Nutritional and Health Assessment of Diabetic Patients in Outpatient Clinic of Federal Teaching Hospital Owerri

@ 2025 | PUBLISHED BY GJR PUBLICATION, INDIA 111 Global Journal of Research in Medical Sciences ISSN: 2583-3960 (Online) Volume 05 | Issue 06 | Nov.-Dec. | 2025 Journal homepage: https://gjrpublication.com/gjrms/ Original Research Article Nutritional and Health Assessment of Diabetic Patients in Outpatient Clinic of Federal Teaching Hospital Owerri *Uzoagba Henrietta Chibugo 1, Olivia Afam-Anene 2 and Esther-Ben Onyeneke 3 1 Department of Nutrition and Dietetics, Faculty of Health Sciences Imo State University, Owerri *Corresponding author: Uzoagba Henrietta Chibugo Department of Nutrition and Dietetics, Faculty of Health Sciences Imo State University, Owerri Introduction A chronic metabolic disease that affects millions of people worldwide, diabetes mellitus is a significant global health concern. About 537 million persons worldwide had diabetes as of 2021, demonstrating the disease's growing prevalence and serious public health consequences [1]. The illness affects people of all ages, races, and ethnicities and is linked to serious but mostly avoidable consequences. Diabetes can lead to renal failure, myocardial infarction, and other cardiovascular problems if it is not properly treated; Nigerians are increasingly reporting these results. With an estimated Abstract This study aims to evaluate the nutritional status of diabetic patients who visit the Federal Teaching Hospital's outpatient clinic in Owerri, Imo State, Nigeria. Respondents who visited the Federal Teaching Hospital's OutPatients Clinic made up the study population, and a sample size of 120 was employed. One hundred and twenty (120) diabetes patients were asked to complete a well-structured questionnaire that asked about their sociodemographic information, food consumption habits, health condition, alcohol or tobacco usage, vitamin intake, and exercise. Data from biochemical tests and anthropometric measurements, including height and weight, were gathered to ascertain the respondents' nutritional health, and a food frequency questionnaire was employed to evaluate their food consumption habits. SPSS version 17 was used to analyse the data, and the results were presented as percentages and frequencies. Significant differences were evaluated using correlation. The majority (56%) were female, 56% had completed secondary school, 53% had no family history of diabetes, and 72% had not been ill in the previous two weeks, according to the results. Diet plus insulin were utilised by 85% of diabetics, while diet alone was used by 15%. Anthropometry analysis reveals that the patients' mean height and weight did not differ significantly (P > 0.05$). In contrast, women were more likely than men to be obese (56% vs. 44%). According to BMI, 41.7% of people were overweight and 30% were obese, and both sexes' fasting blood glucose levels were higher above the typical range of 70–100 mg/dl. The serum iron reserve was depleted in thirty (30%) of the responders. 38.4% of people had hypertension, according to their systolic blood pressure. The respondents' consumption pattern for non-starchy vegetables was low; they consumed them four times a week (37%) compared to the minimum recommended consumption of five servings per day. Additionally, their daily intake of fat was marginally higher than the dietary requirement. For diabetics to maintain appropriate glycaemic control, they require specialised nutrition education to enhance their diets. The respondents' systolic blood pressure and meal skipping had a negative significant link (r=-0.313; p=0.015), while their snack consumption and meal skipping had a positive significant correlation (r=0.504; p>0.000). The respondents' systolic blood