Knowledge, Attitude and Compliance to Dietary Recommendation Among Type-2 Diabetes Patients Attending Medical Outpatient Clinic at the University College Hospital, Ibadan, Southwest Nigeria


Diabetes mellitus
dietary management
compliance to dietary recommendation

How to Cite

Ariyo, O., Taiwo, A., Ogunjinmi, J., & Oduneye, M. (2023). Knowledge, Attitude and Compliance to Dietary Recommendation Among Type-2 Diabetes Patients Attending Medical Outpatient Clinic at the University College Hospital, Ibadan, Southwest Nigeria. African Journal of Biomedical Research, 26(3), 347–353.


Dietary management is important in preventing complications associated with diabetes mellitus and enhancing quality of life. However, compliance to dietary recommendations among Diabetes Patients (DPs) remain unknown. This study was designed to assess the Knowledge, Attitude and Compliance (KAC) of Type 2 diabetic patients to dietary recommendation. This cross-sectional study involved 101 DPs attending Medical Outpatient Clinic at University College Hospital, Ibadan, Nigeria. A semi-structured, interviewer-administered questionnaire was used to obtain information on socio-demographic characteristics, diabetes history and KAC to dietary recommendation. Knowledge was assessed on a 26-point scale and categorized as good (≥18.0) and poor (<17.0). Attitude was assessed on a 34-point scale and considered as positive and negative at ≥27 and <27, respectively. Compliance was assessed on a 42-point scale and classified as good (≥29) or poor (<29). Data were analyzed and summarized as descriptive statistics and association among variables was determined using Chi-square test at p<0.05. Age of respondents was 56.9±11.6 years, 58.4% were female, 72.2% were married, and 11.9% had no formal education. About half (49.5%) of the participants had normal body mass index, 30.7% were overweight and 16.8% were obese. Diabetes duration was 9.4±5.7 years, 46.4% had family history of diabetes mellitus, and 93.1% relied on Dietitians for dietary plans. Patients on diet and drug, diet alone, and diet and insulin constituted 79.2%, 14.9% and 5.9%, respectively. Only 8.9% had normal blood glucose level and 31.7% were pre-diabetic. Mean fasting blood glucose value was 108.94±19.54mg/dL and 42.6% had co-morbidities including hypertension (25.7%), eye problem (7.9%), renal problem (5.0%) and ulcer (4.0%). Respondents with good knowledge, positive attitude and good compliance were 53.5%,  63.4%, and 77.2%, respectively/ Compliance with dietary recommendations was higher than observed knowledge and attitude levels of the respondents. Efforts should be intensified to strengthen compliance to reduce diabetes complications.


Abioye-Kuteyi EA, Ojofeitimi EO, Fasanu AO, Ijadunola KT. Assessment of dietary knowledge, practices and control in type 2 diabetes in a Nigerian teaching hospital. Nigerian Journal of Medicine. 2005;14(1):58-64.

Adisa R, Alutundu MB, Fakeye TO. Factors contributing to nonadherence to oral hypoglycemic medications among ambulatory type 2 diabetes patients in southwestern Nigeria. Pharm Pract. 2009;7(3):163–9.

Ala AO, Ojo OA, Enikuomehin CA, Ajani GO, Olamoyegun MA, Akinlade AT, Olabode OR. Prevalence and Determinants of Complementary and Alternative Medicine (CAM) Use among Diabetes Patients in Southwestern Nigeria. West African Journal of Medicine. 2020 Oct 1;37(5):528-36.

American Diabetes Association. Lifestyle Management. Diabetes care. 2017;40(1):33-43

American Diabetes Association. Position statement of the American Diabetes Association. Evidence based nutrition principle and recommendation for the treatment and prevention of diabetes related complications. Diabetes care. 2003;26(1)

Ang CW, Ismail R, Kassim Z, Mohd Ghazali AN, Reidpath D, Su TT. Frequent Eating Out and 10-Year Cardiovascular Disease Risk: Evidence from a Community Observatory in Malaysia. BioMed Research International. 2022 Mar 7;2022.

Arokiasamy, P., Salvi, S., Selvamani, Y. (2021). Global Burden of Diabetes Mellitus. In: Kickbusch, I., Ganten, D., Moeti, M. (eds) Handbook of Global Health. Springer, Cham.

Barclay, A., Gilbertson, H., Marsh, K., & Smart, C. (2010). Dietary management in diabetes. Australian family physician, 39(8), 579-583.

Bautista-Martinez S, Aguilar-Salinas CA, Lerman I, Velasco ML, Castellanos R, Zenteno E, et al. Diabetes knowledge and its determinants in a Mexican population. Diabetes Education. 1999;25(3):374-81

Evert AB, Boucher JL, Cypress M, Dunder SA, Franz MJ, Mayer-Davis EJ, et al. Nutrition therapy recommendations for the management of adults with diabetes. Diabetes care. 2014;37(1):120-43

Fasil A, Biadgo B, Abebe M. Glycemic control and diabetes complications among diabetes mellitus patients attending at University of Gondar Hospital, Northwest Ethiopia. Diabetes, metabolic syndrome and obesity: targets and therapy. 2018 Dec 21:75-83.

