RESUMO
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.