pressure and snack consumption were significantly correlated negatively (r=-0.300; p=0.020); their idea of diabetes and fasting blood sugar were significantly correlated negatively (r=-0.397; p>0.002); their idea of diabetes and serum ferritin were significantly correlated negatively (r=-0.315; p=0.014); and their idea of diabetes and diastolic blood pressure were significantly correlated positively (r= 0.257; p=0.047). Keywords: nutritional, health assessment, diabetic, Owerri. Global J Res Med Sci. 2025; 5(6), 111-127 @ 2025 | PUBLISHED BY GJR PUBLICATION, INDIA 112 1.7 million people with type 2 diabetes mellitus (T2DM) in 2006, Nigeria has the largest diabetes burden in Africa. By 2030, that number is expected to increase to 4.8 million [2]. Glycaemic control in people with type 2 diabetes is known to be significantly influenced by nutritional status, which includes dietary consumption and body composition. Diets high in fruits, vegetables, whole grains, and lean meats were linked to lower levels of glycated haemoglobin (HbA1c), according to a systematic review and meta-analysis. In a similar vein, better glycaemic control and fewer complications from diabetes were achieved by consuming more plant-based foods and fewer animal-based products [3]. Poor glycaemic control has been connected in Africa in a number of cross-sectional studies to low educational attainment, inconsistent medication adherence, and restricted access to healthcare. Research conducted in Nigeria also shows that poor glycaemic outcomes are significantly predicted by suboptimal nutritional status, which might show up as underweight or overweight/obesity [4]. There have been reports of widespread poor glycaemic management among T2DM patients in Nigeria, which has been linked to low socioeconomic position, a lack of nutritional awareness, and limited access to treatment. To enhance metabolic outcomes for Nigerians with diabetes, more data points to the necessity of multidisciplinary treatment models and culturally relevant nutritional interventions [5]. In order to effectively manage diabetes, metabolic syndrome, and cardiovascular disease, glucose management is crucial. Fasting blood glucose (FBG) offers important information about short-term glucose regulation, even if HbA1c is frequently used to evaluate long-term glycaemic control. Glycaemic outcomes and metabolic health are strongly associated with nutritional markers including body mass index (BMI) and waist-hip ratio (WHR). Even in people without diabetes, elevated FBG levels have been linked to an increased risk of cardiovascular disease and are a reliable indicator of the onset of type 2 diabetes in the future. [6] One important aspect affecting glycaemic regulation is obesity. Obese people are much more likely than those with normal BMI to develop type 2 diabetes, according to a systematic review. On the other hand, people with a healthy BMI have better glycaemic control and fewer problems. Insulin resistance, poor glucose tolerance, and type 2 diabetes are also predicted by central obesity as determined by WHR (Dada & Igbe, 2020). Elevated FBG and a higher risk of undiagnosed diabetes are consistently linked to high WHR [7]. These trends are supported by recent research from Nigeria. Along with high FBG levels (42.9%), diabetic patients have high rates of obesity (76.9%), overweight (62.6%), and higher WHR. a 6.5% prevalence of diabetes and highlighted the significant roles played by growing obesity, demographic changes, urbanisation, and physical inactivity. Preventive measures and knowledge are still insufficient. For example, low levels of physical exercise, frequent consumption of high-carb diets, and patients' lack of information about diabetes. In a similar vein, research from Abuja and Lagos indicates that a