Nursing Journal Volume 10.
Issue 2.
Page 215 Ae 222 e-ISSN: 2354-6050 https://ejurnal.
id/index.
php/JKep DOI: https://doi.
org/10.
32668/jkep.
FACTORS ASSOCIATED WITH DIETARY COMPLIANCE WITH TYPE 2
DIABETES MELLITUS IN THE ELDERLY IN SOUTH TANGERANG
Syifa Rezkya Murodi Abstract Nia Damiati* Diabetes mellitus is classified as one of the main causes of poor health in the One of the populations most at risk and increasing in number is the To achieve successful control of diabetes mellitus, one of them depends on dietary compliance.
Dietary adherence is an important factor to keep blood sugar stable and not cause complications.
This study aims to determine the factors associated with dietary compliance with type 2 diabetes mellitus in the elderly in the Pisangan Health Center area.
This type of research is observational analytics with a cross sectional approach.
The number of samples in this study was 70 respondents taken using purposive sampling techniques.
The instruments in this study used demographic questionnaires, influencing factors, and PDAQ (Perceived Dietary Adherence Questionnair.
The results showed that there was a significant relationship between education, knowledge, and self-motivation with DM diet adherence.
Meanwhile, there was no significant association between sex, occupation, family support, and the role of health workers with DM dietary adherence.
In this study, there were 24 respondents with low diet adherence, and 46 respondents with high diet adherence.
Researchers hope that health workers can pay more attention to groups that have not been exposed to information related to DM and DM diet management and can pay attention again to other factors that are less related to dietary compliance in the elderly.
Ita Yuanita Dwi Setiowati Maulina Handayani Waras Budi Utomo Faculty of Health Sciences.
UIN Syarif Hidayatullah Jakarta.
South Tangerang.
Indonesia email: nia_damiati@uinjkt.
Keywords:
Diet Adherence Elderly Factors Type 2 Diabetes Mellitus Received: November 2025 Accepted: November 2025 Published: November 2025 A year The Authors.
Published by Published Jurusan Keperawatan.
Politeknik Kesehatan Kemenkes Jakarta i.
This is Open Access article under the CC-BY-SA License .
ttp://creativecommons.
org/licenses/by-sa/4.
0/).
DOI:
https://doi.
org/10.
32668/jkep.
INTRODUCTION
In Indonesia, non-communicable diseases occupy the top ten diseases that cause the most cases of death .
One of the groups or populations most at risk of being affected and increasing in number isthe elderly.
In 2018, the percentage of the elderly population in Indonesia increased compared to 2017, around 24.
49 million people and reached 9.
According to the World Health Organization (WHO), diabetes mellitus is classified as one of the NCDs that is a major cause of poor health in the world.
Diabetes mellitus is a set of metabolic barriers characterized by increased blood sugar levels .
, which occurs due to abnormalities in insulin secretion, insulin activity, or both.
Data from the International Diabetes Federation (IDF) in 2017 showed that people with diabetes mellitus in the world reached 425 million people, mostly aged 20-79 years, and is expected to increase to 629 million people by 2045.
According to the consensus of the Indonesian Endocrine Association (Perken.
states that the success of the diabetes mellitus control process depends on diet compliance or dietary arrangements in people with diabetes mellitus.
Factors that influence dietary compliance are divided into two, namely, internal factors and external factors.
Internal factors consist of knowledge and attitudes while external factors consist of family support and health workers.
Previous research has shown that dietary adherence in JKEP (Jurnal Keperawata.
Vol 10 Issue 2.
November 2025.
Page 215 Ae 222 e-ISSN: 2354-6050 people with type 2 diabetes mellitus is influenced by that the elderly experience changes in their attitudes and various internal and external factors, but there are still behavior.
differences in results regarding the most dominant METHODS factors influencing dietary adherence.
Most studies have This type of research uses an observational analytical been conducted on people with diabetes mellitus in research design with a cross-sectional approach.
This general, while research specifically examining dietary study was conducted from March to June 2023 in the adherence in the elderly is still limited, even though the working area of the Pisangan Community Health elderly experience physical and psychological changes Center.
The population in this study were elderly people that can affect adherence behavior.
