Dietary intake and diabetes-related nutrition knowledge in people with type 2 diabetes

Abstract

Background: Type 2 diabetes mellitus (T2DM) affects millions worldwide, leading to significant health and economic burdens. Effective dietary management, underpinned by nutrition-related knowledge, is essential for improving clinical outcomes in T2DM. However, limited research exists on the relationship between diabetes-specific nutrition knowledge and dietary intake patterns.
Methods: This study included 125 adults with T2DM who received standard dietary guidance. Nutrition knowledge was assessed using the dietary subscale of the Audit of Diabetes Knowledge (ADKnowl) questionnaire. Dietary intake was evaluated through detailed four-day food diaries, analyzed using validated software. The association between nutrition knowledge and nutrient intake was examined using multivariable regression, adjusting for potential confounders.
Results: The mean ADKnowl dietary subscale score was 59.2% (SD = 16.4). Higher nutrition knowledge was associated with greater energy intake relative to basal metabolic rate (EI:BMR ratio, 1.4 ± 0.5 vs. 1.1 ± 0.3, P < 0.005), higher fruit and vegetable consumption (322.8 ± 179.7 g vs. 230.8 ± 175.1 g, P < 0.001), and lower dietary glycemic index (58.4 ± 4.6 vs. 61.4 ± 4.5, P < 0.002). Those with lower knowledge demonstrated higher intake underreporting and consumed less sugar and non-milk sugar.
Conclusion: Diabetes-specific nutrition knowledge significantly influences dietary behaviors, particularly energy reporting, fruit and vegetable intake, and dietary glycemic index. Enhancing nutrition education in T2DM management may support improved dietary habits and metabolic health. Future research should explore targeted interventions to address gaps in dietary knowledge.