Reliability and Structure of Diabetes Diet Adherence Scale (D-DAS): A Follow-up Study among Type 2 Diabetes Patients of India

IntroductionMeasuring dietary adherence is essential while prescribing a diet plan for type 2 diabetes. This study aims to develop and validate a diabetes diet adherence scale (D-DAS) among type 2 diabetes patients in India. MethodsA four-month non-randomised follow-up study was conducted among (n=120) type 2 diabetes patients attending the outpatient clinic. The adherence to the prescribed diet plan was determined using the D-DAS scale. Multiple correspondence analysis (MCA) was used to determine the underlying dimensions of the scale, and confirmatory factor analysis (CFA) with multiple reliability measures was used to determine the reliability and construct validity of the scale. The latent class analysis (LCA) was done to determine the cutoffs for the scale. Although the sample size underpowered for CFA and LCA stability. ResultsThe CFA indicated high reliability, with McDonalds {omega} = 0.836 and Guttmans {lambda}2 = 0.836. The MCA identified dimensions that accounted for 68.4% of the total variance. The D-DAS scale further demonstrated a robust latent structure, evidenced by a composite reliability of 0.900 and an average variance extracted (AVE) of 0.565. Regarding adherence outcomes, 68.3% of participants exhibited adherence to the prescribed diet plan, whereas 31.7% demonstrated non-adherence. ConclusionD-DAS is a reliable and valid scale for measuring dietary adherence among type 2 diabetes patients in India. Adherence was moderate, suggesting the need for targeted interventions to improve dietary compliance and diabetes management.