Evaluation of Dietary Intakes and Nutritional Knowledge in Thai Patients with Type 2 Diabetes Mellitus

Abstract

Introduction Most nutritional guidelines for diabetes management emphasize the importance of having individualized goals, away from a one-size-fits-all approach. However, there is a dearth of information on the dietary intakes and nutritional knowledge of Thai patients with type 2 diabetes mellitus (T2DM). This study is aimed at clarifying dietary intakes in relationship to glycemic control and at examining nutritional knowledge among Thai patients with T2DM. Materials and Methods A cross-sectional study of outpatients with T2DM at Theptarin Hospital and Ramathibodi Hospital (Bangkok, Thailand) was performed to assess dietary intakes by food records. Diabetes nutritional knowledge and dietary self-care behavior was also evaluated. Results A total of 304 Thai patients with T2DM (female 52.6%, mean age 57.4 ± 10.9 years, body mass index (BMI) 27.3 ± 4.8 kg/m2, and baseline A1C 7.2 ± 1.3%) participated in the study. The mean daily calorie intake was 1427 ± 425 kcal, and mean intake for each macronutrient was acceptable (carbohydrate 52%, protein 17%, and fat 31%). However, the intake of free sugar was much higher (12.1 ± 5.8% of total daily energy intake) and dietary fiber intake (9 grams per day) was much lower than recommended. There were no correlations between dietary intake and glycemic control. A subset of patients (N = 213) completed the diabetes nutritional knowledge survey. There was no association between diabetes nutritional knowledge and the actual dietary self-care behavior. Conclusion These results indicate that compliance of Thai patients with T2DM to dietary recommendations is not completely satisfactory, especially for free sugar and dietary fiber intakes. Addressing the reality of how patients with T2DM eat in their daily lives and their knowledge gaps would enable them to adhere to medical nutrition therapy.

Low Reported Adherence to the 2019 American Diabetes Association Nutrition Recommendations among Patients with Type 2 Diabetes Mellitus, Indicating the Need for Improved Nutrition Education and Diet Care

“…In Italy, a great proportion of patients with T2DM adhered to the recommendations for protein and added sugars, but the respective percentage of those meeting SFA and fiber goals was lower [ 60 ]. A similar pattern was noted in Thailand [ 61 ], with the majority of patients with T2DM failing to meet local SFA and fiber recommendations, issued based on the ADA respective guidelines. In Finland [ 62 ], a mere 28% of patients with T1DM with nephropathy restricted their SFA intake according to the recommended levels of less than 10% of the total energy intake based on the Finish Diabetes Association (FDA) guidelines.…”

Consumo de bebidas azucaradas, verduras y frutas en sujetos con alteración del metabolismo de la glucosa

“…Consumo de bebidas azucaradas, verduras y frutas en sujetos con alteración del metabolismo de la glucosa que el cumplimiento de los pacientes con DM2 a las recomendaciones dietéticas (medido como fibra dietética) no fue satisfactorio 29 . Más aun, un estudio longitudinal realizado en el Reino Unido reportó limitada evidencia de que el diagnóstico de DM2 aliente un cambio en las conductas saludables, especialmente en aquellas relacionadas a incremento de actividad física o consumo de frutas y verduras 30 .…”

Diabetes Health Promotion Self-Care Scale: Reliability and Validity of the Turkish Version

“…In the study of Nie et al (23), the alpha reliability coefficient ranged between 0.64 and 0.93.In the study conducted by Wang et al (19), the reliability of the "Foot Care" sub-factor could not be determined, the "Adherence to the Recommended Regime" factor was determined to be α=0.78, and in our study the "Diet" sub-factor was α=0.689.It is emphasized that patients with diabetes who can follow dietary self-care advice generally have better glycemic control, resulting in less diabetic complications. However, it is emphasized that it is challenging to motivate patients to achieve self-care behaviors with diet and requires ongoing efforts between patients and a multidisciplinary team (24). Relevant studies noted that the compliance of individuals with diabetes to dietary recommendations is not at the desired level (24,25).…”