large percentage of diabetics are obese and that there is no information or guidance regarding diet [8]. Another prevalent metabolic problem in people with type 2 diabetes is dyslipidaemia. It has been found that 63% of Nigerian diabetics have dyslipidaemia, which includes significantly raised triglycerides (88%), low HDL (47%), and high cholesterol (33%). Diabetic dyslipidaemia, which is defined by elevated triglycerides and low HDL, may develop even in prediabetes, according to previous publications, highlighting the significance of early identification and treatment [9]. An estimated 347 million people worldwide suffered from diabetes in 2012, with more than 80% of those affected living in lowand middle-income nations like Nigeria. According to WHO (2013), the number of deaths from diabetes was expected to quadruple between 2005 and 2030. The most prevalent type, type 2 diabetes, is caused by both insufficient insulin production and impaired insulin action. With 463 million cases in 2019 and a predicted 51% growth by 2045— rising to 143% in Africa—diabetes was named the fastest-growing global health issue by the International Diabetes Federation. Every year, diabetes and its consequences cause about 1.5 million fatalities [10]. Diabetes outcomes in Nigeria continue to deteriorate due to non-adherence to treatment and incorrect dietary practices, which are exacerbated by lifestyle changes, westernised meals, low physical activity, socioeconomic constraints, and a lack of information about nutrition. The eyes, kidneys, nerves, heart, and blood vessels are among the organ systems that gradually suffer harm from uncontrolled hyperglycemia. Consequently, diabetes lowers quality of life, raises morbidity, and drastically shortens life expectancy [11]. Because it raises healthcare expenses, lowers worker productivity, and increases adult morbidity and death, diabetes's expanding prevalence in Nigeria poses a serious danger to the country's progress. The attainment of sustainable development goals is also at risk due to the rising prevalence of diabetes. These difficulties highlight how important it is Global J Res Med Sci. 2025; 5(6), 111-127 @ 2025 | PUBLISHED BY GJR PUBLICATION, INDIA 113 to evaluate the glycaemic control and nutritional status of diabetic patients who visit the Federal Teaching Hospital in Owerri, Imo State, for outpatient clinics. Materials and Methods Study Area The study was conducted at the Federal Teaching Hospital (FTH), Owerri, Imo State, Nigeria. The hospital, located along Orlu Road by Amakohia in Owerri Municipal, is a major specialist and referral centre in the South-East region. Study Population The study population comprised all patients with type 2 diabetes mellitus (T2DM) attending the Endocrinology Clinic of the Medical Outpatient Department, FTH Owerri. Patients attend the clinic weekly and represent diverse age groups and socioeconomic backgrounds. Inclusion Criteria Participants were eligible if they met the following conditions: Physician-diagnosed type 2 diabetes mellitus Aged 20 years and above Regular attendees of the diabetes clinic Exclusion Criteria Individuals were excluded if they: Did not provide informed consent Were hospitalized or receiving emergency medical care Study Design A descriptive cross-sectional study design was employed. This design allowed recruitment of a representative sample of T2DM patients to assess nutritional status, dietary practices, and glycemic control. Sampling Procedure A purposive sampling technique was used to select 120 physician-diagnosed T2DM patients (54 males and 66 females) attending the diabetes clinic during the study period. Eligible individuals were approached, the purpose of the study was explained, and written informed consent was obtained. Ethical approval