Diabetes is a chronic disease requiring ongoing care and maintenance. The majority of diabetes care is performed by the patient -- up to 95 percent of it, according to the Journal of the American Medical Association, or JAMA. If a patient does not follow prescribed diet or health guidelines, it can result in medical problems, complications and frustration for both patient and physician. According to Dr. Alan Delamater in the journal Clinical Diabetes, approximately half of all recommended lifestyle and diet changes for those with chronic illnesses are not followed.
Diabetes Education
According to a study written up in the British Medical Journal, individuals with diabetes were more compliant when new and imaginative teaching methods were used to teach the patients about their disease and diet guidelines. The study found that when patients were given an educational videotape or applied lunchtime demonstrations, these patients were more likely to have consistent and compliant carbohydrate intake than those who were given a standard information sheet on a diabetic diet.
Physician Attitudes
When patients and doctors have two different goals, the problem typically manifests itself as noncompliance. According to a JAMA article, physicians who approach the patient-doctor relationship with the idea that they are the sole expert are more likely to be frustrated with outcomes. When doctors recognize that patients know themselves the best and work with the patient toward common goals, noncompliance decreases greatly. Determining what the client sees as her goals, strengths and weaknesses can give the physician a better idea of how to provide guidance and better understand barriers that may be interfering with dietary changes.
Demographic Factors
Individuals with diabetes may have factors associated with their lives that can affect compliance with diabetic diets. Low socioeconomic status, ethnic minority status and lower levels of education have all been associated with higher rates of death from diabetes, lower rates of compliance to diabetic guidelines and lower rates of self-monitoring of blood glucose levels, says Delamater. Delamater also found that lower levels of social support made it less likely that an individual would be compliant.
Medical Factors
Sometimes features of the disease can affect an individual's likelihood to comply with dietary regimens. According to Delamater, compliance is reduced with a chronic disease, complicated regimens and when symptoms cease. Making diabetic diets easy to follow, along with stressing that being asymptomatic does not mean a patient can go off the diet, can help increase the likelihood that the patient will follow the diet.
