Knowledge Profile and Control in Diabetic Patients

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Abstract
Knowledge about diabetes was assessed using a previously described interactive computer‐based questionnaire in 79 patients with insulin‐dependent (IDDM) and 72 with non‐insulin‐dependent (NIDDM) diabetes mellitus routinely attending a single diabetic clinic. Simple linear correlation of total knowledge score with glycosylated haemoglobin (HbA1c) showed no significant relationship for either IDDM (r=‐0.12: p=0.18) or NIDDM (r=‐0.15: p=0.1). However, quintile grouping of knowledge scores showed the mean HbA1c to be significantly higher in the lowest scoring NIDDM quintile (10.6±0.5: ±SE) with respect to the pooled mean of all the higher scoring quintiles (9.0±0.3) (p=0.027). Mean HbA1c (9.6±0.5) was also higher in the least knowledgeable IDDM quintile than any other quintile group (range 8.8–9.0) but this was not significant with respect to the pooled mean of higher scoring patients (p>0.1). The mean age of the lowest scoring IDDM quintile group (60.5±13.9 years) was significantly higher (p1c in IDDM subjects. IDDM showed greater knowledge of diabetes than NIDDM but ignorance in key areas was unacceptably high in both diabetic subtypes, indicating that regular knowledge assessment and educational reinforcement may be essential for good diabetic control as well as patient safety, particularly in older IDDM patients. This analysis provides support for the concept that for good blood glucose control, a minimum (threshold) level of knowledge is necessary above which other factors, including attitudes and motivation, are likely to be of much greater importance.