Elements of effective nutrition education for adults with diabetes mellitus in resource-poor settings: A review

Abstract

This review article highlights the key factors that need consideration in planning an effective nutrition education programme for adults with type 2 diabetes mellitus in resource-poor settings. Type 2 diabetes is increasing to epidemic levels globally. Low socio-economic status is associated with poorer health outcomes and a higher economic burden. Individuals with diabetes cite dietary adherence as the most difficult self-care area. Effective nutrition education achieves the desired goals and outcomes, which include appropriate change in dietary behaviour, improved glycaemic control, plasma lipid levels, blood pressure and body weight, as well as improved potential mediators (knowledge, skills and attitudes). Elements that contribute to a successful nutrition education programme include interventions tailored to the needs, abilities and socio-cultural context of the target group, the active involvement of the patient, a behaviour-focused approach based on appropriate theory, suitable delivery methods and individual/group approaches. Adequate contact time with an educator (> 10 hours), the educator’s competence, provision of social support and follow-up intervention are also crucial. Effectively educating diabetic individuals from resource-poor settings in nutrition is a challenging task. It needs innovative and skilled educators who are sensitive to the unique needs of the target group and who use appropriate approaches to address these needs. Opsomming Hierdie artikel beklemtoon die sleutelfaktore wat in oorweging geneem moet word wanneer 'n effektiewe voedingsopleiding- program vir volwassenes met tipe 2-diabetes uit hulpbron-arm agtergronde beplan word. Tipe 2-diabetes is besig om globaal tot epidemiese vlakke toe te neem. Lae sosio-ekonomiese status word geassosieer met swakker gesondheidsresultate en 'n hoër ekonomiese las. Dieetnakoming word deur persone met diabetes as die moeilikste selfversorgingsgebied uitgewys. Doeltreffende voedingsopleiding bereik die gewenste doelwitte en resultate wat toepaslike veranderings in dieetgedrag, verbeterde glisemiese beheer, verbeterde bloedlipiede, bloeddruk en liggaams-gewig, en verbeterde potensiële bemiddelaars (kennis, vaardighede en houdings), insluit. Elemente wat tot 'n suksesvolle voedingspleidingprogram bydra, sluit ingrypings in wat geskoei is op die behoeftes, vaardighede en sosiaal-kulturele konteks van die teikengroep, aktiewe betrekking van die pasient, gebruik van 'n benadering wat ingestel is op gedrag en gegrond is op toepaslike teorie, toepaslike metodes van afl ewering en individuele/ groepbe-naderings, geskikte duur en kontaktyd (> 10 uur), een wat vir sosiale ondersteuning en opvolgintervensie sorg, en deur 'n bedrewe verskaffer bemiddel word. Om diabetiese individue uit hulpbron-arm agtergronde op te lei in voeding is 'n uitdagende taak wat vindingryke en bedrewe opvoeders verg. Hierdie opvoeders moet sensitief wees vir die unieke behoeftes van die teiken-groep en toepaslike benaderings volg om genoemde behoeftes aan te spreek.

Keywords

• type 2 diabetes
• nutrition education/dietary intervention
• low-income
• resource limited/poor
• effectiveness
• self-management education