Background Type 2 diabetes mellitus is a major public health problem worldwide. Nonadherence to lifestyle modifications in individuals with type 2 diabetes poses a great problem.

Objective This study assessed magnitude and factors associated with nonadherence to diet and exercise.

Methods An institution-based cross-sectional study was conducted on 302 type 2 diabetic patients at Asella Referral and Teaching Hospital of Arsi University. The data were collected via structured questionnaire. Multivariate logistic regression was used to determine the effects of independent variables on nonadherence to diet and exercise recommendations.

Results Of the individuals in the study, 247(81.8%) patients did not follow the exercise recommendations, and 157(52%) patients did not follow the diet recommendations for type 2 diabetes. Duration since diagnosis > 5 years (AOR = 2.1, 95% CI [1.18–3.36]), doctors’ advice (AOR= 2.3, 95% CI [1.24–4.47]) and family history of DM (AOR= 4.3, 95% CI [2.55–7.29]) were independent determinants of nonadherence to dietary recommendations. Similarly, female sex (AOR= 3.6, 95% CI [1.60–8.60]), duration > 5 years since the diagnosis (AOR= 2.1, 95% CI [1.03–4.43]) and educational status attending only primary school (AOR= 3.33, 95% CI [1.33– 8.34]) and only reading and writing or illiteracy (AOR= 6.7, 95% CI [1.86–24.29]) were independently associated with nonadherence to the exercise recommendation of type 2 diabetes patients.

Conclusions Overall, in our study, many patients were nonadherent to diet and exercise recommendations. Female patients and patients who attended primary school or less and > 5 years since diagnosis were more likely to be nonadherent to exercise. The determinants of diet nonadherence were a lack of doctors’ advice, > 5 years since diagnosis and a lack of family history.

The authors have declared no competing interest.

The author(s) received no specific funding for this work.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval was obtained from Arsi University Ethical Review Committee (A/CHS/RC/138/2024) and permission letter was obtained from ARTH before field activities started. After a detailed explanation of the purpose, benefits, confidentiality of the information, and voluntary nature of participation in the study we obtained written informed consent from all participated T2DM patients prior to their participation. Name and other personal identifiers were not recorded to maintain confidentiality.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

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Co-authors’ emails: name: Email address: ZH: hurizewgmail.com, AD: ayalnehdemissisgmail.com, TG: tesfagm2021gmail.com, ES: enkuselamu7gmail.com

The data is found in the text under supporting information