Investigation into knowledge, attitude, and practice regarding medical nutrition therapy among patients with diabetes in China: Results from a national multicenter cross-sectional study†

Background The study was aimed to investigate knowledge, attitude, and practice (KAP) associated with Medical Nutrition Therapy (MNT) among Chinese adult patients with diabetes and pre-diabetes. Methods From May to August 2014, a cross-sectional study was conducted in 40 hospitals across China. KAP of the respondents was investigated through a pre-tested structured questionnaire in face-to-face interviews. Anthropometric and biochemical indicators were collected, and the KAP score was recorded according to patients’ responses. Results A total of 7,017 out of 7,508 patients were analyzed. The mean scores of the overall KAP and individual K, A, and P were 9.63 ± 3.46, 2.69 ± 1.90, 1.77 ± 1.99, and 5.17 ± 1.99, with total scores of 19, 6, 3, and 10, respectively. Altogether, these results were higher in respondents who received 15 or more minutes of MNT education than in those with shorter sessions. Patients with higher KAP scores displayed significantly better glycemic control, with a higher proportion of patients achieving target HbA1c, FPG, and 2h-PG levels (P < 0.05). “Health publicity in hospitals” and “expert outpatient services” were the most favorable means of acquiring MNT information. The two predominant concerns associated with MNT were “the feasibility” and “the authenticity and professionalism of the information”. Conclusions Patients with diabetes and pre-diabetes achieved moderate scores for knowledge, attitude, and practice toward MNT. The study demonstrated glycemic control was positively correlated with the KAP score. MNT education should be improved, paying special focus on feasibility except authenticity and professionalism in China. Significant findings of the study Patients with diabetes and pre-diabetes in China attained moderate scores in KAP toward MNT. MNT education in China should be improved, meaning that more focus should be placed not only on authenticity and professionalism but also on feasibility. What this study adds The KAP scores were positively correlated with patients’ glycemic control and can be enhanced through MNT education for specified periods of time.