Dietary compliance among insulin-dependent diabetics

An education program to improve dietary compliance in insulin-dependent diabetics was evaluated from 1978 to 1980 at the Royal North Shore Hospital of Sydney. Dietary intake, biochemical status, health beliefs, knowledge, anthropometric and other measurements were made on 140 diabetics and their family members before and, where possible, 6 months after the program. Four aspects of compliance were assessed: dietary composition, body weight, carbohydrate spacing among meal periods and carbohydrate variation between days. There was a significant increase in the proportion of subjects who achieved the recommended goal of a high carbohydrate/low fat diet. Diabetics who complied with this recommendation were significantly more likely to have adequate glycemic control. Most of the participants were initially near ideal weight and there were few substantial weight changes. The proportions of diabetics with acceptable scores for carbohydrate spacing and variation did not change significantly. Subjects who complied with one aspect of the dietary regimen did not necessarily comply with other aspects. Dietary compliance was related to initial patterns of dietary intake but could not be predicted from any other factors such as demographic characteristics, duration of disease, knowledge or health beliefs, although this could have been due to small sample sizes.