Franz MJ, Powers MA, Leontos C, Holzmeister LA, Kulkarni K, Monk A, et al. The evidence for medical nutrition therapy for type 1 and type 2 diabetes in adults. Journal of American Dietetics Association. 2010;101(12):1852-89.

Henry-Unaeze HN, Ngwu EK. Eating habits and dietary practices among outpatient type 2 diabetic adults in Enugu, Nigeria. Journal of Dietitians Association of Nigeria. 2020 Dec 31;11(2):1-2.

International Diabetes Federation (IDF) (2019). Available at 2019-theme/

Jasper US, Ogundunmade BG, Opara MC, Akinrolie O, Pyiki EB, Umar A. Determinants of diabetes knowledge in a cohort of Nigerian diabetics. Journal of Diabetes Metabolism Disorder. 2014;13(1):39.

Kengne AP, Sobngwi E, Echouffo-Tcheugui JB, Mbanya JC. New insights on diabetes mellitus and obesity in Africa-Part 2: prevention, screening and economic burden. Heart. 2013 Aug 1;99(15):1072-7

Mapa-Tassou, C., Katte, J. C., Mba Maadjhou, C., & Mbanya, J. C. (2019). Economic impact of diabetes in Africa. Current diabetes reports, 19(2), 1-8.

Mapa-Tassou, C., Katte, JC., Mba Maadjhou, C. et al. Economic Impact of Diabetes in Africa. Curr Diab Rep 19, 5 (2019).

Mogre V, Johnson NA, Tzelepis F, Shaw JE, Paul C. A systematic review of adherence to diabetes self‐care behaviours: Evidence from low‐and middle‐income countries. Journal of advanced nursing. 2019 Dec;75(12):3374-89.

Muhammad FY, Iliyasu G, Uloko AE, Gezawa ID, Christiana EA. Diabetes-related knowledge, attitude, and practice among outpatients of a tertiary hospital in North-Western Nigeria. Annals of African Medicine. 2021 Jul;20(3):222.

Norris SL, Engelgus MM, Narayan KM. Effectiveness of self-management training in type 2 diabetes: a systematic review of randomized controlled trials. Diabetes care. 2001; 24(3):561-87

Ogunlana MO, Govender P, Oyewole OO, Odole AC, Falola JL, Adesina OF, Akindipe JA. Qualitative exploration into reasons for delay in seeking medical help with diabetic foot problems. International Journal of Qualitative Studies on Health and Well-being. 2021 Jan 1;16(1):1945206.

Olatona FA, Airede CA, Aderibigbe SA, Osibogun A. Nutritional knowledge, dietary habits and nutritional status of diabetic patients attending teaching hospitals in Lagos, Nigeria. Journal of Community Medicine and Primary Health Care. 2019 Oct 16;31(2):90-103.

Omage K, Omuemu VO. Assessment of dietary pattern and nutritional status of undergraduate students in a private university in southern Nigeria. Food science & nutrition. 2018 Oct;6(7):1890-7.

Sheard NF, Clark NG, Brand-Miller JC, Franz MJ, Pi-Sunyer FX, Mayer-Davis E. Dietary carbohydrate (amount and type) in the prevention and management of diabetes: a statement by the American Diabetes Association. Diabetes care. 2004; 27:2266-71

Silnik M. Impact of diabetes on health care and hospitalization. International Hospital Federation Reference Book London: pro-book Pub Ltd. 2007; pp. 54–57

Stephani V, Opoku D, Beran D. Self-management of diabetes in Sub-Saharan Africa: a systematic review. BMC public health. 2018 Dec;18(1):1-1.

Ubajaka CF, Olisa OC, Uchechukwu AP, Ugwunna UA. Knowledge and practice of preventive measures against diabetes mellitus amongst secondary school teachers in Awka South LGA of Anambra State, Nigeria. International Journal of Diabetes Research. 2019 Nov 1;2(1):50-6.

Uthman-Akinhanmi YO, Yangomodou OD, Lawal AO. Nutrient Composition of selected Snacks in South-West Nigeria. KIU Journal of Humanities. 2020 Jul 20;5(2):423-30.

Wareham NJ. Personalised prevention of type 2 diabetes. Diabetologia. 2022 Aug 2:1-8.

World Health Organization (2018a) Diabetes. Available at Accessed on 17 December 2022.

World Health Organization. Diabetes global report 2016.

World Health Organization. Global strategy on diet, physical activity and health. 57th World Health Assembly resolution and decision. 2004.

World Health Organization. Screening for type 2 diabetes: report of a World Health Organization and International Diabetes Federation meeting 2003. Available at

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright (c) 2023 African Journal of Biomedical Research