Current situation of diet self-management in patients with type 2 diabetes: a multi-centre survey in China

Objective To research the current situation of diabetes diet cognition and compliance in patients with type 2diabetes in China. Methods This questionnaire-based survey was conducted in 50 medical centers in China from April to July in 2010. The selected medical centers covered 21 provinces, 4 municipalities, 4 autonomous regions, and the patients were out-patients and in-patients of 144 secondary, tertiary and community hospitals, the subjects had been diagnosed of type 2 diabetes for more than 1 year. The information of diabetes diet and management was collected by questionnaires. The diabetes attitude scale-3 (DAS-3) formulae, a questionnaire of diabetes knowledge, and summary of diabetes self-care activities (SDSCA) scale were used to assess diabetes diet cognition and compliance of patients. Comparison of data between groups was applied by using t test. Results Total of 6043 patients were eligible for the study, and 5961 valid questionnaires were collected. There were 3233 males and 2728 females with an average age of (60±12) years(16-94 years) and a diabetes duration of (9±7) years. The mean body mass index (BMI) 44.04% were normal and 52.21% were overweight or obese. The glycated hemoglobin A1c (HbA1c) was examined in 3048 cases and 32.10% of them reached the standard of <7%. Cognition: 4333(72.69%) cases received diabetic diet education; the average of diet attitudes score was 3.7±1.0; all correct answer rate of the impact of food on glycemia was 1.85%(110/5961), all correct answer rate of the description of food was 0.52%(31/5961); 3669(61.55%) cases treated with insulin, all correct answer rate of diet knowledge was 7.03% (258/3669). Compliance: the average of ordinary diet score was 4.9±2.2 and the average of special diet score was 4.2±1.5 in the SDSCA scale. Total of 4996 cases (83.81%) kept obeying the diet therapy program. And the gender, age, the level of education, BMI, drinking, receive diabetes education, regular follow-up, self-monitoring of blood glucose could influence the patient's compliance with diet therapy. Conclusions The mean BMI is high, the rate of HbA1c<7% and the level of diet cognition is low in Chinese patients with type 2 diabetes. And patient educators should consider the factors in diabetic health education, such as gender, age, the level of education, BMI, drinking, receiving diabetes education, regular follow-up, self-monitoring of blood glucose. Key words: Diabetes mellitus, type 2; Patient education; Diet