Meal Skipping among Patients with Type 2 Diabetes Mellitus (T2DM) and Its Associations with Glycaemic Control, Eating Out of Home and Binge Eating

Skipping Meals among Patients with Type 2 DM
Vol. 15 No. 2 : 2020 (246-261)

TOHID H TOHID H
Ooi CF Ooi CF
Leong YH Leong YH
Mohamad Ngasri NE Mohamad Ngasri NE
Ismail MI Ismail MI
Mohamad Alwi SNN Mohamad Alwi SNN
Jafri NNA Jafri NNA
Md Monoto EM Md Monoto EM

Abstract
Meal skipping is a common way to restrict diet, but its practice by patients with type 2 diabetes mellitus (T2DM) remains undetermined due to the scarcity of the research. The main aim of this study was to assess how common patients with T2DM skipped meals. Its associations with sociodemographic and clinical characteristics, HbA1c, eating out of home and binge eating were examined too. This cross-sectional study was conducted in 2015 among 203 patients at a public healthcare clinic in Kuala Lumpur. A self-administered questionnaire including the Malay-version Binge Eating Scale was used. The proportions of participants who frequently skipped meals and ate out of home were 41.4% and 61.6%, respectively. Only 2% of them had binge eating disorder. Multiple logistic regression showed only Chinese was significantly associated with frequent meal skipping compared to Malay (adjusted odds ratio: 0.36; 95% confidence interval: 0.16-0.77; p value= 0.009) after controlling for age, employment status, educational status, HbA1c, presence of complication, type of treatment, eating out of home and binge eating. In conclusion, meal skipping was a frequently practised eating behaviour. Eating out of home was common too, but binge eating was rare. Meal skipping was not influenced by both eating practices and it had insignificant associations with glycaemic control. Cultural and religious factors may play an important role in defining their eating practice. Further studies are needed to assess the safety and acceptability of this practice, but clinically, its effects must be individually examined to prevent unwanted consequences on their health.
Keywords : blood glucose, Diabetes mellitus, feeding behaviour, meals,
Abstrak
Tabiat langkau waktu makan adalah kaedah lazim untuk mengawal diet. Namun, amalan kaedah permakanan ini oleh pesakit diabetes melllitus (T2DM) masih belum diketahui berikutan kekangan kajian. Matlamat utama kajian ini adalah untuk mengenal pasti selazim mana pesakit T2DM melangkau waktu makan. Kaitannya dengan faktor sosiodemografi dan klinikal, HbA1c, makan di luar rumah dan kecelaruan gaya pemakanan turut dikaji. Kajian keratan lintang ini telah dijalankan pada tahun 2015 dalam kalangan 203 pesakit di klinik kesihatan awam di Kuala Lumpur. Borang soal selidik yang diisi sendiri oleh subjek termasuk borang Skala Kecelaruan Gaya Pemakanan dalam Bahasa Melayu. Seramai 41.4% subjek kerap melangkau waktu makan dan 61.6% subjek sering makan di luar.  Hanya 2% sahaja yang mempunyai masalah kecelaruan gaya pemakanan. Regresi logistik berbilang menunjukkan subjek berbangsa Cina mempunyai kaitan yang kuat dengan tabiat melangkau waktu makan berbanding dengan subjek berbangsa Melayu (nisbah ganjil selaras: 0.36; 95% sela keyakinan: 0.16-0.77; nilai p: 0.009) setelah mengambil kira faktor usia, status pekerjaan, tahap pendidikan, HbA1c, komplikasi, jenis rawatan, makan di luar dan kecelaruan gaya pemakanan. Kesimpulannya, tabiat melangkau waktu makan merupakan satu amalan lazim begitu juga dengan makan di luar rumah. Namun, kecelaruan gaya pemakanan jarang dijumpai. Tabiat melangkau waktu makan tiada kaitan dengan amalan pemakanan ini dan juga kawalan gula dalam darah. Faktor budaya dan keagamaan berkemungkinan mempengaruhi  amalan pemakanan individu. Kajian lanjut perlu dijalankan bagi mengenal pasti tahap keselamatan dan penerimaan berkaitan dengan amalan ini.  Walau bagaimanapun, kesannya daripada sudut klinikal perlu diperiksa dengan teliti untuk mengelakkan komplikasi kesihatan.  
Kata Kunci : diabetes mellitus, gaya pemakanan, gula darah, makanan,

Correspondance Address
Associate Professor Dr Hizlinda Tohid. Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Tel: +6019-2222109 Email: hizlinda2202@gmail.com