was granted by the Research and Ethics Committee of FTH Owerri. Participants were aged 20–70 years and had no severe diabetic complications at the time of recruitment. Data Collection Procedures Questionnaire Administration A structured and validated questionnaire, developed by the Department of Nutrition and Dietetics, Imo State University, was used to collect data on: Socio-demographic characteristics Dietary habits and feeding patterns Nutritional knowledge Health and disease history Anthropometric Measurements Anthropometric assessments followed standard procedures Height Measurement Height was measured using a stadiometer with participants standing erect, barefoot, heels together, and arms hanging by the sides. The headpiece was lowered to rest on the crown of the head, and height was recorded to the nearest 0.05 cm. Weight Measurement Body weight was measured using a calibrated bathroom weighing scale. Participants wore light clothing without shoes. Readings were taken to the nearest 0.5 kg. Body Mass Index (BMI) BMI was calculated using: BMI=weight (kg)height (m)2BMI = \frac{\text{weight (kg)}}{\text{height (m)}^2}BMI=height (m)2weight (kg) Global J Res Med Sci. 2025; 5(6), 111-127 @ 2025 | PUBLISHED BY GJR PUBLICATION, INDIA 114 Waist Circumference Waist circumference was measured at the midpoint between the lower rib and iliac crest, recorded to the nearest 0.1 cm. WHO cutoff values: Biochemical Assessments Blood Sample Collection Following an overnight fast, 5 mL of venous blood was collected from each participant using sterile procedures. Samples were placed in labeled tubes, stored in insulated ice packs, and transported to the laboratory. Serum and plasma were obtained via centrifugation and stored at –80°C until analysis. Serum Cholesterol Determination Total cholesterol was measured using the enzymatic CHOD-PAP method. Serum Ferritin Determination Serum ferritin was analyzed using an enzyme-linked immunosorbent assay (ELISA). Fasting Blood Glucose Measurement Fasting blood glucose (FBG) was measured using a FineTest glucometer (Infopia Co. Ltd, Korea). After cleaning the fingertip with methylated spirit, capillary blood was obtained using a sterile lancet, and measurements were recorded in mmol/L. Blood Pressure Measurement Blood pressure was measured using a mercury sphygmomanometer and stethoscope following standardized procedures. Systolic and diastolic pressures were recorded based on Korotkoff sounds. Statistical Analysis Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 17.0. Descriptive statistics were presented as means, frequencies, and percentages.An independent samples t-test was used to compare BMI across sex. Pearson’s correlation analysis assessed associations between dietary practices, age, socioeconomic factors, and glycemic indicators. Statistical significance was set at p < 0.05. RESULT Demographic and Socio-Economic Characteristics of the Respondent. A total of 120 subjects were used. Table 4.1 shows the demographics and socio-economic characteristics of the Respondents. More than half (55.0%) of the respondents were female and 45.0% were male. More than one third (35.0%) of the respondents were aged 35 - 44 years, 56.7% were married, 36.7% were civil servants, 56.7% had post-secondary school, 41.7% earned less than N7,500 as a monthly allowance, and 71.7% of the households had 4-7 persons per household. Table 4.1: Demographics and Socio-Economic Characteristics of the Respondents Variables Frequency Percent Sex Male 54 45.0 Female 66 55.0 Total 120 100.0 Age (Year) 20 - 34 Yrs 28 23.3 35 - 44 Yrs 42 21.7 45 - 54 Yrs 24 20.0 55 - 64 Yrs 26 35.0 Total 120 100.0 Marital Status Single 52 43.3 Married 68 56.7 Total 120 100.0 Occupation Artisan 4 3.3 Student 24 20.0 Unemployed 28 21.7 Global J Res Med Sci. 2025; 