Published in PLOS One on 2026-06-10, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Nebyu Mekonen, Zewdu Hurisa, Enku Selamu, Tesfa G/meskel, Ayalneh Demissie, Muhammad Farooq Umer
Source: PLOS One • DOI 10.1371/journal.pone.0330576
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Type 2 diabetes mellitus is a major public health problem worldwide. Nonadherence to lifestyle modifications in individuals with type 2 diabetes poses a great problem.
This study assessed magnitude and factors associated with nonadherence to diet and exercise.
An institution-based cross-sectional study was conducted on 302 type 2 diabetic patients at Asella Referral and Teaching Hospital of Arsi University. The data were collected via structured questionnaire. Multivariate logistic regression was used to determine the effects of independent variables on nonadherence to diet and exercise recommendations.
Of the individuals in the study, 247(81.8%) patients did not follow the exercise recommendations, and 157(52%) patients did not follow the diet recommendations for type 2 diabetes. Duration since diagnosis > 5 years (AOR = 2.1, 95% CI [1.18–3.36]), doctors’ advice (AOR = 2.3, 95% CI [1.24–4.47]) and family history of DM (AOR = 4.3, 95% CI [2.55–7.29]) were independent determinants of nonadherence to dietary recommendations. Similarly, female sex (AOR = 3.6, 95% CI [1.60–8.60]), duration > 5 years since the diagnosis (AOR = 2.1, 95% CI [1.03–4.43]) and educational status attending only primary school (AOR = 3.33, 95% CI [1.33–8.34]) and only reading and writing or illiteracy (AOR = 6.7, 95% CI [1.86–24.29]) were independently associated with nonadherence to the exercise recommendation of type 2 diabetes patients.
Overall, in our study, many patients were nonadherent to diet and exercise recommendations. Female patients and patients who attended primary school or less and > 5 years since diagnosis were more likely to be nonadherent to exercise. The determinants of diet nonadherence were a lack of doctors’ advice, > 5 years since diagnosis and a lack of family history.
Introduction
Diabetes mellitus (DM) refers to a group of metabolic diseases characterized by hyperglycemia (high blood glucose) resulting from defect in insulin secretion, insulin action, or both. Chronic hyperglycemia in diabetes is associated with long-term damage, dysfunction and failure of various organs especially eyes, kidneys, nerves, heart, and blood vessels [1]. Type 2 diabetes mellitus (T2DM) is the most common form of diabetes in adults, accounting for 90% of all diabetic adults [2].
According to a population-based study performed in 81 different countries, 439 million adults are expected to be diagnosed with diabetes by 2030. [3]. In Subsaharan Africa, the incidence of Noncommunicable diseases (NCDs) is predicted to exceed that of infectious diseases by the year 2030 [4,5].
According to a systematic review and meta-analysis, the overall magnitude of T2DM in Ethiopia is approximately 5.95% for patients aged ≥ 40 years and 3.6% for patients aged less than 40 years [6].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Nebyu Mekonen, Zewdu Hurisa, Enku Selamu, Tesfa G/meskel, Ayalneh Demissie, Muhammad Farooq Umer. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Prevalence and determinants of metabolic syndrome among long-shift healthcare professionals in primary hospitals of Central Gondar Zone, Northwest Ethiopia
- Evidence brief: Diabetic kidney disease in northwest Ethiopia: Prevalence and determinants among adults with type 2 diabetes
- Evidence brief: Occupation is a significant independent predictor of hypocalcemia among diabetic patients in Jinja, Uganda
