Association  between  adherence to diabetes  diet and glycemic control among type 2 diabetes mellitus adult patients attending diabetes clinics in selected hospitals, Addis Ababa, Ethiopia: a health facility based unmatched case-control study.

Background Suboptimal adherence to diabetes diet can drive the occurrence of diabetes complications. However, the association between adherence to diabetes diet and glycemic control was limited to non-analytical surveys and fasting blood sugar determinationin in low-income countries. This study was aimed to assess the association between adherence to diabetes diet and glycemic control among adult type 2 DM patients on follow-up in selected hospitals, Addis Ababa, Ethiopia. Methods Hospital-based unmactched case-control study was conducted among 156 diabetes patients ( 104 controls and 52 cases ) from May to September 2022. Data were collected using pretested structured questionnaire .Blood sugar level was tested using HgA1c test. Cases were patients with HgA1c < 7% while controls had HgA1c ≥ 7%. Descriptive statistics was used to describe all relevant data. Binary logistic regression analysis was done to assess the association between glycemic control and adherence to diabetes diet and other predictors. Adjusted odds ratios alongside 95% confidence intervals (CIs) were estimated to measure the strength of association between response and explanatory variables at p-value less than 0.05. Results A total of 156 type 2 diabetes patients were enrolled in this study. The mean (± SD) age of respondents was 52.65(± 9.94) and 51.04 (± 10.84) years among cases and controls respectively. In multivariable analysis, poor adherence to diabetes diet [(adjusted odds ratio(AOR) = 3.89,95%CI:(1.58,9.54)] and diabetes medication [(AOR = 3.74,95% CI:(1.42,9.85)], lack of dietary education [(AOR = 4.97,95% CI:(1.56,15.87)], patient’s income level of ≤ 2500 Ethiopian birr (ETB) [(AOR = 3.17,95%CI:(1.24,8.07)], presence of diabetes comorbidities [(AOR = 4.78,95%CI:(1.37,16.71)] and diabetes complications [(AOR = 5.11,95%CI:( (1.60,15.87)] were significant determinants of poor glycemic control. Conclusion Poor dietary and medication -adherence ,lack of dietary education, low economic status, presence of comorbidities ,and diabetes complications were determinants of poor glycemic control. Thus, health care providers should design appropriate interventions in line with modifiable determinants of poor glycemic control.