5(6), 111-127 @ 2025 | PUBLISHED BY GJR PUBLICATION, INDIA 115 Apprentice 6 5.0 Trader 16 13.3 Civil Servant 44 36.7 Total 120 100.0 Education Qualification No Formal Education 2 1.7 Primary School 2 1.7 Secondary School 48 40.0 Post Secondary School 68 56.7 Total 120 100.0 Monthly Allowance Less Than N7,500 50 41.7 N7,500-N10,000 16 13.3 N11,000-N25,000 24 20.0 N26,000-N50,000 10 8.3 Above N50,000 20 16.7 Total 120 100.0 Household Size 1-3 18 15.0 4-7 86 71.7 Above 7 16 13.3 Total 120 100.0 Fig 4.1: Demographics and Socio-Economic Characteristics of the Respondents Dietary Habits and Patterns of the Respondent Table 4.2: Shows the dietary habits and patterns of the respondents. More than one quarter (30%) and 1.7% of the respondents ate twice and once respectively per day, 35% of the subjects foods were prepared by house help in the household, 48.3% of the respondents takes snacks, 40% skips meal, 30.0% has no appetite for food, and more than half (51.7%) of the respondents ate with family and friends daily. 0 10 20 30 40 50 60 70 80 90 100 Sex Male Female Age (Year) 20 - 34 Yrs 35 - 44 Yrs 45 - 54 Yrs 55 - 64 Yrs Marital Status Single Married Occupation Artisan Student Unemployed Apprentice Trader Civil Servant Education Qualification No Formal Education Primary School Secondary School Post Secondary School Monthly Allowance Less Than 7,500 7,500-10,000 11,000-25,000 26,000-50,000 Above 50,000 Household Size 1-3 4-7 >7 Frequency Percentage Global J Res Med Sci. 2025; 5(6), 111-127 @ 2025 | PUBLISHED BY GJR PUBLICATION, INDIA 116 Table 4.2: Dietary habits and patterns of the respondents Variables Frequency Percent Number of times you eat food per day Once 2 1.7 Twice 36 30.0 3 times 82 68.3 Total 120 100.0 Who prepare the food House-help 42 35.0 Mother 38 31.7 Children 38 31.7 Yourself 2 1.7 Total 120 100.0 Intake of snacks Yes 58 48.3 No 62 51.7 Total 120 100.0 Skip of meal Yes 48 40.0 No 72 60.0 Total 120 100.0 Appetite for food Yes 84 70.0 No 36 30.0 Total 120 100.0 Frequency at which one eat with family and friends Daily 62 51.7 Once/twice a week 34 28.3 Once a month 24 20.0 Total 120 100.0 Fig 4.2: Dietary habits and patterns of the respondents 0 10 20 30 40 50 60 70 80 90 Frequency Percent Global J Res Med Sci. 2025; 5(6), 111-127 @ 2025 | PUBLISHED BY GJR PUBLICATION, INDIA 117 Table 4.3: Shows the intake of tobacco or alcohol, vitamins and exercise of the respondents. Less than one quarter (23.3%) of the respondents takes tobacco or alcohol, 85.0% takes vitamins, 39.2% takes vitamin C, and 86.7% of the respondents engaged in exercise. Table 4.3: Intake of Tobacco or Alcohol, Vitamins and Exercise of the Respondents. Variables Frequency Percent Intake of Tobacco or Alcohol Yes 28 23.3 No 92 76.7 Total 120 100.0 Intake of Vitamins Yes 102 85.0 No 18 15.0 Total 120 100.0 Which of the Vitamins Taken Vitamin A 14 13.7 Vitamin B 3 5.9 Vitamin C 40 39.2 Vitamin D 12 11.8 Vitamin E 6 5.9 Multivitamins 12 11.8 Fruits 12 11.8 Total 120 100.0 Do You Exercise Yes 104 86.7 No 16 13.3 Total 120 100.0 Table 4.3: Intake of Tobacco or Alcohol, Vitamins and Exercise of the Respondents. 0 20 40 60 80 100 120 Frequency Percent Global J Res Med Sci. 2025; 5(6), 111-127 @ 2025 | PUBLISHED BY GJR PUBLICATION, INDIA 118 Health Status of the Respondent Table 4.4 shows the health status of the Respondents. About (18.3%) of the respondents had been sick in the last 2 weeks, 43.3% of the respondents had diabetes mellitus, and with 18.3% of them suffered from heart diseases, 71.7% had knowledge of diabetes mellitus, 35% had family history of diabetes, 21.7% had 1-2 persons in the family suffering from diabetes. Most (63.3%) of the respondents use both diet and insulin to control diabetes, while 36.7% use diet alone, and 16.7% were admitted to hospital in the last