Original Research

Non-adherence to diet and exercise recommendations amongst patients with type 2 diabetes mellitus attending Extension II Clinic in Botswana

Adewale B. Ganiyu, Langalibalele H. Mabuza, Nomsa H. Malete, Indiran Govender, Gboyega A. Ogunbanjo
African Journal of Primary Health Care & Family Medicine | Vol 5, No 1 | a457 | DOI: https://doi.org/10.4102/phcfm.v5i1.457 | © 2013 Adewale B. Ganiyu, Langalibalele H. Mabuza, Nomsa H. Malete, Indiran Govender, Gboyega A. Ogunbanjo | This work is licensed under CC Attribution 4.0
Submitted: 16 May 2012 | Published: 13 May 2013

About the author(s)

Adewale B. Ganiyu, Department of Family Medicine, University of Botswana, Botswana
Langalibalele H. Mabuza, Department of Family Medicine and Primary Health Care, University of Limpopo, South Africa
Nomsa H. Malete, Department of Family Medicine and Primary Health Care, University of Limpopo, South Africa
Indiran Govender, Department of Family Medicine and Primary Health Care, University of Limpopo, South Africa
Gboyega A. Ogunbanjo, Department of Family Medicine and Primary Health Care, University of Limpopo, South Africa

Abstract

Background: Patients diagnosed with type 2 diabetes mellitus in Extension II Clinic in Botswana have difficulty in adhering to the lifestyle modifications recommended by healthcare practitioners. Poor adherence to lifestyle recommendations leads to poor control of the condition and consequently to complications.

Objectives: The aim of the study was to determine reasons for poor adherence to lifestyle recommendations amongst the patients. The objectives were to determine: reasons for pooradherence to dietary requirements, exercise recommendations, the support they had in adhering to the recommendations, and their understanding of the role of dietary and exercise requirements in the management of their condition.

Method: This was a cross-sectional descriptive study. The sample comprised of 105 participants. Data on participants’ baseline characteristics and adherence to dietary and exercise habits were analysed using the SPSS 14.0 version.

Results: The sample of 104 participants comprised of 61 (58.7%) women. The rates of nonadherence to diet and exercise were 37% and 52% respectively. The main reasons for nonadherence to diet were: poor self-discipline (63.4%); lack of information (33.3%) and thetendency to eat out (31.7%). The main reasons for non-adherence to exercise were: lack of information (65.7%); the perception that exercise exacerbated their illness (57.6%) and lack of an exercise partner (24.0%).

Conclusion: There was a relatively high rate of non-adherence to both diet and exercise recommendations by patients suffering from type 2 diabetes mellitus at Extension II Clinic,Botswana, with non-adherence to exercise recommendations more common.


Keywords

Non-adherence, lifestyle modification recommendations, diet, exercise, type 2 diabetes mellitus patients

Metrics

Total abstract views: 13339
Total article views: 22868

 

Crossref Citations

1. Health literacy of hypertensive patients and related factors: A cross sectional study
Samira Vazifeh, Nasrin Jafari, Soudabeh Mehdizadeh, Farzaneh Ahmadi
Payesh (Health Monitor) Journal  vol: 22  issue: 5  first page: 639  year: 2023  
doi: 10.61186/payesh.22.5.639

2. The influence of mobile phone-based health reminders on patient adherence to medications and healthy lifestyle recommendations for effective management of diabetes type 2: a randomized control trial in Dhaka, Bangladesh
Farzana Yasmin, Nazmun Nahar, Bilkis Banu, Liaquat Ali, Rainer Sauerborn, Aurélia Souares
BMC Health Services Research  vol: 20  issue: 1  year: 2020  
doi: 10.1186/s12913-020-05387-z

3. The Effects of Laparoscopic Sleeve Gastrectomy on the Parameters of Leptin Resistance in Obesity
Tagleb S. Mazahreh, Mahmoud Alfaqih, Rami Saadeh, Nabil A. Al-Zoubi, Moad Hatamleh, Ahmad Alqudah, Abdelwahab J. Aleshawi, Abdallah Alzoubi
Biomolecules  vol: 9  issue: 10  first page: 533  year: 2019  
doi: 10.3390/biom9100533

