Adherence to Dietary Recommendations and Barriers Among Type 2 Diabetic Patients: A Cross-Sectional Study at Ho Teaching Hospital, Ghana
Authors
Department of Home Economics, E.P.C. Mawuko Girls' Senior High School, Ho; Department of Food and Nutrition Education, Faculty of Health, Allied Sciences and Home Economics Education, University of Education, Winneba (Ghana)
Department of Food and Nutrition Education, Faculty of Health, Allied Sciences and Home Economics Education, University of Education, Winneba (Ghana)
Department of Food and Nutrition Education, Faculty of Health, Allied Sciences and Home Economics Education, University of Education, Winneba (Ghana)
Article Information
DOI: 10.47772/IJRISS.2026.100300042
Subject Category: Public Health
Volume/Issue: 10/3 | Page No: 666-673
Publication Timeline
Submitted: 2026-03-09
Accepted: 2026-03-14
Published: 2026-03-25
Abstract
Background: Type 2 Diabetes Mellitus (T2DM) is a growing global health burden, with dietary adherence central to glycaemic management.
Objective: This study investigated adherence levels and barriers to dietary recommendations among T2DM patients at Ho Teaching Hospital, Ghana.
Methods: A cross-sectional survey of 135 patients using a modified Perceived Dietary Adherence Questionnaire was employed.
Results: Adherence was high for avoiding sweets (93.33%) and alcohol (93.33%) but poor for fruits (85.93%) and vegetables (69.63%). Financial constraints (41.48%) were the leading barrier; 71.11% reported at least one barrier. Younger patients faced significantly more barriers (p = 0.002).
Conclusion: Targeted dietary education and economic support strategies are urgently needed for T2DM management in Ghana.
Keywords
type 2 diabetes mellitus, dietary adherence, barriers, glycaemic control, Ghana
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References
1. American Diabetes Association. (2022). Standards of medical care in diabetes — 2022. Diabetes Care, 45(Suppl. 1), S1–S264. https://doi.org/10.2337/dc22-Sint [Google Scholar] [Crossref]
2. Kautzky-Willer, A., Leutner, M., & Harreiter, J. (2023). Sex differences in type 2 diabetes. Diabetologia, 66(6), 986–1002. https://doi.org/10.1007/s00125-023-05891-x [Google Scholar] [Crossref]
3. International Diabetes Federation. (2021). IDF Diabetes Atlas (10th ed.). IDF. [Google Scholar] [Crossref]
4. Bawah, A. T., Ngambire, L. T., Abaka-Yawson, A., Anomah, A., Kinanyok, S., & Tornyi, H. (2021). A community-based prevalence of type 2 diabetes mellitus in the Ho municipality of Ghana. Journal of Public Health, 29, 403–409. https://doi.org/10.1007/s10389-019-01182-z [Google Scholar] [Crossref]
5. Issah, S., Aseidu, M., Danquah, A., Akwaa, O., & Kadir, A. (2022). Undiagnosed type 2 diabetes mellitus prevalence and associated risk factors in an urban and rural metropolis in Ghana. Journal of Nutrition and Metabolic Disease Care, 8, 062. [Google Scholar] [Crossref]
6. Dawite, F., Girma, M., Shibiru, T., Kefelew, E., Hailu, T., & Temesgen, R. (2023). Factors associated with poor glycemic control among adult patients with type 2 diabetes mellitus in Southern Ethiopia: A case-control study. PLOS ONE, 18(3), e0276678. https://doi.org/10.1371/journal.pone.0276678 [Google Scholar] [Crossref]
7. Eshete, A., Lambebo, A., Mohammed, S., Shewasinad, S., & Assefa, Y. (2023). Effect of nutritional promotion intervention on dietary adherence among type II diabetes patients in North Shoa Zone, Amhara Region: Quasi-experimental study. Journal of Health, Population and Nutrition, 42(1), 1–10. https://doi.org/10.1186/s41043-023-00368-2 [Google Scholar] [Crossref]
8. Doglikuu, B. I. D., Abdulai, A., Yaseri, M., Shakibazadeh, E., Djazayery, A., & Mirzaei, K. (2021). Association of household socioeconomic status, neighbourhood support system and adherence to dietary recommendation among persons with T2DM in Ghana. BMC Public Health, 21(1), 1–8. https://doi.org/10.1186/s12889-021-10449-y [Google Scholar] [Crossref]
9. Al-Salmi, N., Cook, P., & D'Souza, M. S. (2022). Diet adherence among adults with type 2 diabetes mellitus: A concept analysis. Oman Medical Journal, 37(2), e361. https://doi.org/10.5001/omj.2022.26 [Google Scholar] [Crossref]
10. Asaad, G., Sadegian, M., Lau, R., Xu, Y., Soria-Contreras, D. C., Bell, R. C., & Chan, C. B. (2015). The reliability and validity of the Perceived Dietary Adherence Questionnaire for people with type 2 diabetes. Nutrients, 7(7), 5484–5496. https://doi.org/10.3390/nu7075231 [Google Scholar] [Crossref]
11. Raj, S. P., & Sridhar, M. G. (2018). Perceived dietary adherence and barriers among type 2 diabetes mellitus patients. International Journal of Health Sciences and Research, 8(2), 14–19. [Google Scholar] [Crossref]
12. Bekele, H., Asefa, A., Getachew, B., & Belete, A. M. (2020). Barriers and strategies to lifestyle and dietary pattern interventions for prevention and management of type-2 diabetes in Africa: Systematic review. Journal of Diabetes Research, 2020, 1–12. https://doi.org/10.1155/2020/1536518 [Google Scholar] [Crossref]
