| dc.description.abstract | Introduction: Type 1 diabetes mellitus (T1D) is a chronic condition requiring lifelong
management, including strict adherence to dietary recommendations. Despite the critical role of
diet in managing T1D and preventing complications, many adolescents with T1D struggle with
dietary adherence. This poor adherence among adolescents compromises effective diabetes
management and increases the risk of complications. Understanding the factors that influence
adherence is crucial to developing effective dietary interventions and behavioral strategies that can
improve adherence and health outcomes in this population.
Aim of the study: This study determined the prevalence of adherence to dietary recommendations
among adolescents with Type 1 Diabetes and explored the factors influencing adherence among
adolescents with T1D in St. Francis hospital Nsambya and Uganda Martyr’s hospital Lubaga.
Method: A facility-based convergent parallel mixed methods study was conducted. Quantitative
data were collected from 103 adolescents aged 10-19 years through structured questionnaires and
24-hour dietary recall. The major dependent variable was dietary adherence, while independent
variables included factors such as demographic characteristics, family support, nutrition
counseling attendance, knowledge about nutrition for T1D adolescents, Qualitative data were
obtained via 15 In-depth interviews with adolescents and 7 key informant interviews with
healthcare providers. Quantitative analysis involved descriptive statistics and a modified Poisson
model using STATA v14, while qualitative data were analyzed thematically with Atlas.Ti
software.
Results: Overall dietary adherence among adolescents with Type 1 diabetes across the four
macronutrients was at 17.5%, with specific adherence rates of 29.1% for protein, 15.5% for
carbohydrates, 33% for fiber, and 79.6% for fat intake. Religion was significantly associated with
adherence (PR = 2.93, 95% CI:1.15–7.47 p = 0.025). Higher adherence was observed among
adolescents who regularly attended nutrition counseling attendance (19.7%) and having fathers as
primary caregivers (31.3%). Qualitative findings highlighted barriers to adherence, including peer
influence, school challenges, frequent hunger, and financial constraints.
Conclusion: The study revealed that only 17.5% of adolescents with Type 1 Diabetes Mellitus
adhered to dietary recommendations according to the ISPAD (International Society for Pediatric
and Adolescent Diabetes) criteria across the four macronutrient groups. Key barriers included
developmental challenges, difficulties within the school environment, frequent hunger, and
financial constraints. Religion, social support, and consistent nutritional education emerged as
important factors influencing adherence. Strengthening continuous nutrition education and
counseling at the diabetic clinics, as highlighted by health workers, may improve adherence rates.
Targeted interventions focusing on enhancing nutrition knowledge, providing emotional and
involving caregivers are recommended to improve dietary adherence among adolescents with
T1D. | en_US |