Furthermore, in the with type 2 diabetes mellitus in the working area of the Pisangan Community Health Center area.
East Ciputat Pisangan Community Health Center.
The criteria for District, there has been no research examining the patients with type 2 diabetes by medical personnel, aged factors that influence the level of dietary adherence in over 60 years, cognitively and mentally healthy, patients the elderly with type 2 diabetes mellitus.
Therefore, this undergoing treatment at the Pisangan Community study was conducted to fill this gap by identifying the Health Center.
The sampling technique in this study factors that most influence dietary adherence in elderly used a purposive sampling technique of 64 samples and with type 2 diabetes mellitus.
a 10% excess to prevent missing data.
The research Based on research conducted by Fitriana and Salviana instruments used were a demographic questionnaire, a .
regarding the analysis of factors affecting dietary questionnaire that influences adherence, and a PDAQ compliance in the elderly with type 2 diabetes mellitus, (Perceived the results of this study found that there was a close Dietary Adherence Questionnair.
questionnaire with a validity and reliability test result of relationship between family support, knowledge.
Cronbach's alpha of 0.
In this study, the influencing income, and nutritional counseling in the level of dietary factors consisted of knowledge, self-motivation, family compliance in the elderly.
Furthermore, in a study support, and the role of health workers.
These factors conducted by Yaslina, et al.
, .
which examines have been tested for validity and reliability by Yulia changes in the aging process entitled Physical and .
, resulting in a Cronbach's alpha value of 0.
psychosocial aspects of functional status in the This research has undergone ethical testing by the elderly.
The journal explains that there are several Health Ethics Committee of UIN Syarif Hidayatullah changes in the aging process, namely physical changes.
Jakarta, psychosocial changes, changes in cognitive aspects, and .
Un.
01/F.
10/KP.
1/KE.
SP/06.
079/2023 .
functional changes.
And the results of the study found there is a relationship between RESULTS AND DISCUSSION psychosocial aspects and changes in attitudes that occur Table I.
Characteristics of Respondents with Type 2 Diabetes Mellitus Patients in the Pisangan Health Center Area .
= .
in the elderly .
Therefore, researchers chose to conduct research on Characteristics elderly subjects because it is in accordance with the Gender Male Female Last Education Not School/Not Graduated urgency obtained by researchers regarding the lack of obedient attitudes of the elderly towards the DM diet and in line with research conducted by Yaslina et, al.
, .
Frekuensi Persentase (%) JKEP (Jurnal Keperawata.
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SLTP
HIGH SCHOOL
Higher Education Jobs Work Not Working Knowledge Less (O60%) Good (Ou60%) Self Motivation Less Good Family Support Negative Positive The role of health workers Less Good DM Dietary Adherence Low High e-ISSN: 2354-6050 Questionnaire measuring instrument.
The results of the totaling 24 respondents .
3%), and high dietary results of the above analysis it can be concluded that was measured based on the level of dietary compliance in elderly patients with type 2 diabetes mellitus during the last 7 days of consuming food.
The level of dietary compliance uses the Perceived Diet Adherence dietary adherence variable were low dietary adherence adherence totaling 46 respondents .
7%).
From the high dietary compliance is greater as many as 46 Based on the results of this study, it was found that the highest number of respondents in the gender of patients with type 2 diabetes mellitus in the elderly in the Based on Table 1, the frequency distribution of Pisangan Health Center area were men as many as 37 characteristics in elderly patients with type 2 diabetes respondents .
9%) while a small proportion of mellitus during May-June 2022 at the Pisangan Health respondents were female as many as 33 respondents Center obtained the results of the gender variable with .
1%).
The results of this study indicate that both men 70 respondents, the majority of whom were male, and women have the same risk of developing diabetes totaling 37 respondents .
9%).
The results obtained mellitus.
And the results of this study are also from the majority of education variables are high school, supported by research in Indonesia conducted by totaling 32 respondents .
7%).
The results obtained Riskesdas in 2007 that the prevalence does not differ by from the employment variable with 70 respondents.
The results of research conducted by Riskesdas namely the majority did not work, totaling 54 on gender were 1.
1%, which means that men and women respondents .
1%).
The results of the knowledge have the same risk of developing DM.
variable the majority of respondents had good knowledge of more than 60%, totaling 53 respondents Based on the statistical results in this study, it was found .