13. Bai, R. R., & Kumari, R. (2020). Perceived dietary adherence and its barriers to dietary recommendations among type 2 diabetes mellitus patients. Innovative Journal of Nursing and Healthcare, 6(3), 1–5. [Google Scholar] [Crossref]
14. Ghimire, S. (2021). Barriers to diet and lifestyle modification in type 2 diabetes patients and their perspectives on problem solving: A qualitative study. Journal of Diabetes Research, 2021, 5556842. https://doi.org/10.1155/2021/5556842 [Google Scholar] [Crossref]
15. Mohammed, S. H., & Sharew, N. T. (2019). Dietary practice and its associated factors among type 2 diabetes patients in Southeast Ethiopia. BMJ Open Diabetes Research & Care, 7(1), e000729. https://doi.org/10.1136/bmjdrc-2019-000729 [Google Scholar] [Crossref]
16. Ciarambino, T., Crispino, P., Leto, G., Mastrolorenzo, E., Para, O., & Giordano, M. (2022). Influence of gender in diabetes mellitus and its complications. International Journal of Molecular Sciences, 23(16), 8850. https://doi.org/10.3390/ijms23168850 [Google Scholar] [Crossref]
17. Yan, Z., Cai, M., Han, X., Chen, Q., & Lu, H. (2023). The interaction between age and risk factors for diabetes and prediabetes: A community-based cross-sectional study. Diabetes, Metabolic Syndrome and Obesity, 16, 85–93. https://doi.org/10.2147/DMSO.S388415 [Google Scholar] [Crossref]
18. Bellary, S., Kyrou, I., Brown, J. E., & Bailey, C. J. (2021). Type 2 diabetes mellitus in older adults: Clinical considerations and management. Nature Reviews Endocrinology, 17(9), 534–548. https://doi.org/10.1038/s41574-021-00512-2 [Google Scholar] [Crossref]
19. Tirfie, M., Birhanu, Z., Mengistie, B., & Amsalu, S. (2020). Dietary practices and associated factors among type 2 diabetes mellitus patients in Northwest Ethiopia: A cross-sectional study. Journal of Diabetes Research, 2020, 3534272. https://doi.org/10.1155/2020/3534272 [Google Scholar] [Crossref]
20. Mogre, V., Abanga, Z. O., Tzelepis, F., Johnson, N. A., & Paul, C. (2021). Adherence to and factors associated with self-care behaviours in type 2 diabetes patients in Ghana. BMC Endocrine Disorders, 17(1), 1–8. https://doi.org/10.1186/s12902-017-0169-3 [Google Scholar] [Crossref]
21. Portela, R. A., Silva, J. R. S., Nunes, F. B. B. F., Lopes, M. L. H., Batista, R. F. L., & Silva, A. C. O. (2022). Diabetes mellitus type 2: Factors related to adherence to self-care. Revista Brasileira de Enfermagem, 75, e20210260. https://doi.org/10.1590/0034-7167-2021-0260 [Google Scholar] [Crossref]
22. Boshe, B. D., Yimar, G. N., Dadhi, A. E., & Bededa, W. K. (2021). The magnitude of non-adherence and contributing factors among adult outpatients with diabetes mellitus in Dilla University Referral Hospital, Ethiopia. PLOS ONE, 16(3), e0247952. https://doi.org/10.1371/journal.pone.0247952 [Google Scholar] [Crossref]
23. Landa-Anell, M. V., Melgarejo-Hernández, M. A., García-Ulloa, A. C., Del Razo-Olvera, F. M., Velázquez-Jurado, H. R., & Hernández-Jiménez, S. (2020). Barriers to adherence to a nutritional plan and strategies to overcome them in patients with type 2 diabetes mellitus. Endocrinología, Diabetes y Nutrición, 67(1), 4–12. https://doi.org/10.1016/j.endinu.2019.02.010 [Google Scholar] [Crossref]
24. Ayele, A. A., Emiru, Y. K., Tiruneh, S. A., Ayele, B. A., Gebremariam, A. D., & Tegegn, H. G. (2021). Level of adherence to dietary recommendations and barriers among type 2 diabetic patients: A cross-sectional study in an Ethiopian hospital. Clinical Diabetes and Endocrinology, 4(1), 1–7. https://doi.org/10.1186/s40842-018-0054-7 [Google Scholar] [Crossref]
25. Akumiah, P. K., Lamptey, R., & Ankomah, S. E. (2017). Adherence to dietary regimen among type 2 diabetic patients at Agogo Presbyterian Hospital, Ghana. International Journal of Research in Medical Sciences, 5(12), 5212–5218. https://doi.org/10.18203/2320-6012.ijrms20175397 [Google Scholar] [Crossref]
26. Beverly, E. A., Ritholz, M. D., Wray, L. A., Chiu, C. J., & Suhl, E. (2018). Understanding the meaning of food in people with type 2 diabetes living in northern Appalachia. Diabetes Spectrum, 31(1), 14–24. https://doi.org/10.2337/ds17-0003 [Google Scholar] [Crossref]
27. Salama, M., Biggs, B. K., Creo, A., Prissel, R., Al Nofal, A., & Kumar, S. (2023). Adolescents with type 2 diabetes: Overcoming barriers to effective weight management. Diabetes, Metabolic Syndrome and Obesity, 16, 693–711. https://doi.org/10.2147/DMSO.S365529 [Google Scholar] [Crossref]
28. Jepkemoi, R., Kyalo, C., & Mutisya, R. (2021). Factors influencing dietary adherence among type 2 diabetes patients attending Kenyatta National Hospital, Nairobi, Kenya. African Journal of Health Sciences, 34(2), 115–129. [Google Scholar] [Crossref]
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