two weeks. Table 4.4: Health Status of the Respondents Variables Frequency Percent Sick in the last 2 weeks Yes 22 18.3 No 98 81.7 Total 120 100.0 Ailments suffered in the past Diabetes mellitus 52 43.3 Heart disease 22 18.3 Hypertension 2 1.7 No response 44 36.7 Total 120 100.0 Idea of diabetes Yes 86 71.7 No 34 28.3 Total 120 100.0 Family history of diabetes Yes 42 35.0 No 78 65.0 Total 120 100.0 Number of people suffering from diabetes in your family 1-2 26 21.7 3-4 4 3.3 4-5 14 11.7 None of the above 76 63.3 Total 120 100.0 Control of diabetes Diet alone 36 36.7 Diet and insulin Diet and OHD 62 22 51.7 11.6 Total 120 100.0 Admitted to Hospital in the Last Two Weeks Yes 20 16.7 No 100 83.3 Total 120 100.0 Global J Res Med Sci. 2025; 5(6), 111-127 @ 2025 | PUBLISHED BY GJR PUBLICATION, INDIA 119 Fig 4.4: Health Status of the Respondents Food consumption pattern of the respondent Table 4.5 shows the food consumption frequency of the respondents. More than half (53.3%), 41.7%, 40%, 30% and 26.7% of the respondents consumes vegetables: such as garden egg, water leaf, carrots, bitter leaf, and cucumber respectively occasionally, 33.3% and 28.3% consumes pumpkin leaf and okro respectively four times or more per week. About 31.7% consumes orange daily, 45%, 36.7% and 33.3% consumes pineapple, paw-paw and water melon respectively occasionally, 45% and 28.3% consumes apple and guava respectively less than 4 times per week, while 68.3% never consumes mango. Less than half (33.3%) and 31.7% consumes bread and rice respectively daily, 43.3% consumes maize occasionally, 85% never consume millet. Approximately (31.7%) consumes beans less than four times per week, 38.3% consumes soya beans occasionally, 43.3% consumes groundnut four times and more per week, and 31.7% consumes bambara nut occasionally, 38.3% consumes cassava occasionally, 31.7% consumes garri less than 4 times per week. Less than half (43.3%), 40%, 40% and 30% consumes cocoyam, unripe plantain, irish potato and yam respectively occasionally, 26.7% consumes egg daily, 30% consumes meat four times and more per week, 28.3% each consumes fish daily and four times and more, 51.7% and 38.3% consumes ice cream and yoghurt respectively, 31.7% consumes milk four times and more, 26.7% takes coffee less than 4 times per week, 55% takes tea occasionally, 40% takes snacks daily, 46.7% and 43.3% consumes biscuit and meat pie occasionally with 38.3% consumption of crackers less than 4 times per week. Table 4.5: Food Consumption Frequency of the Respondents Variables Daily High 4 – 6 x Per Week Moderate < 4 x Per Week Low Occasionally Very Low Never Total Water Leaf 10 (8.3) 6 (10.0) 15 (25.0) 25 (41.7) 9 (15.0) 120 (100) Bitter Leaf 2 (1.7) 13 (21.7) 18 (30.0) 18 (30.0) 10 (16.7) 120 (100) Pumpkin Leaf 26 (21.7) 20 (33.3) 9 (15.0) 13 (21.7) 5 (8.3) 120 (100) Okro 26 (21.7) 17 (28.3) 10 (16.7) 13 (21.7) 7 (11.7) 120 (100) Cucumber 14 (11.7) 13 (21.7) 13 (21.7) 16 (26.7) 11 (18.3) 120 (100) Garden Egg 16 (13.3) 6 (10.0) 7 (11.7) 32 (53.3) 7 (11.7) 120 (100) 0 20 40 60 80 100 120 Sick in the last 2 weeks Yes No Ailments suffered in the past Diabetes mellitus Heart disease Hypertension No response Idea of diabetes Yes No Family history of diabetes Yes No Number of people suffering from… 1-2 3-4 4-5 None of the above Control of diabetes Diet alone Diet and insulin Diet and OHD Admitted to Hospital in the Last… Yes No Frequency Percent Global J Res Med Sci. 2025; 5(6), 111-127 @ 2025 | PUBLISHED BY GJR PUBLICATION, INDIA 126 The high vitamin intake and frequent exercise indicated by many respondents, despite the presence of unhealthy lifestyle choices, may be the result of health education messages that are regularly given to diabetic patients. Frequent exercise is still a crucial tactic for reducing obesity