets.In the light of the findings,this study recommends that nutritional intervention being a key factor in the management of diabetes, producers of all marketed processed/consumable food items in Nigeria should clearly state the glycemic index as part of the nutritional information.. To mention but a few.
Chapter One
Introduction
1.1 Background of the Study
Diabetes mellitus (DM) is a chronic disorder that is not only assuming pandemic proportions worldwide but also poised to affect the developing countries of the world much more than their developed counterparts. The world prevalence is estimated to increase from 425 million people in 2017 to 629 million by 2045[1], and in Africa, the number of people with diabetes will increase from 14.2 million in 2015 to 34.2 million in 2040; predominantly populated in some of the region’s most populous countries: South Africa, the Democratic Republic of Congo, Nigeria and Ethiopia[2]. In 2015, diabetes was one of the leading causes of non-communicable diseases (NCD) death, contributing 1.5 million deaths globally[3,4] and 321,100 deaths in the African region[2].
Along with urbanization and economic growth, many countries have experienced dietary changes favoring increased caloric consumption[5,6], and nutrition is one of the major risk factors of DM. Nutritional management is a key cornerstone modality in the attainment of good glycemic control in DM, and of course, nutrition management of DM is targeted at improving the overall health by achieving and maintaining optimal nutritional status, attaining good glycemic control and preventing acute and long term complications of DM. The current general recommendation is that carbohydrates should provide between 45%-65% of the daily caloric intake, fat should be 25%-35% of total daily calories and protein should be 15%-20% of total daily calories[7,8]. In Nigeria, there is a delusion particularly amongst the diabetic populace that consumption of carbohydrate foods is usually associated with hyperglycemia; hence the popular view that people with DM should either completely avoid carbohydrates or at best take minimal quantities[8].
It is a well-known fact that DM, being a metabolic, endocrine disorder, is directly connected to carbohydrate, lipid and protein metabolism. As a result, nutrition therapy forms an integral part of diabetes management and diabetes self – management education[9]. Medical nutrition therapy has been introduced to guide a systematic and evidence-based approach to the management of diabetes through diet, and its effectiveness has been demonstrated[10]. Also, most diabetes guidelines recommend starting pharmacotherapy only after first making nutritional and physical activity lifestyle changes, but this is not always followed in practice globally[11,12]. Additionally, it is commonly believed that diabetes cannot be completely cured, but it may be more easily regulated and controlled with the right diet and nutritional intake; and with strict adherence to nutritionist’s advice, diabetic patients may be able to significantly improve their quality of life[9].
Furthermore, diabetes mellitus (DM) is a diverse group of metabolic disorders that is often associated with a high disease burden in developing countries such as Nigeria[8]; and most Governments of African countries including Nigeria do not recognize the catastrophic potential of the diabetes epidemic and need to reverse the current trend where DM occupies very low priority in their National Health care agenda, before time runs out[15]. Additionally, cross-sectional studies in Africa indicate low adherence to dietary recommendation for macronutrients intake, and fruits and vegetables consumption among diabetic patients[16,17]. Similarly, most physicians are not trained in nutritional interventions and this is a barrier to the counselling of patients[11,12], and dietary information is often neglected, even though at least modest attention to diet is needed to achieve adequate glycaemic control[12,18].
Despite several recommendations and a number of scientific findings on the beneficial role of appropriate nutritional practices of diabetes, there are still reports on the poor adherence to dietary/nutritional recommendations amongst people with DM[19,20,8], and dietary management as an aspect of DM care is seen as the turf of the nutritionists and as a result, quite a number of physicians have a poor knowledge on nutritional counselling[8]. Thus, the aim of this study is to examine the nutritional practices and challenges of diabetes patients in Oyo State.
1.2 Statement of the Problem
Nigeria is mainly an agrarian country[13], and in the early nineties, not much was known about DM in Nigeria, and traditionally, people related DM to “curses” or “hexes”[8]. Also, As far back as the beginning of the twentieth century, DM was described by Dr. Cook as being an uncommon disorder in Africa[8]. The low incidence of DM then, perhaps, is traceable to dietary habit which was predominated with local foods. In this light of course, it is not beyond reach for diabetic patients to sustain a good dietary habit which in turn will improves the diabetic condition. However, the transition from our local foods to processed foods and junks tends to be a key player in poor dietary habit. In recent times, there has been an exponential increase in the number of established fast food, consequently contributing to availability of unhealthy diets with high calorie content and unhealthy fats[14,6]. Another key component in the food system transition has been the saturation of large chain supermarkets, which displace fresh local food and farm shops and serve as a source of highly processed foods, high-energy snacks, and sugary beverages[14,6]. In the light of the above, this study seeks to examine the nutritional practices and challenges of diabetes patients in Oyo State.
1.3 Objectives of the Study
The overall aim of this study is to critically examine the nutritional practices and challenges of diabetes patients in Oyo State. Hence, the study will be channeled to the following specific objectives;
- Determine the prevalence of diabetes in Oyo State.
- Determine the level nutritional knowledge among the diabetes patients in Lautech Teaching Hospital Ogbomoso Oyo State.
- Determine the forms of dietary intake among the diabetes patients for effect nutritional practices.
