Assessment of perceived adherence and barriers to the dietary recommendations among type 2 diabetic patients of Pakistan: a cross-sectional study

Background: Type 2 diabetes mellitus (T2DM) is one of the leading global health concerns, with Pakistan having the highest prevalence rate worldwide. International diabetes federation report 2025 suggests that 31.4% of population is diagnosed with diabetes. This ratio is expected to increase if no intervention is made timely. This study aims to evaluate how well patients with type 2 diabetes adhere to recommended diet and their perceived barrier in adhering to guidelines. Methods: The cross sectional study was employed in Outpatient department of various hospitals of Punjab, Pakistan. Simple random sampling technique was used. Data was collected from 142 patients about their self-reported diagnosis, duration of disease, medicine adherence, dietary habits and perceived barriers. Perceived dietary adherence questionnaire (PDAQ-9) and Morisky medication adherence scale (MMAS-4) were used to access dietary and medicine adherence respectively. For barrier assessment, questions were taken from previous similar researches. Results: Among 142 diabetic individuals, 3.52% participants showed good adherence, 38.7% poor adherence and 57.7% no adherence to recommended diet. 50.7% agreed to have lack of knowledge as barrier to recommendations. Chi square analysis showed positive correlation of dietary adherence with age (a=0.016, p<0.05) and lack of knowledge (a=0.036, p<0.05). Conclusions: 3.52% of individuals having good dietary adherence is concerning and needs immediate plan of action by health governance to make pre-emptive measures to address the barrier. Awareness campaign regarding dietary habits and foods to avoid must be launched. National dietary guidelines should be made and communicated with patients during their follow up visits.