Validation of sugar craving assessment tool (MySCAT) among newly diagnosed type II diabetes patients in Kuantan and Terengganu

Abstract

Type II Diabetes Mellitus (T2DM) is increasing dramatically among the Asian population. Many patients with T2DM are struggling to control their blood glucose levels. There is a persistent need to spread awareness regarding the current state of diabetes patients’ sugar intake especially in Malaysia, which is one of the highest consumers of sugar across the Asian region. The purpose of this study is to validate the Sugar Craving Assessment Tool (MySCAT) among T2DM respondents. A total of 168 respondents were recruited to participate in this cross-sectional study. It was conducted in out-patient health clinics in Kuala Terengganu and Kuantan. Respondents sugar craving and dietary behaviour were measured using structured questionnaires which were MySCAT, 3-day dietary recall and demographic data. The interview sessions were conducted by a dietitian. MySCAT internal consistency test had a Cronbach’s alpha value of 0.75 and showed a significant correlation (r=0.56, p < 0.001) with actual sugar intake collected via 3 days diet recall. Receiver operating characteristic (ROC) analysis reported a cut-off point for MySCAT scores as 16.5; the sensitivity = 0.83 and specificity = 0.38. From analysis, 62% of respondents were categorized as cravers and 38% as non-cravers. Males and females had no significant differences in craving status. Body mass index (BMI) had no association with craving scores. The mean carbohydrate (CHO) intake was 195g/day (SD=33.4) of which, mean intake of CHO for cravers was 203 g/day while the mean for non-cravers was 169 g/day. Mean value of calorie consumed over three days was 1620 kcal (SD=260.2). BMI correlated significantly with calorie intake (r = 0.43, p < 0.001), while CHO intake was significantly associated with energy intake (r=0.85, p< 0.001) as well as with BMI (r=0.43, p< 0.001). Moreover, significant correlation was found between sugar intake and carbohydrate intake (r=0.567, p< 0.001). Analysis of eating behaviour using the Dutch Eating Behaviour Questionnaire (DEBQ) showed that, sugar craving scores were similar regardless of respondents eating behaviour (restraint, emotional or external). Most of our respondents were cravers regardless of the eating behaviour. This study found that MySCAT provides an easy and efficient tool which was sensitive enough to identify those with sugar craving problem. It also provides an overview of respondent’s dietary intake and points out their problem with dietary intake compliance. We conclude that MySCAT is an important tool that can aid dietitians in their consultation session.