Do interactions between patients’ psychological distress and adherence to dietary recommendation predict glycemic control among persons with type 2 diabetes in Ghana?

Introduction: Psychological distress is a pervasive mental condition among persons with chronic noncommunicable diseases. Aim: To examine whether interactions between patients’ psychological distress and adherence to dietary recommendations predict glycemic controls among persons with type 2 diabetes mellitus in Ghana. Methods: Facility-based cross-sectional study involving 530 persons with type 2 diabetes mellitus was conducted between October 2018 and September 2019. Six health facilities were randomly selected and normal-weight persons with type 2 diabetes mellitus (T2DM) at baseline consecutively recruited from patients’ registers. Structured questionnaires were used to collect sociodemographic data. Glycemic control was the main outcome variable, and was determined using HbA1c%. Statistical Package for Social Sciences version 22 was used in data analysis. Results: Systolic blood pressure (mm Hg), diastolic blood pressure (mm Hg), total cholesterol, and fasting blood sugar were statistically significant for glycemic control (HbA1c%) (p-value < 0.05). After adjusting for confounding variables, low adherence and moderate adherence to dietary recommendations were independently significant for poor glycemic control (high HbA1c%). Interaction between low psychological distress and low adherence to dietary recommendations was statistically significant for poor glycemic control (high HbA1c%). Interaction between low psychological distress and moderate adherence to dietary recommendations was also statistically significant for poor glycemic control (high HbA1c%), whereas interaction between moderate psychological distress and high adherence to dietary recommendations was statistically significant for poor glycemic control (high HbA1c%). Conclusion: Interaction between psychological distress and adherence to dietary recommendations can influence glycemic controls among persons with T2DM.