4. A systematic review and meta-analysis of physical exercise non-adherence and its determinants among type 2 diabetic patients in Ethiopia
Hailemicahel Kindie Abate, Abere Woretaw Azage, Alebachew Ferede Zegeye, Sintayehu Sime Tsega, Muluken Chanie Agimas, Habtamu Sewunet Mekonnen, Gashaw Adane Nega, Zarko Wako Beko, Chilot Kassa Mekonnen, Philipp Baumert
PLOS ONE  vol: 19  issue: 12  first page: e0314389  year: 2024  
doi: 10.1371/journal.pone.0314389

5. Assessment of knowledge, attitude, practice, and barriers to lifestyle modification among individuals with diabetes mellitus in Kano Nigeria
Al-Amin Abubakar Sadiq, Shmaila Mustafa Hanif, Daha Garba Muhammad
Adesh University Journal of Medical Sciences & Research  vol: 3  first page: 100  year: 2021  
doi: 10.25259/AUJMSR_17_2021

6. Dietary Nonadherence and Its Determinants Among Diabetes Mellitus Patients in Comprehensive Specialized Hospitals, Amhara Region, Ethiopia: A Cross‐Sectional Study
Makda Abate Belew, Rediet Akele Getu, Sewunnet Azezew Getahun, Belete Negese Gemeda, Melese Wagaye Zergaw, Sewnet Getaye Workie
Health Science Reports  vol: 8  issue: 8  year: 2025  
doi: 10.1002/hsr2.71154

7. Psychosocial Facilitators and Barriers to Type 2 Diabetes Management in Adults: A Meta-Synthesis
P. Padma Sri Lekha, E.P. Abdul Azeez
Current Diabetes Reviews  vol: 20  issue: 8  year: 2024  
doi: 10.2174/0115733998283436231207093250

8. Nutritional Diet Knowledge and Barriers to Dietary Recommendations Adherence Among Diabetic Patients in Central Region, Ghana: A Cross‐Sectional Study
Margaret Atuahene, Frank Quarshie, Philip N. Gorleku, Rahmat Taylor, Maurice O. Gorleku, Daniel Eshun, Martin O. Asante, Francis K. Nyasem, Joseph Otchere
Health Science Reports  vol: 8  issue: 2  year: 2025  
doi: 10.1002/hsr2.70510

9. Evaluating Effectiveness of Outpatient Monitoring in Type 2 Diabetes: The One-Year Experience in an Italian Group of Primary Care
Francesca Lazzarini, Luca Barbacane, Giuseppe Scoleri, Rosanna I. Comoretto, Gianni Cogno, Benedetta Disarò, Luigi Gomirato, Francesca Stocco, Alessandro Suppa, Gianluca Toninato, Clara Minto, Danila Azzolina, Sabino Iliceto, Dario Gregori
International Journal of Environmental Research and Public Health  vol: 18  issue: 21  first page: 11540  year: 2021  
doi: 10.3390/ijerph182111540

10. Dietary knowledge and practice and its associated factors among type 2 diabetes patients on follow-up at public hospitals of Dire Dawa, Eastern Ethiopia
Anneleye Fantahun Gebeyehu, Fitsum Berhane, Robel Mekonnen Yimer
SAGE Open Medicine  vol: 10  year: 2022  
doi: 10.1177/20503121221107478

11. Type 2 diabetes mellitus patients’ knowledge, attitude and practice of lifestyle modifications
Paul I. Peter, Wilhelm J. Steinberg, Cornel van Rooyen, Johan Botes
Health SA Gesondheid  vol: 27  year: 2022  
doi: 10.4102/hsag.v27i0.1921

