The results of a psychometric study of the Test of Patient Knowledge are reported. The 50-item, multiple-choice test, developed by Etzwiler and associates at the International Diabetes Center, consists of a total score and seven subscores based on seven nonoverlapping content categories: nutrition, insulin, general knowledge, methods of control, pattern control, exercise, and complications. The results described herein provide evidence for the validity of the test (content, concurrent, and discriminant validity), a high level of reliability (Cronbach's alpha = .88), readability for the layperson at the 7th- to 8th-grade level, and sensitivity to instructional gains. The literature on psychometric research with other tests of patient knowledge of diabetes is reviewed and compared with the results of this study.

A 5-day patient education program, taught on an outpatient basis, was evaluated to determine its effect on metabolic control as reflected by glycosylated hemoglobin test values. A quasi-experimental design was used, consisting of a pretest, a posttest, and a follow-up assessment made approximately 6 months after the posttest. The 72 experimental and 324 comparison subjects all had insulin-dependent diabetes mellitus (IDDM), were between 14 and 78 years of age, and had a duration of diabetes ranging from 1 to 20 years. The experimental group demonstrated a statistically significant improvement in Hb A1 values from pre- to posttest and sustained these posttest levels upon follow-up, although not at statistically significant levels. The comparison group showed no pre- to posttest difference, but demonstrated an improvement from posttest to follow-up assessment.

The trend toward the use of self blood glucose monitoring (SBGM) can be attributed to several factors. Changing attitudes toward healthcare show signs of moving from the traditional authoritarian to a participative model in which health professionals and consumers share decision making. Indications for its use have multiplied, as have the several methods of monitoring. The newest products, Visidex, Glucoscan II, Glucometer, AccuChek bG, and blood-letting devices, are reviewed. Educator responsibilities are included.Thousands of years elapsed between the time ancient observers first noted the presence of sugar in the urine of individuals with diabetes and the advent of methods for measuring urine sugars. Convenient ways for testing urine glucose have been available to consumers for a mere twenty years.

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This study examined whether or not patients (n =57) of specialists in diabetes differed from patients (n=211) ofnonspecialists in terms of their knowledge about diabetes before and after a standardized patient education program in diabetes. A specialist was defined as a physician whose practice consisted of 50 % or more diabetic patients. Patient knowledge about diabetes was measured with a 50-item ques tionnaire consisting of seven subscores and a total score. Prior to the program, the two groups did not differ on five of the subscores nor on the total score. There were statistically significant differences on two of the subscores on the pretest: Methods of Control and Pattern Control, with the specialist group scoring better than the nonspecialist group. No differences on any of the scores were found at the end of the program, nor were there differ ences in the amount of knowledge gained during the program. Several interpretations of these findings are suggested and the implications for patient and physician education and the need for further research are discussed.