Association Between the Acceptability of Dietary Weighing and Clinical Characteristics in Patients with Type 2 Diabetes: Exploration of a Potential Screening Indicator of Poor Adherence

Background/Objectives: Although dietary therapy forms the cornerstone of type 2 diabetes management, strict regimens frequently impose significant cognitive and psychosocial burdens, reducing adherence. This cross-sectional study investigated patient acceptability of individual dietary advice commonly used in nutritional counseling and its clinical associations, aiming to identify a practical screening method for potentially poor adherence. Methods: Among 128 outpatients with type 2 diabetes receiving regular nutritional counseling, patients evaluated their acceptability of 13 standard dietary advice items using a 4-point scale (0 points = Cannot do, 3 points = Can do). We comprehensively analyzed correlations between item-specific acceptability scores and clinical characteristics, including hemoglobin A1c (HbA1c), dietary adherence, and complications. Results: While acceptability for eating vegetables before carbohydrates was extremely high (98%), weighing staple foods and seasonings yielded the highest proportion of 0-point responses (17%, 22 patients). The acceptability score for weighing correlated positively with the nutritional counseling adherence rate (ρ = 0.25) and negatively with HbA1c (ρ = −0.19), estimated salt intake (ρ = −0.28), and diabetic retinopathy (ρ = −0.28) (all p < 0.05). In multivariate logistic regression, the 0-point response to weighing remained significantly associated with lower nutritional adherence (odds ratio [OR] = 0.36, p = 0.02), higher salt intake (OR = 1.96, p < 0.01), and elevated HbA1c (OR = 1.53, p = 0.04), even after adjusting for covariates. Conclusions: Low acceptability of weighing staple foods and seasonings was associated with poorer dietary adherence and worse glycemic control in patients with type 2 diabetes. Assessing this item may help identify patients who could benefit from individualized nutritional counseling. Further prospective studies are needed to validate its utility as a screening indicator.