“Effect of Comprehensive Diabetes Nutrition Education on Knowledge, Attitude, and Practice in Adults with Type 2 Diabetes in Public Hospitals of Hawassa City, Ethiopia, 2025: A Quasi-Experimental Study”

Abstract

Back ground: Diabetes mellitus is a chronic metabolic disorder marked by persistent hyperglycemia due to insufficient insulin or reduced effectiveness. Nutrition education is vital for managing diabetes and reducing complications. However, there is a lack of experimental studies in this area, and the findings could inform strategies to improve quality of life and guide future interventions for the affected community. Objectives: To assess the effect of comprehensive diabetes nutrition education on knowledge, attitude, and practice among adult Type 2 diabetes patients in public hospitals of Hawassa City, Ethiopia, 2025. Methods: An institution-based quasi-experimental study was conducted among 156 adult diabetic patients (78 intervention, 78 control) selected through simple random sampling in public hospitals. Data were collected at baseline (Feb 30–Mar 10, 2025) and end line (May 10 20, 2025), using structured face-to-face interviews to assess changes in knowledge, attitude, and practice following a three-month nutritional education intervention. The control group received standard care. Data were analyzed using SPSS Version 26. Paired and independent t tests were used for within- and between-group comparisons, while GEE assessed changes over time. A p-value < 0.05 was considered statistically significant. Results: The study findings revealed that after three-months comprehensive nutritional education intervention, the intervention group showed significant improvements in knowledge (from a mean of 36.1 ±12.6 to 54.6 ±17.0, p < 0.001), attitude (from 47.2 ±15.4 to 52.6 ±16.5, p = 0.020), and practice scores (from 34.4 ±14.2 to 43.1 ±19.6, p = 0.025) compared to the control group, demonstrating a substantial positive impact on diabetes nutrition management among type 2 DM patients. Good knowledge and attitude were associated with diabetes duration of 6–10 years (AOR = 7.76; 95% CI: 2.49–24.21), family history (AOR = 9.30; 95% CI: 2.62–33.03), and being in the intervention group (AOR = 10.43; 95% CI: 3.63–29.96). Also, living with someone (AOR = 2.96; 95% CI:1.1, 7.95) and intervention group (AOR= 2.33; 95% CI: 1.04–5.22) were significantly more likely to engage in good dietary practices. Conclusions: The nutrition education program significantly improved knowledge, attitude, and practice among T2DM. Better knowledge and positive attitudes greatly increased proper nutrition practices, showing the importance of targeted education. Integrating nutrition education into routine care is recommended to improve outcomes and support self-management.