Diabetes-related nutrition knowledge and dietary intake among adults with type 2 diabetes

Abstract

Nutrition knowledge and skills enable individuals with type 2 diabetes (T2DM) to make food choices that optimise metabolic self-management and quality of life. The present study examined the relationship between nutrition knowledge and skills, and nutrient intake in T2DM. A cross-sectional analysis of diabetes-related nutrition knowledge and nutrient intake was conducted in 124 T2DM individuals managed in usual care (64 % male, age 57·4 (sd 5·6) years, BMI 32·5 (sd 5·8) kg/m2), using the Audit of Diabetes Knowledge (ADKnowl) questionnaire and a 4 d food diary. Data on sociodemographic characteristics, food label use and weight management were also collected. The average ADKnowl dietary subscale score was 59·2 (sd 16·4) %. Knowledge deficits relating to the impact of macronutrients/foods on blood glucose and lipids were identified. Lower diabetes-related nutrition knowledge was associated with lower intakes of sugar (10·8 (sd 4·7) v. 13·7 (sd 4·6) % for lower dietary knowledge score v. higher dietary knowledge score, P< 0·001), non-milk sugar (9·1 (sd 4·8) v. 12·1 (sd 4·7) % for lower dietary knowledge score v. higher dietary knowledge score, P< 0·001) and fruit/vegetables (230·8 (sd 175·1) v. 322·8 (sd 179·7) g for lower dietary knowledge score v. higher dietary knowledge score, P< 0·001), and higher dietary glycaemic index (GI) (61·4 (sd 4·5) v. 58·4 (sd 4·6) for lower dietary knowledge score v. higher dietary knowledge score, P< 0·002). The majority of the participants were dissatisfied with their weight. Sugar was the most frequently checked nutrient on food labels (59 %), with only 12·1 % checking foods for their energy content. Significant knowledge and skill deficits, associated with the impact of macronutrients/foods on metabolic parameters and food label use, were found. Lower diabetes-related nutrition knowledge was associated with lower sugar and fruit/vegetable intake and higher dietary GI. Dietary education, integrated throughout the lifespan of T2DM, may improve nutrition knowledge and skills and promote more balanced approaches to dietary self-management of T2DM.