12. Food security status of patients with type 2 diabetes and their adherence to dietary counselling from selected hospitals in Addis Ababa, Ethiopia: A cross-sectional study
Robel Tezera, Zekariyas Sahile, Delelegn Yilma, Equilnet Misganaw, Endale Amare, Jemal Haidar, Michelle L. Gatton
PLOS ONE  vol: 17  issue: 4  first page: e0265523  year: 2022  
doi: 10.1371/journal.pone.0265523

13. Determinants of adherence to dietary guidelines among Type 2 Diabetes Mellitus patients at Moi Teaching and Referral Hospital-Kenya
Gladys Jepkemoi, C Gichunge, P Masibo
African Journal of Food, Agriculture, Nutrition and Development  vol: 21  issue: 03  first page: 17752  year: 2021  
doi: 10.18697/ajfand.98.19370

14. Predictors of Adherence to Diabetes Self‐Care Management Among Diabetes Patients in Public Health Facilities of Central Ethiopia: A Multicenter Cross‐Sectional Study
Arega Abebe Lonsako, Bereket Samuel, Abdurehman Ayele, Tsehaynew Kasse, Addisalem Haile
Lifestyle Medicine  vol: 6  issue: 2  year: 2025  
doi: 10.1002/lim2.70014

15. Launaea taraxacifolia leaf partitions ameliorate alloxan-induced pathophysiological complications via antioxidant mechanisms in diabetic rats
I.T. Gbadamosi, A.O. Adeyi, O.O. Oyekanmi, O.T. Somade
Metabolism Open  vol: 6  first page: 100029  year: 2020  
doi: 10.1016/j.metop.2020.100029

16. Glycemic control and determinants among type 2 diabetes mellitus in a regional hospital in South West Region, Cameroon
Chugbe N Sawah, Ebot W Ojong, Njeodo N Vigny, Moses N Ngemenya
World Journal of Diabetes  vol: 16  issue: 12  year: 2025  
doi: 10.4239/wjd.v16.i12.109233

17. Understanding patients’ experience living with diabetes type 2 and effective disease management: a qualitative study following a mobile health intervention in Bangladesh
F. Yasmin, L. Ali, B. Banu, F. B. Rasul, R. Sauerborn, A. Souares
BMC Health Services Research  vol: 20  issue: 1  year: 2020  
doi: 10.1186/s12913-019-4811-9

18. Gestational Diabetes Mellitus Knowledge Among Women of Reproductive Age in Southern Nigeria: Implications for Diabetes Education
Rosemary N. Ogu, Omosivie Maduka, Vetty Agala, Folusho Alamina, Obelebra Adebiyi, Ufuoma Edewor, Ibimonye Porbeni, Claribel Abam
International Quarterly of Community Health Education  vol: 40  issue: 3  first page: 177  year: 2020  
doi: 10.1177/0272684X19876526

19. Nonadherence to dietary recommendation and associated factors among type 2 diabetic patients in Illubabor zone, South West Ethiopia
Debalke Rukiya, Zinab Beakal, Belachew Tefera
Global Journal of Obesity, Diabetes and Metabolic Syndrome  first page: 053  year: 2020  
doi: 10.17352/2455-8583.000048

20. Determinants of Dietary Adherence Among Type 2 Diabetes Patients Aimed COVID-19 at the University of Gondar Comprehensive Specialized Hospital
Chilot Kassa Mekonnen, Yohannes Mulu Ferede, Hailemichael Kindie Abate
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy  vol: Volume 14  first page: 917  year: 2021  
doi: 10.2147/DMSO.S297582

21. Adhering to lifestyle change recommendations via the trans-theoretical model: a mixed-methods study among type 2 diabetes patients
Noraishah Mohamed Nor, Suriati Sidek, Nurulwahidah Saad, Nurul Hazirah Jaafar, Nor Azwani Mohd Shukri
Nutrition & Food Science   vol: 51  issue: 2  first page: 362  year: 2021  
doi: 10.1108/NFS-02-2020-0043