and enhancing glucose metabolism [21]. The respondents' dietary habits were typified by a high intake of starchy staples, processed foods, and snacks and a low intake of fruits and vegetables. Due to their accessibility and cost, pumpkin and okro were consumed in moderation. Chronic poor glycaemic control may be caused by a lack of consumption of root and tuber crops and sporadic ingestion of foods with a low glycaemic index, such as cocoyam, Irish potatoes, and unripe plantains [22]. Grain meals like bread and rice were staples, and animal protein sources like fish and eggs were frequently consumed. Nonetheless, the general trend indicates a shift in diet brought about by urbanisation, financial limitations, a lack of information about nutrition, and individual preferences [23]. The significant prevalence of overweight, obesity, diabetes, hypertension, anaemia, and hypercholesterolaemia seen in the study population was probably caused in part by this poor dietary profile. In order to address food insecurity, dietary transition, and the twin burden of malnutrition, the Standing Committee on Nutrition's global appeal to include indigenous foods in dietary regimens is still pertinent. Conclusion Among the diabetic responders in this study, poor glycaemic control, hypertension, iron-deficiency anaemia, hypercholesterolaemia, overweight, and obesity were shown to be highly prevalent. Poor eating habits, such as a lack of fruits and vegetables, missing meals frequently, and relying too much on high-energy snacks, were strongly linked to these problems. These health issues were made worse by lifestyle choices like smoking, drinking, and not exercising. The results highlight the critical necessity for regular blood glucose self-monitoring, early metabolic abnormality identification, and thorough nutrition education. To improve diabetes control and avoid complications, nutritional advice and lifestyle change measures must be strengthened. Healthcare professionals who play crucial roles in the multidisciplinary management of diabetes mellitus, such as nutritionists, dietitians, and endocrinologists, will find these findings to be practically significant. References 1. Adebobola AZ, Attoye TE, Akinwumi AI, Ewedairo OA, Adebobola OA. (2023) Perceived Family Support and Medication Adherence among Diabetic Patients with Good and Poor Glycaemic Control Attending a Teaching Hospital in South-Western Nigeria. Asian J Med Heal. ;21(2):1–11. 2. Thompson J, Parkinson M, Collery R. (2020) Care home staff’s experiences and views of supporting the dietary management and choices of older residents with obesity. Int J Older People Nurs. ;15(4):1–10. 3. Tönnies T, Rathmann W, Hoyer A, Brinks R, &Kuss O (2021). Quantifying the underestimation of projected global diabetes prevalence by the international diabetes Federation (IDF) diabetes atlas. BMJ Open Diabetes Research & Care; 9(1), e002122. 4. YimamAhmed M, Ejigu SH, Zeleke AZ, Hassen MY (2020). Glycemic control, diabetes complications and their determinants among ambulatory diabetes mellitus patients in southwest Ethiopia: A prospective cross-sectional study. Diabetes, Metab Syndr Obes. 13:1089–95. 5. Nirmala,P. V., Gudivada, M., and Lashmi, C. V., (2016). Comparative Study of the Prevalence of Type-2 Diabetes Mellitus in Various Demographic Regions of Andhra Pradesh, India: a Population based Study. Int J MCH AIDS; 5(2): 103–111. 6. Rusdiana R, Savira M, Widjaja SS, Ardinata D. (2020) The effect of health education on control glycemic at type 2 diabetes mellitus patients. Open Access Maced J Med Sci.8(E):133–7. 7. Adeloye D, Ige-Elegbede JO, Ezejimofor M, Owolabi EO, Ezeigwe N, Omoyele C, (2021) Estimating the prevalence of overweight and obesity in Nigeria in 2020: a systematic review and meta-analysis. Ann Med ;53(1):495–507. 