Gain in Patients' Knowledge of Diabetes Management Targets Is Associated With Better Glycemic Control

Abstract

Optimal glycemic, lipid, and blood pressure control has been shown to decrease the microvascular and macrovascular complications of diabetes (1–10). However, the status of control of these cardiovascular risk factors in individuals with diabetes is far from optimal (11,12). Lack of patients' knowledge of the targets of diabetes care might be one of the reasons for the low level of control of risk factors. Some studies showed that only 23–25% of individuals with diabetes know what the target A1C level is (<7%), and about the same percent of patients know how to interpret A1C values in relation to their own glycemic control (13,14). Improving patients' knowledge might help attain the goals of diabetes management, but the supporting studies are limited (14–18). We investigated whether the gain in the knowledge of the targets of diabetes care after receiving diabetes self-management education (DSME) predicts the achievement of target A1C levels (<7%) at 6 months. This is a retrospective study of adult diabetic subjects who received DSME in the American Diabetes Association–certified Diabetes Center of John H. Stroger, Jr. Hospital of Cook County between 2001 and 2004. Patients with baseline A1C levels ≥7% measured within 1 month of receiving DSME and with an ∼6-month follow-up A1C measurement (ranging 3–12 months and at least 3 months from the baseline A1C) were selected for this study. A1C was measured by the high-performance liquid chromatography method throughout the study period. After the educational sessions, patients received follow-up medical care by endocrinologists in conjunction with their primary …