Nutrients, Vol. 18, Pages 742: Nutritional Counseling Is Independently Associated with Greater Knowledge of Drug–Food Interactions in Patients with Type 2 Diabetes
Nutrients doi: 10.3390/nu18050742
Authors:
Joanna Korbela
Agnieszka Białek
Background: Type 2 diabetes mellitus (T2DM) is commonly managed with complex pharmacotherapy combined with dietary modification, which increases the risk of clinically relevant drug–food interactions (DFIs). Despite their potential impact on treatment efficacy and safety, patient knowledge of DFIs—particularly in the context of modern therapies such as glucagon-like peptide-1 receptor agonists (GLP-1 RAs)—remains insufficiently explored. Methods: This cross-sectional study assessed knowledge of DFIs among 103 adults with T2DM using a self-administered, expert-validated questionnaire. Data on sociodemographic characteristics, clinical variables, anti-diabetic therapy (including GLP-1 RAs), sources of education, and attendance at dietary consultations were collected. Knowledge scores were calculated based on correct responses and categorized into tertiles (low, moderate, high). Associations were analyzed using non-parametric tests. Multivariable logistic regression was performed to identify independent predictors of moderate-to-high DFI knowledge. Results: Substantial gaps in DFI knowledge were identified, particularly regarding interactions involving dietary fiber, dairy products, grapefruit juice, and nutrient deficiencies associated with long-term pharmacotherapy. Knowledge level was not significantly associated with age, educational attainment, diabetes duration, or GLP-1 RA use. Female sex was associated with higher knowledge in univariate analysis (p = 0.026); however, this association did not remain significant in the multivariable regression model. Attendance at at least one dietary consultation in the previous year was significantly associated with higher knowledge levels (p = 0.041) and remained an independent predictor in multivariable analysis (OR = 2.31; 95% CI: 1.04–5.15; p = 0.039). Most participants reported not receiving prior education on DFIs, while expressing a strong need for more frequent counseling. Conclusions: Patients with T2DM demonstrate insufficient knowledge of clinically relevant DFIs, including selected issues related to GLP-1 RA therapy. Attendance at structured dietary consultations was independently associated with higher levels of DFI knowledge; however, the directionality and causality of this relationship cannot be established. Given the cross-sectional design and the assessment of knowledge rather than behavioral or clinical outcomes, these findings should be interpreted as hypothesis-generating. Further longitudinal and interventional studies are required to determine whether improved DFI knowledge translates into meaningful changes in dietary behavior, treatment adherence, or metabolic outcomes.
Background: Type 2 diabetes mellitus (T2DM) is commonly managed with complex pharmacotherapy combined with dietary modification, which increases the risk of clinically relevant drug–food interactions (DFIs). Despite their potential impact on treatment efficacy and safety, patient knowledge of DFIs—particularly in the context of modern therapies such as glucagon-like peptide-1 receptor agonists (GLP-1 RAs)—remains insufficiently explored. Methods: This cross-sectional study assessed knowledge of DFIs among 103 adults with T2DM using a self-administered, expert-validated questionnaire. Data on sociodemographic characteristics, clinical variables, anti-diabetic therapy (including GLP-1 RAs), sources of education, and attendance at dietary consultations were collected. Knowledge scores were calculated based on correct responses and categorized into tertiles (low, moderate, high). Associations were analyzed using non-parametric tests. Multivariable logistic regression was performed to identify independent predictors of moderate-to-high DFI knowledge. Results: Substantial gaps in DFI knowledge were identified, particularly regarding interactions involving dietary fiber, dairy products, grapefruit juice, and nutrient deficiencies associated with long-term pharmacotherapy. Knowledge level was not significantly associated with age, educational attainment, diabetes duration, or GLP-1 RA use. Female sex was associated with higher knowledge in univariate analysis (p = 0.026); however, this association did not remain significant in the multivariable regression model. Attendance at at least one dietary consultation in the previous year was significantly associated with higher knowledge levels (p = 0.041) and remained an independent predictor in multivariable analysis (OR = 2.31; 95% CI: 1.04–5.15; p = 0.039). Most participants reported not receiving prior education on DFIs, while expressing a strong need for more frequent counseling. Conclusions: Patients with T2DM demonstrate insufficient knowledge of clinically relevant DFIs, including selected issues related to GLP-1 RA therapy. Attendance at structured dietary consultations was independently associated with higher levels of DFI knowledge; however, the directionality and causality of this relationship cannot be established. Given the cross-sectional design and the assessment of knowledge rather than behavioral or clinical outcomes, these findings should be interpreted as hypothesis-generating. Further longitudinal and interventional studies are required to determine whether improved DFI knowledge translates into meaningful changes in dietary behavior, treatment adherence, or metabolic outcomes. Read More