Which knowledge about diabetes is associated with good HbA1 levels in type-I-diabetes patients?

Introduction:

Today diabetes is a mainly patient managed disease. The physician is rather a coach, except about complications. Usual check for the treatment quality is the HbA1/HbA1c-test, which is easily done, quick and inexpensive. Nevertheless there are situations where caregivers may not have a blood test result at hand, but have to judge by communication with the patient how well the treatment is adjusted. With a sample 61 type-I-diabetics, before and nine months after a self-management training we analyzed different dimensions of knowledge about the disease with the quality of their self-management.

Methods:

HbA1 and other parameters were taken from 61 patients with type I diabetes and their answers in a 20 items questionnaire about diabetes knowledge. Analysis was performed by OLS regression with MicroTSP 7.0.

Results:

Patients were mean aged 36.8 (± 9.7) years and suffered in average 16.6 (± 8.4) from type-I-diabetes. Average HbA1 was 7.97 (± 0.96), BMI was 22.5 (± 2.9). Correct answers on questions were associated with significant lower HbA1: “Blood sugar level of hypoglycemia”: -0.59 (t =-2.00), “carbohydrate units of a banana”: -1.04 (t = 2.49) “milk contains carbohydrates”: -0.94 (t = 2.04). Only one other parameter was associated with significant lower HbA1: “number of daily sugar-level tests”: -0.77 (t = 2.02). For the overall model: R2 = 0.54, R2adj = 0.39, F3.54.

Discussion:

The by far most important influence on HbA1 is knowledge about diet. Caregivers may estimate the quality of the blood-sugar management of a patient by two simple questions about carbohydrates. The results allow the hypothesis that diet should be stressed even more in diabetes education.