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

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.