Abstract:

Objective To develop a dietary decision aids tool for patients with type 2 diabetes mellitus （T2DM） and evaluate its clinical application effect. Methods Firstly，a draft of the dietary decision aids for T2DM patients was formed based on the best evidence of dietary decision-making support tools for T2DM，the Ottawa Decision Support Framework，and relevant research on dietary decision-making for T2DM patients home and abroad. Then，the draft was revised and improved through expert meetings and user evaluations in accordance with international patient decision aid standards. A total of 62 T2DM patients admitted to the endocrinology department of a Grade-A tertiary hospital in Hunan Province from April to September 2022 were selected as the participants. They were divided into a control group（admitted from April to June，n=31） and an experimental group （admitted from July to September，n=31） depending on their order of admission. The control group received routine care，while the experimental group received routine care combined with the dietary decision aids intervention. Indicators were compared between the two groups before the intervention and three months after discharge，including the compliance with diabetes diet therapy，decision-making conflict，and BMI，fasting plasma glucose（FPG），glycated hemoglobin （HbA1c），total cholesterol（TC），triglycerides（TG），low-density lipoprotein（LDL-C），and high-density lipoprotein（HDL-C）. Results The constructed dietary decision aids for T2DM patients mainly consisted of seven components：decision-making stage assessment，information support，pros and cons analysis，support system，value consideration，decision-making tendency，and decision confirmation. 29 patients in the control group and 30 patients in the experimental group completed this study. The scores of diabetes diet control knowledge and compliance with diet therapy in the experimental group were higher than those in the control group（P<0.05） at three-month after discharge. The scores of decision-making conflict，FPG，HbA1c，and LDL-C were lower in the experimental group than in the control group（P<0.05）. Conclusion The application of the dietary decision aids for T2DM patients can，to a certain extent，improve the compliance with diet therapy among T2DM patients，while reducing their decision-making conflict，blood glucose，and blood lipids.

Key words: Diabetes mellitus, Type 2, Dietary decisions, Decision aids, Decision conflict, Shared decision-making