CHAPTER THREE: METHODOLOGY
3.1 Research Design
This study adopted a descriptive cross-sectional design aimed at assessing the nutritional
status of diabetic patients attending General Hospital, Katsina. This design was chosen
because it allows for the collection of data at a single point in time, enabling the description
of existing conditions and relationships among variables within the target population. The
cross-sectional approach is also cost-effective and appropriate for identifying patterns and
associations in nutritional and health indicators among diabetic patients.
3.2 Study Area
The study was conducted at General Hospital, Katsina, located in Katsina Metropolis,
Katsina State, Nigeria. The hospital is one of the major public health facilities in the state,
providing both primary and secondary health care services. It has specialized clinics,
including a diabetic clinic that caters to a large number of diabetic patients from within
Katsina metropolis and neighboring communities. The hospital serves as a referral center
for other health facilities in the region.
3.3 Study Population
The study population comprised all registered diabetic patients attending the diabetic clinic
at General Hospital, Katsina. The patients include both male and female adults who have
been diagnosed with diabetes mellitus (either Type 1 or Type 2) and are attending regular
follow-up visits at the hospital.
Type 1 diabetes mellitus is an autoimmune condition in which the pancreas produces little
or no insulin due to the destruction of insulin-producing cells. It usually occurs in childhood
or early adulthood and requires lifelong insulin therapy.
Type 2 diabetes mellitus, on the other hand, results from the body’s inability to use insulin
effectively (insulin resistance) or produce sufficient amounts of it. It is more common
among adults and is often associated with poor diet, sedentary lifestyle, and obesity.
Management typically involves dietary modification, regular exercise, oral hypoglycemic
agents, and sometimes insulin therapy.
Inclusion Criteria
- Diagnosed diabetic patients (Type 1 or Type 2) attending the diabetic clinic.
- Adults aged 18 years and above.
- Patients who provided informed consent to participate.
Exclusion Criteria
- Pregnant or lactating women.
- Patients with severe illness or those unwilling to participate.
- Patients below 18 years of age.
3.4 Sample Size Determination
The sample size was determined using Yamane’s (1967) formula for a finite population:
n = N / (1 + N(e)^2)
Where:
n = sample size
N = total population of diabetic patients attending the clinic
e = level of precision (0.05)
Assuming an estimated population of 250 diabetic patients attending the clinic, the sample
size was calculated as:
n = 250 / (1 + 250(0.05)^2) = 250 / 1.625 = 153.8
Thus, a sample size of 154 respondents was selected for the study.
3.5 Sampling Technique
A systematic random sampling technique was used to select participants from the clinic
register. The sampling interval (k) was obtained by dividing the total number of diabetic
patients by the calculated sample size. The first participant was selected randomly, and
subsequent participants were chosen at regular intervals until the required number was
obtained.
3.6 Instruments for Data Collection
A structured questionnaire and anthropometric measurement tools were employed for data
collection.
3.6.1 Questionnaire
The questionnaire was designed to collect information on:
- Socio-demographic characteristics (age, gender, occupation, education, etc.)
- Medical history and duration of diabetes
- Dietary intake pattern (using a 24-hour dietary recall)
- Lifestyle factors such as physical activity and smoking
3.6.2 Anthropometric Measurements
Anthropometric assessments included:
- Weight (kg): measured using a digital weighing scale to the nearest 0.1 kg.
- Height (m): measured with a stadiometer to the nearest 0.01 m.
- Body Mass Index (BMI): calculated as weight (kg) divided by height (m²).
BMI = Weight (kg) / Height (m)²
BMI was classified using WHO (2020) standards:
<18.5 = Underweight
18.5–24.9 = Normal
25–29.9 = Overweight
≥30 = Obese
3.6.3 Biochemical Data (if applicable)
Blood glucose and HbA1c levels were extracted from patients’ medical records to support
nutritional assessment.
3.7 Validity and Reliability of Instruments
The questionnaire was validated by experts in Nutrition and Dietetics and Public Health. A
pre-test was conducted among 10 diabetic patients at a nearby health center not included in
the main study to ensure clarity and reliability. Necessary modifications were made based
on feedback before administering the final questionnaire.
3.8 Method of Data Collection
Data were collected over a period of four weeks during routine clinic days. The researcher
and trained assistants administered the questionnaire and took anthropometric
measurements following WHO standardized procedures. Privacy and confidentiality were
maintained throughout the process.
3.9 Method of Data Analysis
Data collected were coded and entered into Statistical Package for Social Sciences (SPSS)
version 25.0 for analysis. Descriptive statistics (frequency, percentage, mean, and standard
deviation) were used to summarize data. Inferential statistics, such as the chi-square test,
were applied to assess associations between nutritional status and socio-demographic
variables. Results were presented in tables, charts, and graphs for clarity.
3.10 Ethical Considerations
Ethical clearance was obtained from the Research and Ethical Committee of General
Hospital, Katsina. Permission to conduct the study was sought from the hospital
management. Informed consent was obtained from all participants after explaining the
purpose of the study, ensuring that participation was voluntary. Confidentiality of
information was strictly maintained, and data were used solely for research purposes.
3.11 Limitations of the Study
The cross-sectional nature of the study limits the ability to establish causal relationships.
Self-reported dietary data may be prone to recall bias. Limited biochemical data availability
for all patients due to incomplete hospital records.