Magnitude of nonadherence to diet and exercise recommendations and associated factors among type 2 diabetes patients on treatment follow-up at Asella Referral and Teaching Hospital, Arsi, Ethiopia: A cross sectional study.

The majority of type 2 diabetes patients did not follow exercise recommendations.

• 247 out of 302 patients (81.8%) were nonadherent to exercise recommendations.
• The study was conducted at Asella Referral and Teaching Hospital of Arsi University, Ethiopia.
• Sample size was 302 type 2 diabetic patients on treatment follow-up.
• Data were collected via structured questionnaire using an institution-based cross-sectional design.

More than half of type 2 diabetes patients did not follow dietary recommendations.

• 157 out of 302 patients (52%) were nonadherent to dietary recommendations.
• This is notably lower than the exercise nonadherence rate of 81.8% in the same population.
• Both diet and exercise nonadherence were assessed in the same cross-sectional study of 302 patients.

Duration since diagnosis greater than 5 years was an independent determinant of nonadherence to both dietary and exercise recommendations.

• For dietary nonadherence: AOR = 2.1, 95% CI [1.18–3.36].
• For exercise nonadherence: AOR = 2.1, 95% CI [1.03–4.43].
• This factor was significant in multivariate logistic regression analyses for both outcomes.
• Patients with longer disease duration were more than twice as likely to be nonadherent to both diet and exercise.

Lack of doctor's advice was an independent determinant of nonadherence to dietary recommendations.

• AOR = 2.3, 95% CI [1.24–4.47] for doctor's advice as a determinant of dietary nonadherence.
• Patients who received doctor's advice were more likely to adhere to dietary recommendations.
• This factor was identified through multivariate logistic regression analysis.
• Doctor's advice was not reported as a significant factor for exercise nonadherence.

Family history of diabetes mellitus was an independent determinant of nonadherence to dietary recommendations.

• AOR = 4.3, 95% CI [2.55–7.29] for family history of DM as a determinant of dietary nonadherence.
• Patients with a family history of DM had more than four times the odds of being nonadherent to dietary recommendations.
• This was the strongest predictor identified for dietary nonadherence among the factors examined.
• Notably, the abstract states 'lack of family history' was a determinant, suggesting those without family history were more nonadherent, consistent with the direction of the AOR.

Female sex was an independent determinant of nonadherence to exercise recommendations.

• AOR = 3.6, 95% CI [1.60–8.60] for female sex as a determinant of exercise nonadherence.
• Female patients had 3.6 times the odds of being nonadherent to exercise recommendations compared to male patients.
• Sex was not reported as a significant determinant of dietary nonadherence.
• This was identified through multivariate logistic regression.

Lower educational status was independently associated with nonadherence to exercise recommendations.

• Patients who attended only primary school had AOR = 3.33, 95% CI [1.33–8.34] for exercise nonadherence.
• Patients who were only able to read and write or were illiterate had AOR = 6.7, 95% CI [1.86–24.29] for exercise nonadherence.
• The association between educational status and exercise nonadherence showed a dose-response pattern, with illiteracy conferring the highest odds.
• Educational status was not reported as a significant determinant of dietary nonadherence.