7%).
According to Notoatmojo .
states that that the highest number of respondents' education in the knowledge is very important in shaping a person's elderly with type 2 diabetes mellitus was high school, behavior and that knowledge is the first step for a person totaling 32 respondents .
7%).
The results of this to determine their attitude and behavior.
The results of study are in line with research conducted by the self-motivation variable the majority of respondents Kasumayanti .
Most respondents had a high had good self-motivation totaling 40 respondents school education level with 34 respondents .
5%).
1%).
Based on the statistical results in this study, it was found The results of the family support variable the majority that the highest number of respondents was not working, of respondents had positive family support totaling 34 totaling 54 respondents .
1%).
The results of this respondents .
6%).
The results of the health worker study are in line with the results of research conducted by Pratiwi .
that the highest number of role variable were the majority of respondents had a good health worker role totaling 38 respondents respondents was not working as many as 56 respondents .
3%).
Furthermore, dietary adherence in this study .
6%).
This is because in the study the majority of JKEP (Jurnal Keperawata.
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Page 215 Ae 222 e-ISSN: 2354-6050 respondents did not work because they had reached an gender and DM diet compliance with a p value of 1,000.
advanced age of 60 years and over or had retired.
This shows that gender is not a factor that is directly Table 2.
Relationship between Characteristics and Dietary Adherence in Elderly Diabetes Mellitus Type 2 Patients Compliance Total Correlation Varibel related to compliance behavior .
Level Gender
Male
Female Education Not School
SLTP
High School Higher Education Reinstock et.
al in Lestari .
state that gender is not a factor directly related to compliance.
Rather, gender
Coefficient Low
(%)
High
(%)
0,152
0,055
conducted on the education variable and the level of DM figure is not more than 0.
05, which means that there is a is directly related to perceptions and these perceptions are directly related to adherence because gender affects the mental changes of patients to decide to take action to 0,173 prevent disease or complications from continuing.
0,230
The results of the Spearman rank correlation test diet compliance resulted in a p value of 0.
055 where this significant relationship between the two variables.
Education is an effort to instill an understanding and Jobs Work Not Working 0,532 purpose in order to grow attitudes in individuals to be 0,076 able to understand and perform positive actions.
This study is in line with research conducted by Susanti Based on the results of table 2 on the variables of gender, .
testing the correlation between knowledge and education, occupation with dietary complianceand DM diet compliance with a p value of 0.
determine the relationship between the two variables.
From a total of 70 respondents in the study, it was found Based on the results of this study, it was found that 22 that the majority of male gender had a high level of respondents out of a total of 70 respondents had low compliance totaling 27 respondents .
7%) while the dietary compliance than respondents with higher level of compliance in female gender had a low level of During the field research, respondents with compliance totaling 14 .
3%).
The results obtained higher education were much more able to understand from the education variable from 70 respondents and accept all DM diet recommendations given by showed that the majority of the compliance level in high health workers.
This led the researcher to assume that school had high compliance, totaling 20 respondents the extensive knowledge of the respondents would allow .
5%).
The results obtained from the occupational the individual to control himself against the nutrients variables of 70 respondents showed that the majority of consumed that could cause an increase in blood sugar the compliance rate on not working had a high level of and complications in his disease so that the individual compliance as many as 34 respondents .
9%).
would adhere to his diet.
In this study, there was no significant relationship The results of the Spearmen rank correlation test between gender and the level of DM diet compliance conducted on the employment variable and the level of with p value = 0.
152, which is >0.
In the elderly who DM diet adherence resulted in a p value of 0.
532 where suffer from diabetes mellitus 2, both women and men do the number> 0.
05 which means there is no significant not provide a significant relationship to dietary relationship between the two variables.
In this variable.
This is in line with what was done by there is no relationship between employment status and Rohani .
that there is no correlation between JKEP (Jurnal Keperawata.
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Page 215 Ae 222 e-ISSN: 2354-6050 compliance in dietary management.
This study is in line the risks that would be caused and accepted so as to with research conducted by Hestiana .
that there is create awareness for individuals and finally individuals no correlation between employment and DM diet would behave according to what individuals knew if compliance with the results of p value 0.
they did not comply with their diet.
