Assessment of Nutritional and Physical Inactivity Risk Factors Related to the Management of Type 2 Diabetes in Bamako, Mali

Abstract

Objectives: The prevalence of diabetes is increasing rapidly in sub-Saharan Africa. Lifestyle and dietary measures play a key role in controlling glycemic imbalance and cardiovascular complications of diabetes. The objectives of this study were to describe the nutritional factors of type 2 diabetic patients followed in the reference health centers of Bamako, to describe their dietary and physical exercise practices and to identify the factors influencing them.

Methods: This was a descriptive and analytical cross-sectional study that took place in 2021 in the health structures of Bamako. A total of 240 diabetics were included.

Results: The patients had an average age of 57 ± 10.86 years and had been diabetic for an average of 5.3 ± 4.9 (1 - 23) years. The main comorbidities were overweight ( 70%) , high blood pressure ( 36.3%) and (22.5%) reported having nocturnal hypoglycemia. More than half of the patients, or 64.2%, said they had received recommendations from doctors – diabetes referents related to foods not recommended for diabetics. Regarding their eating habits, 73.3% did not skip meals and ate at fixed times and 60.8% ate out of the house. The foods most concerned were sweets (34.2%) and fatty and fried preparations (27.5%). Participants said (78.3%) that they exercised because of diabetes. The types of physical exercise practiced were (76.3%) for walking; 35.8% for climbing stairs. 37.5% said they practiced it at least 3 to 5 times a week and 16.3% more than 5 times a week.

In addition, the relationship between following the doctor’s recommendations and normal BMI was statistically significant, as were glycemic control and the practice of physical activity (P=0.003).

Conclusions: Strengthening nutritional care and improving physical exercise through therapeutic education sessions is essential to improve the dietary practices of type 2 diabetics in Mali.