Public Health Nutrition


Nutritional and eating education improves knowledge and practice of patients with type 2 diabetes concerning dietary intake and blood glucose control in an outlying city of China

Huan Wanga1, Zhenfeng Songa1, Yanhui Baa2, Lin Zhua1 and Ying Wena1 c1

a1 Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, 150086 Harbin, People's Republic of China

a2 Hulunbeier Vocational Technical College, Hulunbeier, People's Republic of China


Objective To describe the knowledge, attitudes and practices of type 2 diabetics in Yakeshi City and to assess the effect of implementation of nutritional and eating education in enhancing knowledge and practices regarding a healthy diet.

Design A questionnaire-based survey was conducted with 162 diabetics to determine their nutrition knowledge, attitudes and practices; fifty-four participants received nutritional and eating education for 6 months. Diabetes-related nutrition knowledge, awareness, practice accuracy, dietary intake and glycaemic control were assessed before and after education.

Setting Yakeshi, a remote city in northern China.

Subjects A total of 162 type 2 diabetics recruited from three hospitals, fifty-four of whom were selected randomly to receive education.

Results Among the 162 respondents, most diabetics (75 %) considered that controlling diet was important in the methods of controlling blood glucose. Scores for knowledge, practices and overall KAP (knowledge–attitude–practice) were low, but scores for attitude were high. Participants with diabetes education experiences, practice duration over 1 year or high education level all had higher scores for KAP (P < 0·001, P < 0·05 and P < 0·001, respectively) than their counterparts. After education, patients’ nutrition knowledge, awareness and practice accuracy improved significantly (P < 0·05). The rates of patients with recommended daily intake of vegetables, grains and dairy were boosted (P < 0·05). Various nutrient intakes increased (P < 0·05) but not protein, Fe, Zn and Se. Significant improvements were also found in glycaemic control (P < 0·05).

Conclusions Diabetics in Yakeshi had positive attitudes, but relatively poor nutrition knowledge and practices. Nutritional and eating education was effective in improving diabetics’ nutrition knowledge and practices, and this optimal practice helped them control blood glucose effectively.

(Received January 17 2013)

(Revised July 02 2013)

(Accepted August 28 2013)

(Online publication October 14 2013)


  • Type 2 diabetes;
  • Knowledge–attitude–practice (KAP);
  • Nutritional and eating education


c1 Corresponding author: Email