The Role of Family, Knowledge, and Dietary Behaviors of Patients With Type II Diabetes With Uncontrolled Blood Glucose in Rural Areas of Nakhon Ratchasima Province

Abstract

Type 2 diabetes is a common chronic health problem in rural Thailand. Patients often struggle to control their blood glucose levels due to limited knowledge and inappropriate dietary behaviors. The family plays a key role in supporting healthy eating habits and managing meals for diabetic patients. This descriptive study aimed to explore the role of family members in meal management, along with assessing the dietary knowledge and behaviors of patients with type 2 diabetes. The sample consisted of 30 diabetic patients and 30 family food managers residing in rural areas. Data were collected using a structured questionnaire assessing patients’ dietary knowledge and behaviors, and a focus group discussion guide for family food managers. Descriptive statistics and content analysis were used for data analysis. The results indicated that the role of the family in dietary management consisted of four main aspects. First, food selection was primarily determined by the food manager, who often prioritized convenience and price, which sometimes resulted in the selection of foods inappropriate for the patient's health condition. Second, food preparation was typically based on familiar routines and shared family meals, with no differentiation in food provided specifically for the patient. Third, regarding food quantity, meals were prepared in the same proportions for all family members. As a result, some patients consumed more than appropriate, especially when influenced by the belief that eating large amounts of rice would provide sufficient energy for daily activities. Fourth, meal frequency was maintained through regular main meals; however, many patients continued to consume snacks between meals, contributing to poor dietary control. The participants demonstrated a good level of dietary knowledge (x̄ = 14.37, S.D. = 2.82), but their actual eating behaviors remained at a moderate level (x̄ = 3.26, S.D. = 0.87). These findings suggest that effective dietary management requires the integration of both knowledge and behavior change, with families playing a central role. Interventions should focus on continuous, clear, and applicable health education, promoting sustainable behavior change in daily life.