Dietary practices and associated factors among adult diabetic patients at academic tertiary-level hospitals in central Ethiopia: convergent mixed study

Diabetes mellitus (DM) is one of the most prevalent chronic diseases worldwide. Despite the existence of national strategies to prevent potential complications, DM-related morbidities and mortality continue to rise in Ethiopia. Although studies have been conducted regarding dietary practices among DM patients in the country, there is a lack of in-depth understanding of the situation. To assess dietary practices and associated factors among adult DM patients at academic tertiary-level hospitals in central Ethiopia in 2024. A concurrent mixed-methods study was conducted from January 01 to 30, 2024, involving 420 adult DM patients. Participants were selected using a simple random sampling technique for the quantitative study. A purposive sampling technique was used to select sixteen participants for qualitative analysis. For the quantitative study, a self-administered structured questionnaire was used to collect data, and in-depth interviews were conducted for the qualitative part. Multivariate binary logistic regressions were used to assess the explanatory variables associated with dietary practice. A thematic analysis was performed for qualitative data. Of 420 eligible participants, 406 (96.7%) participated in the study. The overall proportion of good dietary practices among participants was 172 (42.4%). Being female, residing in urban areas, having a family history of DM, and having good dietary knowledge were significantly associated with better dietary practices. From the qualitative analysis, two themes emerged "Living as before and not adhering to diabetic dietary recommendations" and "Barriers to adherence to effective eating practices." Less than half of adult DM patients had good dietary practices. Sex, geographic location, family history of DM, and level of knowledge of diabetic diet were associated with dietary practice. Intervention programs on awareness creation and training to improve the dietary practice by stakeholders were recommended.