Knowledge of Diabetes mellitus and Glycaemic Control

Abstract

It has been claimed that lack of knowledge of diabetes mellitus has been a cause of excess admissions and morbidity. There is also some evidence that diabetic education programs can improve self-regulatory behaviour and reduce hospital admissions. In this report we test the hypothesis that greater knowledge of diabetes should be associated with better glycaemic control and lower fasting blood glucose levels. Responses to diabetes knowledge questions were provided by 420 patients attending diabetic clinics in Kuwait. In an earlier and complementary report a principal components analysis revealed that knowledge of diabetes cannot be understood in terms of a single general factor. With a subsequent Varimax rotation we obtained 12 uncorrelated knowledge factors with eigenvalues greater than unity and these would all be confounded in the simple aggregation of correct answers to diabetes knowledge questions employed in earlier studies. Results are now described which show that the 12-factor model of diabetes knowledge is better able to predict blood glucose levels than the scores obtained on a single scale by just summing the correct answers to all diabetes knowledge questions. A standard multiple linear regression with the diabetes knowledge factors age, sex and ‘years since diagnosis’ as independent variables, and fasting blood glucose levels as the dependent variable, shows that 4 of the 12 factors yield statistically significant semi-partial correlation coefficients that account for unique fractions of the total variance of blood glucose levels. The meaning of these 4 factors is discussed with special reference to glycaemic control and blood glucose levels.