Diabetes knowledge in young adults: associations with hemoglobin A1C.

Abstract

The purpose of this study was to quantify associations between hemoglobin A1C (A1C) and diabetes knowledge score using an assessment tool developed to evaluate the level of diabetes knowledge in young adults with Type 1 diabetes (T1DM) and their parent/primary caregiver. Seventy-five participants with T1DM, ages 15-22 years, completed questionnaires. Two 25-item questionnaires were developed: one for patient and one for caregiver. Linear regression quantified associations between correct items on the tools and participant A1C and demographic characteristics. Mean age of participants was 16.7 ± 1.7 years, diabetes duration 5.9 ± 4.2 years, 46.7% male, 74.7% Caucasian, 69.3% on multiple daily injections, and 30.7% on continuous subcutaneous insulin infusion therapy; 78.7% of parents/caregivers completed the questionnaire. A significant interaction was observed between patient and caregiver scores with A1C by diabetes duration. Among patients with diabetes <6 years, higher patient and caregiver scores were associated with lower A1C (-0.25 ± 0.11, p = .03 and -0.59 ± 0.19, p = .005, respectively) accounting for age, gender, race, therapy, and insurance. Neither patient nor caregiver score was associated with A1C in patients with diabetes duration ≥6 years. Better performance on a diabetes knowledge assessment (for both patient and the caregiver) was found to be associated with more favorable levels of glycemic control among young adults with diabetes <6 years. Additional evaluation of these questionnaires and novel interventions to enhance knowledge in this population are needed.