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 aim of the present study was to investigate knowledge, attitude, and practice (KAP) associated with medical nutrition therapy (MNT) among Chinese adult patients with diabetes and prediabetes. Methods: From May to August 2014, a cross-sectional study was conducted in 40 hospitals across China. The KAP of respondents was investigated through a pretested structured questionnaire in face-to-face interviews. Anthropometric and biochemical data were collected, and KAP scores were recorded according to patient responses. Results: In all, responses from 7017 of 7508 patients were analyzed. The mean (+/- SD) overall KAP score was 9.63 +/- 3.46, with individual scores for the K, A, and P components being 2.69 +/- 1.90, 1.77 +/- 1.99, and 5.17 +/- 1.99, respectively (out of possible total scores of 19, 6, 3, and 10, respectively). All scores were higher in respondents who received >= 15 min MNT education than in those with shorter sessions. Patients with higher KAP scores exhibited significantly better glycemic control, with a higher proportion achieving target HbA1c, fasting plasma glucose, and 2-h postprandial blood glucose 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 prediabetes achieved moderate scores for KAP towards MNT. Glycemic control was positively correlated with the KAP score. Thus, MNT education should be improved, with a particular focus on feasibility and authenticity and professionalism, in China.