Abstract
This study aimed to develop a preliminary diabetes-specific Nutritional Literacy (NL) scale and examine its associations with key variables, including HbA1c%. A cross-sectional survey was disseminated to adults with Type 2 Diabetes (T2D) attending primary care clinics in Qatar via SMS. An NL scale and administered after answering sociodemographic and health-related variables. Following content validity, reliability and principal component analysis, we developed a preliminary unidimensional NL scale. We then assessed the relationship between demographic, behavioral and clinical characteristics and the developed NL scale, in a multivariate logistic regression test, after assessing covariate in bivariate tests. The NL scale demonstrated internal consistency and a unidimensional structure. Compared to having HbA1c% levels of 5.7–6.4%, those with levels of 6.5–8% (OR = 0.45) and > 8% (OR = 0.28) had significantly lower odds of high NL. Relative to exercising 0–1 days/week, exercising 6–7 days/week (OR = 18.0) and 4–5 days/week (OR = 2.78) were associated with increased odds of high NL. Further, those who had not visited a clinic in over a year (OR = 0.22) had lower odds of high NL compared to those that visited a clinic 1–6 months ago. Marginal associations were found for clinical referrals (OR = 1.99), smokers (OR = 0.48), and having other chronic diseases (OR = 0.60), relative to no referrals, not smoking and not having other chronic diseases respectively. Higher NL is associated with better glycemic control, healthier behaviors, and healthcare utilization, highlighting the importance of integrating tailored nutrition education into diabetes care.
Data availability
Due to the highly sensitive nature of the patient data, it is confidential, and we are required to delete the data within three years of its collection as per PHCC regulations. Further queries can be directed to corresponding author.
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Acknowledgements
Open Access funding provided by QU Health, Qatar University. We thank all participants for taking the time to complete the study. Generative AI, ChatGPT (version GPT-5, OpenAI, 2025), was used for the sole purpose of language improvement of some paragraphs.
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Alanood Al-marri: Writing—original, Investigation, Formal analysis, and Conceptualization. Yosaf Al-rabeei: Writing—review & editing, Mohammed Al-Hamdani: Writing—original, Writing—review& editing, Supervision, Formal analysis, Methodology, and Conceptualization.
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The first and second authors are PHCC staff. However, the consent form stated that participation has no impact on patient care and the participants were recruited through the operations office.
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This study received ethical clearance from the Institutional Review Board (IRB) of the Primary Health Care Corporation (PHCC) under approval number BUHOOTH-D-24-00777, as well as from the Qatar University IRB (Approval Number QU-IRB 108/2025-EM). All procedures conducted as part of this research adhered to applicable national regulations and guidelines, which are aligned with internationally recognized ethical standards, including the Declaration of Helsinki (1964), with amendments made in 2000.
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All participants completed an online consent form after reading a detailed information sheet. Only those that agreed to participating via clicking on “I agree to participate” that was preceded with statements that indicate that they agree to participate and fully understand the premise, risks and benefits associated with the study.
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Al-Marri, A., AlRabeei, Y. & Al-Hamdani, M. Nutrition literacy for people with type 2 diabetes and its associations with demographic, behavioral and clinical characteristics. Sci Rep (2026). https://doi.org/10.1038/s41598-026-47194-2
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DOI: https://doi.org/10.1038/s41598-026-47194-2
