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BACKGROUND: Diabetes mellitus (DM) is considered a major health problem due to its complications. However, it could be prevented or delayed by modifications in the patients’ behavior and diets. The objective of this study was to explore the utility of the theory of planned behavior (TPB) and complications of diabetes perceived risk to find modifiable diabetes-related beliefs in order to make behavioral changes feasible. METHODS: The present descriptive-analytical cross-sectional study was conducted in diabetes clinics in Semirom, Iran, based on TPB and complications of diabetes perceived risk using a self-administered questionnaire. A total of 154 patients with diabetes without complications of diabetes participated in the study. Measured variables were patients’ attitude, subjective norm, perceived behavioral control, complications of diabetes perceived risk, intention to maintain a healthful diet and nutritional style. Structural equation modeling was used to analyze data. RESULTS: The results revealed that the TPB and perceived risk of diabetes complications fitted the data acceptably well among patients with type 2 diabetes and within dietary behavior. Perceived behavioral control, subjective norm, perceived risk of diabetes complications, and intention to maintain a healthy diet were related to healthy diet behavior. No relation was found between attitude and intention to follow a healthy diet. CONCLUSION: The TPB and perceived risk of diabetes complications is a useful theory in determining intentions of patients with diabetes and their adherence to a healthy diet.