Impact of nutrition education on diabetes knowledge and attitudes of adults with type 2 diabetes living in a resource-limited setting in South Africa: a randomised controlled trial

Objective: To evaluate the effect of a nutrition education (NE) programme on diabetes knowledge and attitudes of adults with type 2 diabetes mellitus (T2DM).Methods: Eighty-two adults (40–70 years) with poorly controlled T2DM (HbA1c ≥ 8%) and attending two community health centres in Moretele, North West Province (South Africa) participated in a one-year randomised controlled trial. Participants were randomised to the intervention group (n = 41; 8 weekly group education (2–2.5 hours); follow-up meetings and education materials) or control group (education materials only). Diabetes Knowledge Form B assessed knowledge about diabetes. Diabetes Attitudes Scale-III assessed the attitudes towards diabetes and treatment. Assessments were done at 6 and 12 months. Analysis of co-variance compared the groups (baseline, age, gender and clinic adjustments). An intention-to-treat analysis was employed.Results: The intervention group had higher mean diabetes knowledge scores + 0.95 (p = 0.033) and + 2.05 (p < 0.001) at 6 and 12 months respectively. However, the scores were below 50%. Patient autonomy for diabetes attitudes was the only score significantly higher in the intervention group + 0.27 (p = 0.028) at 12 months.Conclusion: NE significantly improved diabetes knowledge in the intervention group, though not satisfactorily, but had limited effects on the attitudes towards diabetes.