Influencing Factors of Knowledge, Attitude, and Practice regarding Medical Nutrition Therapy in Patients with Diabetes: A National Cross-Sectional Study in Urban China.

Zijian Li,Xiaohui Guo,Lulu Jing,Wei Chen,Sainan Zhu,China Needs Study Group,Zilin Sun,Xiaohui Zhao,Haimin Jin

doi:10.1155/2017/8948452

Abstract

To investigate the knowledge-attitude-practice (KAP) score in diabetes patients living in urban China regarding Medical Nutrition Therapy (MNT) and explore the influencing factors, this national survey recruited diabetes and prediabetes patients in 40 hospitals across 26 provinces in China. A self-designed questionnaire was used to collect the data and assess the knowledge, attitude, and practice regarding MNT. Logistic regression was used to explore the factor influencing KAP scores. A total of 6441 diabetes patients (mean age: 60.02 ± 13.14 years) completed this survey. The mean glycosylated hemoglobin (HbA1c) level was 8.12 ± 2.12%, and the control rate of HbA1c (HbA1c < 7.0%) was 38.92%. Of the total, 53.56% had received MNT education. Over half of the patients had a poor total KAP score as well as poor K, A, and P scores. Patients with higher KAP scores had higher control rate of HbA1c (P < 0.05) but lower levels of fasting plasma glucose (FPG) and 2-hour postprandial blood glucose (2h-PG). Gender, occupation, residence, education level, and MNT education could influence the KAP scores (P < 0.05). This study showed that diabetes patients in urban China generally had poor understandings and practices related to MNT. Patients with higher KAP scores exhibited better control of blood glucose.

Highlights

Diabetes is a common chronic metabolic disease that greatly affects people’s health and quality of life
Patients who were retired (OR, 1.44; 95% CI, 1.25–1.66; P < 0.001) and who received Medical Nutrition Therapy (MNT) education (OR, 3.45; 95% CI, 3.08–3.86; P < 0.001) had significantly higher P scores than those in service and did not receive MNT education, respectively (Table 5). This is the first large-scale study investigating the application of MNT and the influencing factors in patients with diabetes living in urban China
In this national cross-sectional survey with over 6000 patients included, the results showed that over half of the patients with diabetes in urban China received MNT education

Summary

Introduction

Diabetes is a common chronic metabolic disease that greatly affects people’s health and quality of life. It is estimated that about 415 million individuals aged 20–79 years lived with diabetes in 2015, while another 318 million were diagnosed with impaired glucose tolerance. With improvements in living standards and changes of life styles, more and more individuals are diagnosed with diabetes in developing countries. The consensus pointed out that, for the blood glucose control in subjects with obesity, metabolic syndromes, prediabetes, diabetes, pregnancy with gestational hyperglycemia, and pregnancy in the perioperative period, MNT has several advantages including higher feasibility, safety, and effectiveness and could improve the prognosis and reduce the medical expenses. Previous studies have already shown that applying MNT in diabetes management can substantially improve the rate of blood glucose control [9, 10]. Individualized MNT, according to the specific conditions of each patient, could further bring benefits to both medical and economic aspects [11]

Methods

Results

Conclusion