Quoted from Macgilchrist .
that there is a Table 4.
Relationship between self-motivation and dietary adherence in elderly patients with type 2 diabetes relationship between employment status and DM diet management compliance.
because, people with DM who Self
Motivation have low income will cause non-compliance in managing the diet compared to people with high
Less Good
This is because people who have lower incomes Compliance Level Low
High
(%)
(%)
Total p Correlation value Coefficient 0,001 0,396 have fewer opportunities to buy foods that are suitable Based on the results of table 4 on self-motivation for DM diet management.
variables with dietary adherence and knowing the Table 3.
Relationship between Knowledge and Dietary Adherence in Elderly Diabetes Mellitus Type
2 Patients Knowledge Gender
Male
Female Compliance Level Low
High
(%)
(%)
Total relationship between the two variables.
Of the total 70 respondents in the study, 32 respondents .
6%) had p Correlation value Coefficient good self-motivation and a high level of adherence.
The results of the Spearmen rank correlation test conducted on the self-motivation variable and the level 0,014 0,293 of DM diet compliance resulted in a p value of 0.
where this figure is <0.
05, which means that there is a Based on the results of table 3 on the variable knowledge significant relationship between the two variables.
with dietary compliance and knowing the relationship Individual compliance can be influenced by motivation between the two variables.
Of the total 70 respondents from within the individual to carry out healthy behavior in the study, it was found that 37 respondents .
and always maintain their health.
This study is in line had good knowledge and a high level of compliance.
with research by Nurmala Datuela .
testing that The results of the Spearmen rank correlation test there is a correlation between family support and DM conducted on the knowledge variable and the level of diet compliance with a p value of 0.
DM diet compliance resulted in a p value of 0.
014 where this figure is <0.
05, which means that there is a This shows that good motivation will influence significant relationship between the two variables.
This individuals to carry out health behavior according to the study is in line with research conducted by Rohani recommendations given by health workers.
Based on the .
testing the correlation between knowledge and results of this study, 40 respondents had good self- DM diet compliance with a p value of 0.
motivation and showed that the proportion of DM diet compliance was more in respondents who had good self- In the results of this study, 53 respondents had good motivation than respondents who had less motivation.
knowledge and had a high level of compliance as many as 37 respondents out of a total of 70 respondents.
During interviews with respondents, it was found that respondents with high knowledge of DM and DM management proved to be obedient to the diet they were carrying out because the respondents already understood JKEP (Jurnal Keperawata.
Vol 10 Issue 2.
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Page 215 Ae 222 e-ISSN: 2354-6050 Table 5.
Relationship between Family Support and Dietary Adherence in Elderly Diabetes Mellitus Type 2 Patients Based on the results of table 6 on the variable role of health Family Support between the two variables.
Of the total 70 respondents in the workers with dietary compliance and knowing the relationship
Compliance Total
Correlation Level value Coefficient Low
High
(%)
(%)
47,8 51,4 0,222 0,148
52,2 48,6
Negative Positive study, 25 respondents .
3%) had a good role of health workers and a high level of compliance.
The results of the Spearmen rank correlation test Based on the results of table 5 on family support conducted on the variable role of health workers and the variables with dietary adherence and knowing the level of DM diet compliance resulted in a p value of relationship between the two variables.
Of the total 70 891 where this figure is> 0.
05, which means that there respondents in the study, 24 respondents .
2%) had is no significant relationship between the two variables.
positive family support and a high level of compliance.
This study is in line with research conducted by Febriyanti .
testing that there is no correlation The results of the Spearmen rank correlation test between the role of health workers and DM diet conducted on the family support variable and the level compliance with a p value of 0.
This shows that of DM diet compliance resulted in a p value of 0.
the interaction between health workers and patients does where this figure is> 0.
05, which means that there is no not lead to an understanding of the importance of significant relationship between the two variables.
This treatment when consultation is being carried out.
study is in line with the results of Febriyanti's research In the results of this study there were 32 respondents .
that there is no correlation between family .
7%) who had a lack of role of health workers, but support and DM diet compliance with a p value of had high dietary compliance as many as 21 respondents.