- Identify the challenges affecting the nutritional practices of diabetes patients in among the diabetes patients.
1.4 Research Question
The study will be guided by the following questions;
- What is the prevalence of diabetes in Oyo State?
- What is the level nutritional knowledge of diabetes patients in Lautech Teaching Hospital Ogbomoso Oyo State?
- What are the forms of dietary intake among the diabetes patients for effect nutritional practices?
- What are the challenges affecting the nutritional practices of diabetes patients in among the diabetes patients?
1.5 Significance of the Study
The essence of this study is to emphasize on the need for functional foods that promote healthy status, especially among diabetes mellitus patients, going by the increasing prevalence of DM particularly in Nigeria. The outcome of the study will educate such patients on the appropriate and recommended diets for effective management of their condition.
More so, this study will educate and bring to the awareness of key organizations and officials on the factors affecting the appropriate nutritional intake of diabetes.
Additionally, subsequent researchers will use it as literature review. This means that, other students who may decide to conduct studies in this area will have the opportunity to use this study as available literature that can be subjected to critical review. Invariably, the result of the study contributes immensely to the body of academic knowledge with regards to the nutritional practices and challenges among diabetes patients in Lautech Teaching Hospital Ogbomoso Oyo State.
1.6 Scope of the Study
This study is structured to generally evaluate the nutritional practices and challenges among diabetes patients. However, the study will further determine the prevalence of diabetes in Oyo State, determine the level nutritional knowledge among the diabetes patients, determine the forms of dietary intake among the diabetes patients for effect nutritional practices, and identify the challenges affecting the nutritional practices of diabetes patients in among the diabetes patients. Thus, the respondents for this study will be obtained among diabetes patients in Lautech Teaching Hospital Ogbomoso Oyo State.
1.7 Limitation of the Study
Like in every human endeavour, the researcher encountered slight constraints while carrying out the study. Insufficient funds tend to impede the efficiency of the researcher in sourcing for the relevant materials, literature, or information and in the process of data collection, which is why the researcher resorted to a limited choice of sample size. More so, the researcher simultaneously engaged in this study with other academic work. As a result, the amount of time spent on research will be reduced.
Moreover, the case study method utilized in the study posed some challenges to the investigator including the possibility of biases and poor judgment of issues. However, the investigator relied on respect for the general principles of procedures, justice, fairness, objectivity in observation and recording, and weighing of evidence to overcome the challenges.
1.8 Definition of Terms
Knowledge:
This is a familiarity or awareness, of someone or something, such as facts, skills, or objects contributing to ones understanding.
Diabetes:
This is also known as diabetes mellitus. It is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves.
Nutrition:
The food and drink consumed by an individual or group of persons.
Chapter Five
Summary, Conclusions and Recommendations:
5.1 Introduction
This chapter summarizes the findings on the nutritional practices and challenges among diabetes patients in Lautech Teaching Hospital Ogbomoso Oyo State. The chapter consists of summary of the study, conclusions, and recommendations.
5.2 Summary of the Study
In this study, our focus was onthe nutritional practices and challenges among diabetes patients in Lautech Teaching Hospital Ogbomoso Oyo State.The study is was specifically set to determine the prevalence of diabetes in Oyo State, determine the level nutritional knowledge among the diabetes patients in Lautech Teaching Hospital Ogbomoso Oyo State, determine the forms of dietary intake among the diabetes patients for effect nutritional practices, and identify the challenges affecting the nutritional practices of diabetes patients in among the diabetes patients.
The study adopted the survey research design and randomly enrolled participants in the study. A total of 35 responses were validated from the enrolled participants where all respondent were diabetes patients in Lautech Teaching Hospital Ogbomoso Oyo State.
5.3 Conclusions
In the light of the analysis carried out, the following conclusions were drawn.
- The prevalence of diabetes in Oyo State is high.
- Diabetes patients in Lautech Teaching Hospital Ogbomoso Oyo State does not have an adequate nutritional knowledge.
- The forms of dietary intake among the diabetes patients for effect nutritional practices include; oat, brown rice, wheat bread, millet, okra, unripe plantain, bitter leaf.
- The challenges affecting the nutritional practices of diabetes patients in among the diabetes patients include; lack of adequate nutritionist’s advice, poor nutritional and physical activity lifestyle, inappropriate adherence to nutritionist’s advice, scarcity of healthy diets and fats, physicians are not trained in nutritional interventions, and poor affordability of healthy diets.
5.4 Recommendation
Based on the findings the researcher recommends;
- Nutritional intervention being a key factor in the management of diabetes, the recommend that producers of all marketed processed/consumable food items in Nigeria should clearly state the glycemic index as part of the nutritional information.
- Professional Nutritionist should be made available at least in local government areas so as to sensitize the general public, retrain health practitioners, and make recommendations on the nutritional needs, especially for those living with DM.
- In all government and private setups there should be Special dietitians department for prevention of diabetes related complication, preparing diet plans and providing the education regarding the importance of diabetes diet.
- Electronic media and print should be used for creating awareness regarding the importance of nutrition among diabetic patients. It will lead to improve the diabetes outcomes.
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