Abstract Background Type 2 diabetes (hereinafter diabetes) stands among the top ten drivers of disease burden. Globally, more than 59 million adults are living with diabetes with a projection of 15% increase by 2045. The Cook2DIAbeat project aims to develop a tailor-made nutrition training program based on culinary medicine, for patients with diabetes to achieve lifelong dietary changes. The aim of the present work was to reveal potential drivers and barriers related to lifelong dietary modifications. Methods The study was implemented in February-July 2023 in Spain, Belgium, Greece, and Cyprus. A mixed-method co-design methodology was conducted: co-creation sessions with individuals with diabetes, family members, and healthcare professionals, and an online survey with patients with diabetes. Results In total, 23 health professionals and 25 patients and family members participated in the co-creation sessions, and 212 patients in the online survey. Patients and health professionals recognized the added value of the culinary approach for diabetes management. The main perceived barriers for changing dietary habits included difficulties accessing reliable and non-conflicting information, lack of time, emotional and psychological issues, and limited social support. Individuals at an advanced age and of low socioeconomic status seem to demand specific educational approaches addressing the actual challenges of their daily life. Conclusions The study indicated that training should provide reliable information and address psychosocial aspects. The translation of the dietary guidelines through the culinary medicine approach seems to be well-received by the target group. Last, the content needs to be tailored to suit the specific age group and socioeconomic background of the patients. Key messages • Reliability, practicability are three key characteristics of a nutrition training program in diabetes management. • Cultural and socioeconomic barriers needs to be taken into consideration.
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