Nutritional Needs, Dietary Knowledge, and Culinary Skills in Individuals with Diabetes Mellitus: A Scoping Review

Abstract

Dietary management is a cornerstone of diabetes mellitus (DM) care. However, a persistent disconnect remains between theoretical nutritional knowledge, what individuals are advised to eat, and the practical culinary skills required to translate these recommendations into daily practice. This gap is frequently compounded by socioeconomic constraints and cultural determinants. To map the available evidence on dietary knowledge, culinary skills, and food-related practices among people with DM, with particular attention to barriers and facilitators in daily-life settings. A scoping review was conducted following the Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping reviews guidelines. Major databases (MEDLINE/PubMed, Scopus, Web of Science, and Embase) were searched for studies published between 2014 and 2025. Extracted variables were mapped deductively to the World Health Organization International Classification of Functioning, Disability and Health, distinguishing self-care and dietary management (d5) from domestic-life competencies related to meal preparation (d6). Forty-six studies were included. The evidence base was heterogeneous and focused largely on dietary self-management, whereas comparatively few studies explicitly assessed instrumental cooking skills (n = 8). Across studies, structural barriers, particularly food insecurity and the cost and availability of healthier foods, frequently limited the feasibility of recommended diets. Skills-based interventions, including culinary medicine and hands-on cooking programs, were associated with improvements in culinary self-efficacy and, in some studies, clinically meaningful hemoglobin A1c reductions. Family dynamics, peer support, and culturally shaped practices (including religious observances) emerged as important determinants of adherence. Current diabetes education strategies risk achieving conceptual adequacy without practical applicability. Effective dietary management in DM requires a shift from predominantly prescriptive nutritional advice toward skills-based approaches grounded in culinary medicine. Future interventions should be culturally responsive and explicitly address environmental and social barriers to bridge the gap between clinical recommendations and real-world implementation. This systematic review followed a protocol registered prospectively on Open Science Framework available at: https://doi.org/10.17605/ OSF.IO/J9PHQ.