The results showed that family support did not This makes the researcher assume that this is because help patients to increase their confidence to carry out even though the role of health workers is lacking, there proper dietary management.
are other important factors that make respondents In this study, 36 respondents .
4%) had negative or adhere to their diet such as strong self-motivation and a lack of family support, but even so there were 22 greater desire to recover.
respondents out of 36 respondents who experienced less The level of dietary compliance in this study was family support they had high compliance.
During measured using the 9-item PDAQ instrument with a interviews with respondents, the average elderly person total sample of 70 respondents.
Based on the statistical in the Pisangan Health Center area has separated from their children, only lives with their spouse, or alone.
results in this study, it shows that there are 2 categories They said that other family members only fulfill their of DM diet adherence levels.
low category there are 24 material needs.
3%), and high category 46 respondents .
7%).
Most of the respondents in this study belonged Table 6.
Relationship between the role of health
workers and dietary adherence in elderly patients with type 2 diabetes mellitus The role of Less Good
Compliance Level Low
(%)
Hig
(%)
Total to the high dietary compliance category.
The resulting data arises because there are several influencing factors.
Correlation Coefficient especially in self-motivation and the level of individual The results of this study are in line with research
0,891
0,017
conducted by Bangun .
that of the 48 respondents JKEP (Jurnal Keperawata.
Vol 10 Issue 2.
November 2025.
Page 215 Ae 222 there were 27 respondents .
3%) compliant with their e-ISSN: 2354-6050 Badan Pusat Statistik.
Statistik penduduk lanjut diet and 21 respondents .
8%) were not compliant Jakarta: BPS.
Available from:
with their diet.
This shows that patient compliance in https://w.
id/publication/2018/12/21/ead undergoing DM diet management is due to the belief bab6507c06294b74adf71/statistik-penduduk- that dietary management can control blood sugar and prevent complications.
this is supported by interviews at American Diabetes Association.
Diagnosis and the time of the study, the respondent said that he had a classification of diabetes mellitus.
Diabetes Care.
high desire to recover from his illness by controlling 33(Suppl .
:S62AeS69.
food and the respondent said that when blood sugar Sugandi A.
Hidayat Y.
Factors affecting diabetes levels rise, it causes headaches, weakness throughout diet adherence in patients with type 2 diabetes the body, and impaired comfort which in turn the JOMPSIK.
respondent maintains his diet.
Fitriana Z, et al.
Analysis of factors affecting dietary compliance in elderly people with type 2
CONCLUSION
diabetes mellitus.
Silampari Nursing Journal.
The results of this study show that most respondents 4.
with Type 2 Diabetes Mellitus had good knowledge, good self-motivation, and high dietary adherence.
The Yaslina Y, et al.
Physical and psychosocial aspects of functional status in the elderly.
Proceedings of factors of education, knowledge, and self-motivation the Pioneer Health Seminar.
:2622Ae were found to have a significant relationship with the level of adherence to the Type 2 DM diet, while gender, occupation, family support, and the role of health Yulia S.
Faktor-faktor yang mempengaruhi kepatuhan dalam menjalankan diet pada penderita workers did not show a significant relationship.
These diabetes mellitus tipe 2.
Semarang: Jurusan Ilmu findings indicate that internal factors play a more Kesehatan dominant role in influencing dietary adherence than Masyarakat.
Fakultas Ilmu Keolahragaan.
Universitas Negeri Semarang.
external factors.
Therefore, it is recommended that health workers focus on increasing patient knowledge and motivation through education and counseling, while Notoatmodjo S.
Ilmu Perilaku Kesehatan.
Jakarta:
Rineka Cipta.
family members are encouraged to provide positive support to patients in maintaining dietary adherence.
Ariani AP.
Metodologi penelitian kebidanan pada kesehatan reproduksi.
Yogyakarta: Nuha Medika.
Further research is suggested to involve a larger number of respondents and explore other variables that may Susilawati RR.
The relationship between age, influence dietary adherence, such as psychological and gender, and hypertension with the incidence of social factors, to obtain a more comprehensive type 2 diabetes mellitus at the Tugu Health Center, understanding and improve the effectiveness of future Cimanggis District.
Depok City.
ARKESMAS.
Badan Penelitian dan Pengembangan Kesehatan.
REFERENCES