Project Materials

EVALUATION OF NUTRITIONAL STATUS AND DIETARY MANAGEMENT OF IN-PATIENT DIABETICS IN UNIVERSITY OF NIGERIA TEACHING HOSPITAL

ABSTRACT

The study included 121 diabetics who were randomly assigned to medical wards at the University of Nigeria Teaching Hospital (UNTH) Ituku-Ozalla. The data collection tool was structured, including verified pre-tested questionnaires, anthropometry, and a nutrition study. Each patient’s BMI was estimated based on their weight and height measurements. The sufficiency of nutrient intake was evaluated by comparing the patient’s energy and nutrient intakes to FAO/WHO recommendations. The contribution of macronutrients (carbohydrate, protein, and fat) to total daily energy consumption was calculated using the American Diabetes Association (ADA) formula. The data gathered was programmed into the computer. Descriptive statistics like frequencies, percentages, means, and standard deviations were computed. Mann-Whitney and Kruskawalli tests were employed to compare means. The results revealed that 54.5% of the respondents were male and 45.5% were female. Females had a substantially higher BMI (27.55±6.61kg/m2) compared to males (24.53±4.64kg/m2). The study found that patients in rural areas had a considerably lower BMI (23.70kg/m2) compared to urban (26.81kg/m2) and suburban (26.20kg/m2). The waist circumferences of males (95.59±10.97cm) and females (88.41±13.24cm) did not differ significantly (p>0.05). Male and female diabetics had mean waist/hip ratios of 0.96 ± 0.08 and 0.91 ± 0.10, respectively. The average daily energy consumption of both male and female diabetics was 99.32% of the recommended level. Male diabetics consumed 75.50% of the FAO/WHO recommended daily calorie consumption, while females consumed 96.06%. The average daily protein consumption for males and females was 164.7% and 179.3% of FAO/WHO, respectively. Patients consumed an average of 77.90g of protein per day, accounting for 15.30% of total daily energy consumption. Carbohydrates accounted for 281.44kg (1125.79kcal), or 52.7% of total daily energy consumption. The average daily fat consumption of patients was 77.23g (695.07kcal), accounting for 32.65%. Diabetics (both male and female) consumed adequate amounts of vitamin A, C, thiamine, and calcium. The iron consumption of male diabetics was 156.02% of the FAO/WHO requirement, while that of female diabetics was 80.80%. Other micronutrients, such as niacin and riboflavin, were below the FAO/WHO minimum for both males and females (63.90% and 88.50%) and (39.62% and 52.91%), respectively. The overall food intake of the in-patient diabetics was adequate for energy and macronutrients for females, but nearly adequate for males. Micronutrient intakes were satisfactory with the exception of riboflavin and niacin.

Chapter one

INTRODUCTION

1.1 Background Of the Study

Diabetes mellitus is a chronic illness caused by the pancreas failing to produce enough insulin or the body’s inability to adequately use the insulin produced (Alva 2000). Diabetes affects an estimated 143 million people globally, with the figure expected to climb to 300 million by 2025 (Alva 2000).

Previously, diabetes was seen as a singular condition. However, it is now known that diabetes is a complex metabolic disorder triggered by a variety of pathways. Diabetes is currently classified based on causation, natural history, and clinical features (Albert, 1998).

Type 1 diabetes requires insulin for survival, whereas type 2 diabetes may require insulin for metabolic management. Type 1 diabetes is more common in children and adolescents, accounting for 10 to 15% of all cases (Alva 2000). More than 90% of diabetics have type 2 diabetes.

Diabetes mellitus can cause long-term problems, many of which are fatal if not treated, and all of which have the potential to decrease people’s quality of life (JAMA, 2002).

Although the underlying pathophysiology and management of both kinds differ, one common aspect is the development of long-term micro and macrovascular consequences such as retinopathy, nephropathy, macrovascular disease, peripheral and autonomic neuropathy. These problems have been linked to higher morbidity and mortality rates.

Diabetes management should include nutrition, physical activity, and pharmaceutical treatments. Globally, the general people and health professionals are increasingly using complementary medicines to control diabetes mellitus (Dunning, 2002). The adjectives “alternative”, “natural”, and “traditional” are used to describe complementary therapies.

Most crucially, while complementary therapies share a conceptual foundation, their approaches are extremely diverse, with each therapy being unique (Wood-Hart, 2002).

Diet and exercise are the initial lines of treatment for all diabetics (IDF, 2002). This study will focus on diabetics’ nutritional management. According to researchers, nutrition therapy is the cornerstone of diabetes management in patients, particularly type 2 diabetes (Garg, 1996).