22. Adherence to recommended diet among patients with diabetes mellitus type 2 on follow-up at Adama Hospital Medical College, Ethiopia
Saron Abose, Godana Arero Dassie, Abebe Megerso, Tesfaye Getachew Charkos
Frontiers in Medicine  vol: 11  year: 2024  
doi: 10.3389/fmed.2024.1484071

23. Using dietary serving scores to assess adequacy of dietary intake and associated factors among adult patients with type 2 diabetes in Kampala: a cross-sectional study
Susan Kisaakye, Nicholas Matovu, David Guwatudde, Richard Kajjura
European Journal of Clinical Nutrition  vol: 75  issue: 3  first page: 555  year: 2021  
doi: 10.1038/s41430-020-00731-2

24. Effect of using mobile phone communication on dietary management of Type 2 Diabetes Mellitus patients in Kenya
Alice Wairimu Theuri, Anselimo Makokha, Florence Kyallo, Josphat Njenga Gichure
Journal of Diabetes & Metabolic Disorders  vol: 22  issue: 1  first page: 367  year: 2022  
doi: 10.1007/s40200-022-01153-6

25. Diabetes Self-Care Activities (Diet & Exercise) and Adherence to Treatment: A Hospital –Based Study among Diabetic Male Patients in Taif, Saudi Arabia
Abubaker Ibrahim Elbur
Journal of Pharmacy and Nutrition Sciences   vol: 4  issue: 2  first page: 106  year: 2014  
doi: 10.6000/1927-5951.2014.04.02.6

26. Diet adherence and factors associated with nonadherence among Type 2 diabetics at an urban health center in Tamil Nadu, India
Janani Selvam, Prabha Thangaraj, Kumarasamy Hemalatha, Pandi Subbian
International Journal of Academic Medicine  vol: 9  issue: 1  first page: 25  year: 2023  
doi: 10.4103/ijam.ijam_10_22

27. Barriers and Strategies to Lifestyle and Dietary Pattern Interventions for Prevention and Management of TYPE-2 Diabetes in Africa, Systematic Review
Hirut Bekele, Adisu Asefa, Bekalu Getachew, Abebe Muche Belete
Journal of Diabetes Research  vol: 2020  first page: 1  year: 2020  
doi: 10.1155/2020/7948712

28. EFFECTIVENESS OF WALKING EXERCISE ON HBA1C AND BMI OF DIABETES MELLITUS TYPE 2: A SYSTEMATIC REVIEW
Nurul Fitri, Yulis Setiya Dewi, Ira Suarilah, Cahyaningsih Efendi, Syahrul Abdul Yazid
Nurse and Health: Jurnal Keperawatan  vol: 13  issue: 2  first page: 394  year: 2024  
doi: 10.36720/nhjk.v13i2.672

29. Prevalence and Predictors of Nonadherence to Diet and Physical Activity Recommendations among Type 2 Diabetes Patients in Southwest Ethiopia: A Cross-Sectional Study
Getandale Zeleke Negera, Dariowani Charles Epiphanio
International Journal of Endocrinology  vol: 2020  first page: 1  year: 2020  
doi: 10.1155/2020/1512376

30. The Role of Social Support in Adherence to Treatment Regimens: Experiences of Patients with Chronic Diseases
Hakimeh Vahedparast, Akram Farhadi, Eesa Mohammadi, Fazlollah Ahmadi
Medical-Surgical Nursing Journal  vol: 7  issue: 1  year: 2017  
doi: 10.5812/msnj.69646

31. Health-related Quality of Life (HRQOL) of Patients with Type 2 Diabetes Mellitus and People without Diabetes at a Tertiary Hospital in Port-Harcourt, Rivers State, Nigeria
Perpetua O. U. Okpuruka, Agnes N. Anarado, Eunice Nwonu, Anthonia Chinweuba, Ngozi P. Ogbonnaya, Hope C. Opara, Chinenye J. Anetekhai
International Journal of Medicine and Health Development  vol: 27  issue: 2  first page: 151  year: 2022  
doi: 10.4103/ijmh.IJMH_20_21

