Background and Objectives: Assessment of the individual diabetic patients’ knowledge of diabetes and diabetes-specific nutrition knowledge is essential before an effective educational program can be implemented. The wide assortment of foods available in Thailand is one of the major obstacles to diet adherence in Thai diabetic patients. Therefore, this study aimed to develop and validate a questionnaire called ‘THEPTARIN DM questionnaire’ to meet a specific need for rapid and reliable knowledge assessment in diabetic patients.
Materials and Methods: The ‘THEPTARIN DM questionnaire’ was developed by generating 10 questions to reflect constructs typically addressed in diabetes nutrition education and relevant to disease management. The questionnaire consists of 10 questions from 4 domains, which included diabetes-specific food choices, basic carbohydrate counting, general diabetes knowledge and diabetes treatment knowledge. The scores were classified into three categories: low (less than 6), moderate (score 6-8), and high (9-10). After three experts validated the content of each question, this questionnaire was evaluated in validation analysis according to the standard psychometric evaluation (internal validity, construct validity, and test-retest reliability) in two populations (50 diabetes care professionals and 50 non-DM people). Finally, the questionnaire was done in 100 adult (age 25-85 years) Thai type 2 diabetes patients. 
Results: In Thai type 2 diabetes patients (females 53%, mean age 58.3±12.0 years, college or university education 51%) revealed a mean score at 6.3±2.0 points (only 14% of patients received high score). Most of diabetes patients resulted low scores in the domain of basic carbohydrate counting knowledge and diabetes treatment knowledge. For the phase of construct validity, the mean score of diabetes care professionals was higher than non-DM people (7.6±1.4 VS. 9.5±0.7, p-value < 0.001). For test-retest reliability, the correlation coefficient revealed a high reliability of this questionnaire (r = 0.704, n = 100). The Cronbach’s alpha across all groups showed an acceptable level of internal validity (α = 0.696, n=200). Therefore, using these standard psychometric evaluations, the results confirmed the possibility to assess diabetes knowledge in Thai type 2 diabetes patients by this rapid reliable questionnaire. 
Conclusions: Assessing diabetic knowledge can lead to the identification of deficient areas of information and, thus, would aid in devising education program. The ‘THEPTARIN DM questionnaire’ would help to identify areas of weakness in diabetes patients’ understanding of diabetes knowledge and will also provide useful data for examining the relationship between nutrition knowledge and dietary behavior in the future.

Development of Theptarin DM questionnaire on diabetes-specific nutrition knowledge for Thai type 2 diabetes patients