Impact of food security, dietary diversity, and nutritional status on glycemic control among adults with type 2 diabetes mellitus in Fako Division, Cameroon

Abstract

Background: Diabetes mellitus (DM) represents a prevalent metabolic disease that has been increasingly recognized as a global health priority. However, the precise influence of food security, dietary diversity, and nutritional status on glycemic control among individuals with type 2 diabetes mellitus (T2DM) remains inadequately characterized. Aims: This study aimed to assess the association between food security, dietary diversity, nutritional status, and glycemic control in adults diagnosed with T2DM undergoing treatment at Buea and Limbe Regional Hospitals within the Fako Division, Cameroon. Patients and Methods: A cross-sectional study design was employed to recruit individuals with T2DM from the aforementioned hospitals. Data collection was conducted using a structured questionnaire, encompassing sociodemographic characteristics, food security status, dietary diversity, nutritional status, blood pressure measurements, and glycemic control assessments. Glycemic control was determined using a glucometer. Data were analyzed using statistical package for the social sciences version 27.0. Results: The study revealed that 28.8% of respondents exhibited a normal Body Mass Index (BMI), while 41.1% were classified as overweight and 30.1% as obese. Additionally, 12.7% of household experienced food insecurity, compared to 87.3% who were food secure. A majority of respondents (77.9%) reported consuming a diverse diet (≥ 6 food groups), 19.1% consumed 4 – 5 food groups and only 3.0% exhibited a low dietary diversity score (1 – 3 food groups). Additionally, 77.9% of participants presented with poor fasting plasma glucose (FPG) levels, whereas 22.1% demonstrated good FPG control. Participants residing in household with ≤ 4 family members were approximately two times more likely to exhibit poor FPG compared to those residing in household with > 4 family members (Adjusted Odds Ratio [AOR]: 1.83, 95% Confidence Interval [CI]: 1.02 – 3.28, p = 0.042). However, no significant associations were observed between food insecurity (p = 0.539), low dietary diversity (p = 0.854), high BMI (p = 0.782), FPG levels (p > 0.05). Conclusions: The majority of individuals with T2DM in the study population were classified as overweight or obese, resided in food-secure households, and reported diverse dietary intake. Small family size was identified as a significant factor negatively impacting glycemic control among adult diabetic patients. Educational and dietary interventions aimed at improving nutritional status and blood glycemic control are recommended. Keywords: Body mass index, Food groups, Food security, Fasting plasma glucose.