32. Lifestyle interventions for improving health and health behaviours in women with type 2 diabetes: A systematic review of the literature 2011–2017
Charrlotte Seib, Joy Parkinson, Nicole McDonald, Haruka Fujihira, Stephanie Zietek, Debra Anderson
Maturitas  vol: 111  first page: 1  year: 2018  
doi: 10.1016/j.maturitas.2018.02.008

33. People with diabetes adherence to drug, dietary, and lifestyle changes in Erbil city, Iraq
Abubakir Majeed Saleh
BMC Endocrine Disorders  vol: 22  issue: 1  year: 2022  
doi: 10.1186/s12902-022-01230-0

34. Adherence to Lifestyle Advice and Treatments in Pakistani Patients with Type 2 Diabetes Mellitus
Sarwar Malik, Rabia Basit, Sabahat Naz, Minaz Mawani, Muhammad Qamar Masood, Jaweed Akhter
Journal of Diabetes Mellitus  vol: 06  issue: 01  first page: 49  year: 2016  
doi: 10.4236/jdm.2016.61006

35. Family and Couple Variables Regarding Adherence in Type 2 Diabetes Patients in the Initial Stages of the Disease
M. Graça Pereira, Susana Pedras, Gabriela Ferreira, José C. Machado
Journal of Marital and Family Therapy  vol: 45  issue: 1  first page: 134  year: 2019  
doi: 10.1111/jmft.12281

36. Knowledge and lifestyle modifications for dyslipidaemia among patients on statins in Pretoria
Thandazile Z. September, John V. Ndimande, Henry I. Okonta, Carien Steyn, Tombo Bongongo
Journal of the Colleges of Medicine of South Africa  vol: 2  issue: 1  year: 2024  
doi: 10.4102/jcmsa.v2i1.25

37. A study of the knowledge and practice of lifestyle modification in patients with type 2 diabetes mellitus in Middelburg sub-district of Mpumalanga
AE Umeh, L Nkombua
South African Family Practice  vol: 60  issue: 1  first page: 26  year: 2018  
doi: 10.1080/20786190.2017.1364012

38. Dietary practice and associated factors among type 2 diabetic patients in Felege Hiwot Regional Referral Hospital, Bahir Dar, Ethiopia
Yeshalem Mulugeta Demilew, Abiot Tefera Alem, Amanu Aragaw Emiru
BMC Research Notes  vol: 11  issue: 1  year: 2018  
doi: 10.1186/s13104-018-3531-2

39. Exploring the barriers of adherence to dietary recommendations among patients with type 2 diabetes: A qualitative study in Iran
Firoozeh Mostafavi‐Darani, Fereshteh Zamani‐Alavijeh, Behzad Mahaki, Arash Salahshouri
Nursing Open  vol: 7  issue: 6  first page: 1735  year: 2020  
doi: 10.1002/nop2.558

40. Adherence to Hypoglycemic Agents in Type 2 Diabetes Mellitus: A Cross-Sectional Study
Yara A Khayyat, Reem M Alshamrani, Doha M Bintalib, Najwa A Alzahrani, Sulafa Alqutub
Cureus  year: 2022  
doi: 10.7759/cureus.22626

41. Dietary adherence and the associated factors among Indonesian patients with type 2 diabetes: what should we be concerned about?†
Rohmah Puriana Khusna, Heny Suseani Pangastuti, Anggi Lukman Wicaksana
Frontiers of Nursing  vol: 10  issue: 4  first page: 427  year: 2023  
doi: 10.2478/fon-2023-0045

42. Digital Biohacking Approach to Dietary Interventions: A Comprehensive Strategy for Healthy and Sustainable Weight Loss
Alessio Abeltino, Giada Bianchetti, Cassandra Serantoni, Alessia Riente, Marco De Spirito, Giuseppe Maulucci
Nutrients  vol: 16  issue: 13  first page: 2021  year: 2024  
doi: 10.3390/nu16132021

