# Individual Dietary Consultation Utilization and Patient-Reported Experiences Among People with Type 2 Diabetes in Israel: A Cross-Sectional Study

## TL;DR

This study explores how often people with type 2 diabetes in Israel use dietary consultations and their experiences, finding low utilization and limited perceived benefits.

## Contribution

The study provides new insights into dietary consultation utilization and patient perceptions in a specific population with type 2 diabetes.

## Key findings

- Only 29.1% of participants attended dietary consultations in the past 12 months.
- Most participants could not name a specific dietary pattern they followed.
- No significant association was found between dietary consultation attendance and Mediterranean diet adherence.

## Abstract

Objectives: To describe the utilization patterns and patient perceptions of individual dietary consultations among people with type 2 diabetes in Israel, and to examine the association between dietary consultation attendance and adherence to the Mediterranean diet. Methods: This cross-sectional study enrolled adults with type 2 diabetes from a specialty diabetes clinic in Israel between July 2022 and May 2023. Participants completed structured interviews in which they were asked to report their perceptions of various diabetes management components, their sources of dietary information, and—among those who had previously attended dietary consultations—their satisfaction with specific aspects of the consultation experience. Medical records were reviewed to determine attendance at dietary consultations. Adherence to the Mediterranean diet was measured using the validated I-MEDAS 17-item questionnaire. Multivariable logistic regression was used to examine the association between attendance at dietary consultation within the past 12 months and adherence to the Mediterranean diet, adjusting for age, sex, socioeconomic status, and obesity (BMI ≥ 30 kg/m2). Results: Overall, 134 patients were interviewed. Their mean age was 69.8 ± 10.7 years, mean diabetes duration was 19.1 ± 9.7 years, and 96.3% were Jewish. Only 29.1% attended a dietary consultation within the past 12 months, and 52.2% had at least one consultation over the preceding 5 years. While 79.9% of participants rated maintaining normal weight and 78.4% rated taking medications as “very helpful” for diabetes control, only 29.9% reported that regular dietitian visits would be “very helpful.” Most participants (74.6%) were unable to name a specific dietary pattern they were following. Among those who recalled ever attending dietary consultations, most reported in interviews that recommendations were culturally aligned with their preferences. No association was found between recent attendance at dietary consultations and adherence to the Mediterranean diet (adjusted OR 1.03, 95% CI 0.39–2.74). Conclusions: Despite having accessible and affordable individual dietary consultations, the utilization of this service remains low, and patient-reported benefit limited. These exploratory findings point to perception-based barriers to engagement that warrant further investigation.