IDF21-0045 Lifestyle modification advice in the control of diabetes in Nigeria: Aspect of Influencing behavioural change wheel

Abstract

Background: Uncontrolled diabetes mellitus and its complications lead to morbidity and mortality. Lifestyle intervention can delay disease progression and development of co-morbidities, especially with regards to cardiovascular complications. Hence, this study progresses previous report, which assessed the pattern of lifestyle-related habits. Aim: The objective of this study is specifically to investigate the levels of lifestyle modification advice given to people about control of diabetes that could positively influence their behavioural change wheel. Method: The was a cross-sectional study in Ndokwa communities of Nigeria, and 418 adults of both genders were enrolled. Data collection occurred at Catholic hospital Abbi, and dental clinic of Eku Baptist Government Hospital, both in Delta state Nigeria. The World Health Organisation (WHO) STEP-wise questionnaire was used to elicit information from the participants. Point-of-care fasting blood glucose test was performed, using CardioChek® analyser. Participants were asked about 6 behavioural habits they could have received from with the community – quitting tobacco, reducing salt intake, eating ≥5 servings of fruit and vegetables daily, reducing fats in diet, engaging in physical activities, and proactive maintenance of body weight. Frequency of responses to the lifestyle modification advice were analysed. The resulting data were analysed, using IDM-Statistical Package for Social Sciences (IDM-SPSS) version 22. Results: Of the 418 participants, point-of-care assessment showed only 41.1% of participants were normoglycaemia, while 40.2% and 18.7% were prediabetes and diabetes respectively. Among them, 52.8% have complete secondary school or higher. Advice to quit tobacco, reduce salt intake, eat ≥5 servings of fruit and vegetables daily, reduce fats in diet, engage in physical activities, and proactively maintain body weight were received by 18.9%, 29.0%, 33.5%, 25.0%, 30.6%, and 27.9% respectively. Overall, fewer proportion of the participants (27.1% females and 27.8% men) admitted having been advised to practice lifestyle modification, to achieve diabetes control and prevent metabolic disease complications. The best indication is 35.4% of women being advised to consume more fruits and vegetables. Discussion: Studies have shown that development and progress of diabetes can be prevented in high-risk subjects by lifestyle intervention. The study identifies in a cross-section of population where 58.9% may be living with hyperglycaemia, and 47.2% possess lower than secondary education; only an averaged 27.5% have received advice on lifestyle modification to reduce risk of developing diabetes and its cardiovascular complications.