43. ACC Reward Location Information Is Carried by Hippocampal Theta Synchrony and Suppressed in a Type 2 Diabetes Model
Guncha Bhasin, Emmanuel Flores, Lauren A. Crew, Ryan A. Wirt, Andrew A. Ortiz, Jefferson W. Kinney, James M. Hyman
The Journal of Neuroscience  vol: 45  issue: 37  first page: e1546242025  year: 2025  
doi: 10.1523/JNEUROSCI.1546-24.2025

44. Adherence challenges encountered in an intervention programme to combat chronic non-communicable diseases in an urban black community, Cape Town
Nasheetah Solomons, Herculina Salomé Kruger, Thandi Rose Puoane
Health SA Gesondheid  vol: 22  first page: 70  year: 2017  
doi: 10.1016/j.hsag.2016.11.006

45. Adherence to physical exercise recommendations among type 2 diabetes patients during the COVID-19 pandemic
Hailemichae Kindie Abate, Yohanes Mulu Ferede, Chilot Kassa Mekonnen
International Journal of Africa Nursing Sciences  vol: 16  first page: 100407  year: 2022  
doi: 10.1016/j.ijans.2022.100407

46. Dietary non-adherence and associated factors among individuals with diabetes who are on treatment follow up at Felege-Hiwot Referral Hospital, Northwest Ethiopia
Mulat Tirfie, Sebsibe Tadesse, Haile Woldie, Teshager Weldegiorgis, Minyichil Birhanu, Tebkew Shibabaw
Heliyon  vol: 6  issue: 8  first page: e04544  year: 2020  
doi: 10.1016/j.heliyon.2020.e04544

47. Pharmacological Primary Prevention of Diabetes Mellitus Type II: A Narrative Review
Ali Naveed, Larabe Farrukh, Muhammad Khawar Sana, Bazigh Naveed, Fawad Ahmad Randhawa
Cureus  year: 2020  
doi: 10.7759/cureus.10033

48. Adherence to Dietary Recommendation and Its Associated Factors among People with Type 2 Diabetes: A Cross-Sectional Study in Nepal
Jijeebisha Baral, Khem Bahadur Karki, Pratibha Thapa, Ashish Timalsina, Rama Bhandari, Rabindra Bhandari, Bijaya Kharel, Nabin Adhikari, Eusebio Chiefari
Journal of Diabetes Research  vol: 2022  first page: 1  year: 2022  
doi: 10.1155/2022/6136059

49. Reference values for intake of six types of soluble and insoluble fibre in healthy UK inhabitants based on the UK Biobank data
Artem Shevlyakov, Dimitri Nikogosov, Leigh-Ann Stewart, Miguel Toribio-Mateas
Public Health Nutrition  vol: 25  issue: 5  first page: 1321  year: 2022  
doi: 10.1017/S1368980021002524

50. Development of a salutogenic intervention for healthy eating among Dutch type 2 diabetes mellitus patients
Kristel C M M Polhuis, Lenneke Vaandrager, Sabita S Soedamah-Muthu, Maria A Koelen
Health Promotion International  vol: 36  issue: 6  first page: 1694  year: 2021  
doi: 10.1093/heapro/daab020

51. Manipal lifestyle modification score to predict major adverse cardiac events in postcoronary angioplasty patients
Tom Devasia, Prasad Narayana Shetty, Hashir Kareem, Yeswanth Rao Karkala, Ajit Singh
Indian Heart Journal  vol: 70  first page: S353  year: 2018  
doi: 10.1016/j.ihj.2018.10.411

52. Patient Perspective on Factors Contributing to Nonadherence to Dietary Therapy: A Qualitative Study in Multicultural Population of Kedah, Malaysia
Mohd Azri Mohd Suan, Siti Ertina Asli, Wan Muhana Abdullah, Zainab Shafie, Nor Hafiza Johari
International Quarterly of Community Health Education  vol: 39  issue: 4  first page: 217  year: 2019  
doi: 10.1177/0272684X18821306