Lifestyle Counseling for Patients with Type 2 Diabetes in the Southwest of Saudi Arabia: An Example of Healthcare Delivery Inequality Between Different Healthcare Settings

PURPOSE: Adherence to a healthy lifestyle can have a positive impact on the course of diabetes management. This investigation aims to study lifestyle counseling provision among patients with type 2 diabetes in Saudi Arabia and the delivery of lifestyle counseling within different healthcare settings. METHODS: This cross-sectional investigation was conducted in the Jazan region in Saudi Arabia. Data were collected using a semi-structured questionnaire during phone interviews. The questionnaire measured items related to the demographics of the patients, diabetes diagnoses, and follow-up locations. The items pertaining to lifestyle counseling were related to whether the patients were given an assessment of dietary and physical activity levels, receipt of a personalized lifestyle change plan, and smoking cessation therapy among smokers. Odds ratios (ORs) were calculated to estimate the probability of receiving the lifestyle counseling items in primary healthcare centers (PHCs) compared to other healthcare facilities. RESULTS: A total of 461 patients diagnosed with diabetes were identified. The development of symptoms or complications related to diabetes was the main cause of diagnosis (63%). Sixty-six patients reported not attending a follow-up at any healthcare facility. The ORs of receiving a lifestyle plan and having daily caloric needs calculated were higher among patients who followed up at hospitals, diabetes centers or within the private sector compared to those who went to PHCs (ORs: 1.8 [1.1–2.8] and 2.7 [1.2–5.9] respectively). In all the identified healthcare settings, health education was mostly provided by the treating physicians, indicating the limited role of nutritionists or health educationists. CONCLUSION: This study suggests a limited receipt of lifestyle counseling services for patients with type 2 diabetes in PHCs compared to other healthcare facilities. The majority of counseling services were provided by physicians, which indicates the limited inter-disciplinary involvement of other health professionals, such as nutritionists and health educationists.