Background: Diabetes is a major public health problem in all regions of the world requiring self-management behavior. However; it is difficult to achieve in real practice and requires new approaches. This study aims to evaluate the effect of nutritional promotion interventions on dietary adherence, with the intention to get lessons to improve self-management, in patients with type II diabetes

Methods: A quasi-experimental study was conducted at public hospitals in the North Shoa Zone Amhara region from January 2020 to February 2021. The study included 216 type II diabetic patients from four public hospitals. Data were entered into Epi Data V.3.1 and analyzed using SPSS version 22. Data were presented as mean for continuous variables and percentage for categorical variables. An independent t-test was used to compare the intervention and control groups in the pre-and post-intervention periods. A p-value less than 0.05 was considered significant for all statistical tests.

Results: A total of 216 type II diabetes patients participated in the study. The nutritional promotion intervention program significantly increased the mean number of days of adherence to a healthy diet (p<0.0001). The proportion of good dietary adherence in the intervention group was 74 (69.8%), and it was higher compared to the control groups, 28 (26.7%) after the intervention. Specifically, nutritional promotion program led to a significant improvement in daily consumption of fruits and vegetables , foods with a low glycemic index , foods rich in fiber, fish healthy oils), reduced sugary foods and improved healthy meal planning (p<0.001). The mean fasting blood glucose level was significantly reduced after the educational intervention (P < 0.05).

Conclusion and recommendation: This study shows that the nutritional promotion intervention led to significant changes in patients' nutritional behavior and effectively improved their glycemic control. Healthcare providers must integrate nutrition education into existing systems as a common therapeutic service. Primary healthcare platforms such as health posts and health centers may play an important role in integrating health promotion program to improve self-management behavior.