Internal medicine residents' comfort with and frequency of providing dietary counseling to diabetic patients

BACKGROUND: Resident physicians' preparedness to provide dietary counseling for the rising number of diabetic patients is unclear. OBJECTIVE: To assess the comfort with, frequency of, and perceived effectiveness of diabetic dietary counseling by internal medicine (IM) residents. DESIGN: Cross-sectional survey. PARTICIPANTS: One hundred eleven IM residents at a single academic institution. RESULTS: Survey response rate was 94%. Fewer residents (56%) were comfortable with diabetic dietary counseling compared with counseling on symptoms of hypo/hyperglycemia (90%, p<0.001). Residents less frequently provided diabetic dietary counseling (63%), compared with counseling for medication adherence (87%, p<0.001). The 28% of residents reporting prior education with chronic disease self-management were more comfortable with diabetic dietary counseling (OR 3.2, 95% CI 1.4-7.3, p=0.006), and reported counseling more frequently, although this difference was not statistically significant (OR 1.8, 95% CI 0.86-3.8, p=0.12). More frequent counseling was reported by those residents who were more comfortable (OR 1.5, 95% CI 1.0-2.2, p=0.03) or felt more effective (OR 3.6, 95% CI 2.1-6.1, p<0.001) with their diabetic dietary counseling. CONCLUSION: Overall, IM residents reported low levels of comfort with and frequency of diabetic dietary counseling. However, residents who were more comfortable or who felt more effective with their dietary counseling counseled more frequently.