Purpose Type 2 diabetes (DM2) is increasing worldwide at epidemic rates, creating heavy burdens on human health and medical care resources. Patient education may help patients manage their illness and result in better clinical outcomes at lower costs. This study assessed patients' knowledge about their diabetes (DM), its association with past diabetes education, and association of level knowledge with level of metabolic control measured by HbA1C level.
Methods Patients over 18 years old with DM2 were identified by diagnosis and billing records in five family practices in Richland, WA. Each patient completed a written questionnaire and gave consent for review of medical records. Patient knowledge about DM was measured with the Michigan Diabetes Research and Training Center's Brief Diabetes Knowledge Test. All patients answered 14-items on DM in general, and insulin-dependent patients answered 9 additional items on insulin. Control of DM was assessed with the most recent HbA1C level documented in office records. Chart review also abstracted relevant characteristics of patients and their diabetes, including past formal DM education. Analysis used descriptive statistics and tested for differences with t-tests for means and Chi-square tests for frequencies, with two-tailed tests at significance level p ≤ .05.
Results The study included 100 patients with DM, 55 males and 45 females, 78 non-insulin dependent and 22 insulin dependent. Patient age ranged from 19 to 93 years. 95% had insurance coverage. Mean score on the knowledge of DM test, (number of questions answered correctly) was 10.1 ± 2.7 (SD) in 36 patients with no diabetic education and 11.1 ± 2.3 in 64 patients with education. The mean HbA1c value was 6.7 ± 1.9% for patients with no education and 7.3 ± 1.8% for those with education. There was no correlation between the correct responses (knowledge) and HbA1c values. Correct answers to individual questions show most patients know about the effect of exercise on blood glucose (90%) and eating foods lower in fat decreases risk of heart disease (93%), and fewest patients know about hemoglobin A1c (54%) and the definition of free food (60%).
Conclusions Most patients with DM2 have moderately high levels of knowledge about their illness. Patients with formal diabetic education had only marginally better glycemic control. Diabetic education of the types available in this primary care setting may have limited effectiveness in helping patients control their blood glucose levels.