Research Article| Volume 27, ISSUE 7, P642-650, July 2017

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Self-reported adherence to diet and preferences towards type of meal plan in patient with type 2 diabetes mellitus. A cross-sectional study


      • A low adherence to diet is frequently found in patients with type 2 diabetes (T2DM).
      • We evaluated the attitudes of 500 T2DM patients towards the provided dietary plan.
      • Few T2DM patients declared to fully adhere to the prescribed diet.
      • Unexpectedly, one third of patients did not even perceive the given plan as a diet.
      • Attitudes towards diet were related to age, sex, BMI, HbA1c and educational level.


      Background and aims

      Few studies have evaluated the attitudes of patients with type 2 diabetes mellitus (T2DM) towards the given dietary plans. In this study, we aimed to evaluate: i) the self-reported adherence of T2DM patients to the prescribed diets; ii) the use of other types of diet schemes; iii) the patients' preferences towards the type of meal plans.

      Methods and results

      A 16 multiple-choice items questionnaire was administered to 500 T2DM patients; 71.2% (356/500) of them had the perception of having received a dietary plan; only 163/356 declared to be fully adherent. The latter had lower BMI (25.8 ± 4.5 vs 29.1 ± 4.5 kg/m2, p < 0.001) than patients who were partly adherent. Among patients not following the given diet, 61.8% was eating in accordance to a self-made diet and 20.9% did not follow any diet. Only a few patients (2.4%) had tried a popular diet/commercial program. Most patients preferred either a “sufficiently free” (201/500) or a “free” (218/500) scheme. The use of supplements attracted younger, obese individuals, with higher education, and most managers. In a multinomial regression model, age and diabetes duration were inversely associated with the choice of a “rigid” scheme, diabetes duration and glycated hemoglobin levels were inversely correlated with a “free” diet choice, obesity was associated with a “strategic” scheme choice, while lower education (inversely) and obesity (directly) correlated with the preference for “supplement use”.


      Socio-cultural/individual factors could affect attitudes and preferences of T2DM patients towards diet. These factors should be considered in order to draw an individually tailored dietary plan.


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