Diabetes has reached epidemic proportions. Most of the morbidity, mortality, and cost of type 2 diabetes is related to cardiovascular complications (1). These complications can be decreased by improving glycemic control (2,3). However, one problem in diabetes care is the poor translation of knowledge derived from research to clinical practice (4). A lack of patients understanding the long-term ramifications of poor glycemic control may play a role in this. To further test this hypothesis, we performed the following study to determine whether patient diabetes knowledge was related to glycemic control.

Diabetes knowledge was measured using the Michigan Diabetes Knowledge Test (J.T. Fitzgerald, University of Michigan, Ann Arbor, MI) (5). Only questions pertaining to type 2 diabetes were used. HbA1c values were determined. Data were analyzed using SAS software version 6.1 (SAS, Cary, NC). Logistic regression analysis was done using Pearson’s correlation coefficient.

Seventy-seven subjects completed the study. The average number of questions answered correctly was 8.5 ± 2.3. The mean HbA1c value was 8.05 ± 1.6%. Regression analysis demonstrated an inverse correlation between the number of correct responses and HbA1c values. For each increase in the number of questions answered correctly, HbA1c decreased by 0.239 (r = −0.337, P < 0.003).

These results suggest that improved diabetes knowledge improves glycemic control. Other studies have shown that patient educational interventions lower HbA1c values (6). Patient education should be part of the diabetes treatment plan as this provides another modality for reaching glycemic targets. Patient empowerment is a strong tool that can be attained through knowledge of disease processes.

In conclusion, we have shown that improved diabetes knowledge is associated with better glycemic control. Empowering diabetic patients with knowledge of their disease may help combat this financially draining epidemic.

We thank the Michigan Diabetes Research and Training Center for use of the Michigan Diabetes Knowledge Test.

1
Rubin RJ, Altman WM, Mendelson DN: Health expenditures for people with diabetes.
J Clin Endo and Metab
 
78
:
809A
–809F,
1992
2
U.K. Prospective Diabetes Study Group: Effect of intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 34).
Lancet
 
352
:
837
–853,
1998
3
Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, Hadden D, Turner RC, Holman RR: Association of glycemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study.
BMJ
 
321
:
405
–412,
2000
4
George PB, Tobin KJ, Corpus RA, Devlin WH, O’Neill WW: Treatment of cardiac risk factors in diabetic patients. How well do we follow the guidelines?
Am Heart J
 
142
:
857
–863,
2001
5
Fitzgerald JT, Anderson RM, Funnell MM, Hiss RG, Hess GE, Davis WK, Barr PA: The reliability and validity of a brief diabetes knowledge test.
Diabetes Care
 
21
:
706
–710,
1998
6
Van den Arend IJ, Stolk RP, Rutten GE, Schrijvers GJ: Education integrated into structured general practice care for type 2 diabetic patients results in sustained disease knowledge and self-care.
Diabet Med
 
17
:
190
–197,
2000
DIABETES CARE
2003