Keywords
Dietary Compliance
Glycemic Control
Afghanistan
Chronic Disease Management
How to Cite
Abstract
Background: Diabetes mellitus poses a rapidly growing public health challenge in Afghanistan, where dietary non-compliance significantly contributes to poor glycemic control and long-term complications. Despite this, data on dietary practices among diabetic populations in Afghan clinical settings remain scarce. This study aimed to assess dietary compliance and its association with socio-demographic and clinical factors among diabetic patients at Bayazid Rokhan Teaching Hospital, Kabul, Afghanistan. Methods: A prospective cross-sectional study was conducted over 12 months (March 2024–February 2025) among 300 adult diabetic patients. Data were collected using a culturally adapted structured questionnaire, clinical assessments, and laboratory tests. Dietary compliance levels, awareness, and socio-demographic characteristics were analyzed using descriptive statistics in SPSS version 26. Results: Among 300 participants (61% male; mean age: 56.8 ± 10.5 years), 35.3% were fully compliant with dietary recommendations, 45.7% were partially compliant, and 19.0% were non-compliant. Compliance decreased with longer diabetes duration: 46.6% among those <5 years versus 20.3% for >10 years. A significant association was found between non-compliance and diabetes-related complications (40.6% non-compliant with complications vs. 11.0% without). Although 70.7% were aware of dietary guidelines, a knowledge-practice gap was observed. Additionally, 71% of participants expressed intent to improve dietary adherence. Conclusion: Dietary compliance among diabetic patients in this study was suboptimal and significantly influenced by duration of illness, complication status, and socio-demographic factors. Despite high awareness levels, behavioral adherence remains low. These findings underscore the urgent need for structured education programs, improved access to nutritional counseling, and culturally tailored interventions to enhance diabetes management and reduce complication risks in Afghanistan.