8. Agofure O, Okandeji-Barry OR, Ogbon P (2020). Pattern of diabetes mellitus complications and co-morbidities in Ughelli North local government area, Delta State, Nigeria. Nigerian Journal of Basic and Clinical Sciences; 17(2):123. 9. Brown MC, Marciniak CM, Garrett AM, Gaebler-Spira DJ (2021). Diet quality in adults with cerebral palsy: a modifiable risk factor for cardiovascular disease prevention. Dev Med Child Neurol. 63(10):1221–8. 10. Gortzi O, Dimopoulou M, Androutsos O, Vraka A, Gousia H, Bargiota A. (2024) Effectiveness of a Nutrition Education Program for Patients with Type 2 Diabetes Mellitus. Appl Sci. 2024;14(5):2114. 11. Jeroh, E., Awhin, E. P., Osademe, L., and Awire, E. I., (2012) Effect of carbonated drinks on the activities of Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) in Serum and Kindney in Rattus novergicus. Asian J. Biochem; 7:59-62. Global J Res Med Sci. 2025; 5(6), 111-127 @ 2025 | PUBLISHED BY GJR PUBLICATION, INDIA 127 12. Ngwu, E. K., Ndiokwelu, I. C., Ibaro, U. S., and Nwachi, I. C., (2012). Effect of African Yam Bean (AYB) Gruel consumption on the health characteristics of Diabetics in a Rural Community. Journal of Dietetian Association of Nigeria. Vol. 3;1-11. 13. Sendekie AK, Belachew EA, Dagnew EM, Netere AK (2022). Rate of glycaemic control and associated factors in patients with type 2 diabetes mellitus treated with insulin-based therapy at selected hospitals in Northwest Ethiopia: a multicentre cross-sectional study. BMJ Open. ;12(9):1–9. 14. Jones-McLean, E. M., Shatenstein, B., Whiting, S. J., (2010) Dietary patterns research and its applications to nutrition policy for the prevention of chronic disease among diverse North American populations. Appl Physiol Nutr Metab; 35:195–198. 15. Lorenzo, C., Hartnett, S., Hanley, A. J., (2013). Impaired fasting glucose and impaired glucose tolerance have distinct lipoprotein and apolipoprotein changes: the insulin resistance atherosclerosis study. J Clin Endocrinol Metab; 98(4):1622–30. 16. Dada IO, Igbe IA (2020). Feeding habits, Overweight, Obesity and Hypertension and Associated Factors among Polytechnic Students in Ekiti State, Southwest Nigeria. J Multidiscip Res Healthc. ;7(1):33–48. 17. Mahato, M. R., Gyawali, p., Raut, P. P., Regmi, P., Singh, K. P., Pandeya, D. P., and Gyawali, P., (2011) Association between glycaemic control and serum lipid profile in type 2 diabetic patients; Glycated haemoglobin as adual biomarker. Biomedical Research, 22(3): 375-380. 18. Ali QM, Akram M, Imran A, Shafique S, Kaleem Ullah HM, Khan R (2022). Factors Associated with Poor Glycemic Control: a Real World Data from a Private Outpatient Clinic of South Punjab, Pakistan. J Pak Soc Int Med [Internet]. 3(3):210–5. 19. Arca M, Pigna G, Favoccia C., (2012). Mechanisms of diabetic dyslipidemia: relevance for atherogenesis. Curr Vasc Pharmacol;10 (6):684–6. 20. Bin Rakhis SA, AlDuwayhis NM, Aleid N, AlBarrak AN, Aloraini AA (2021). Glycemic Control for Type 2 Diabetes Mellitus Patients: A Systematic Review. Cureus. 2022;14(6):6–13. 21. Mwamba GN, Nzaji MK, Hoff NA, Mukadi PK, Musene KK, Gerber SK, (2024). Nutritional Status Link with Polioseronegativity Among Children from Poliomyelitis Transmission High-Risk Area of the Democratic Republic of the Congo (DRC). J Multidiscip Healthc.; 17:1219–29. 22. Stratton, I. M., Adler, A. I., Neil, H. A. W., (2000). Association of glycaemia with macrovascular and microvascular complications of Type 2 diabetes (UKPDS 35): prospective observational study. BMJ 321; 405–412 23. Abdulmumini Y, Shafiu D, Abdulllahi S. Mainasara, P.O,. Anaja, B. Musa, Haliru AH (2020). Determinants of poor glycaemic control among Type 2 Diabetic patients at a suburban tertiary Hospital in North-Western Nigeria. Int J Sci Healthc Res. ;5(4):207–14.